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Muscle Soreness

You all know the feeling. After a long, hard, intense session at the gym, your muscles fatigued after being hammered rep after rep. You felt like you’ve had a really excellent session, but you also know that the next two days are going to be filled with awkward stiff movements and soreness every time you move those muscles. But does it have to be this way? Read on to find out more about muscle soreness and whether you can’t do something about it.

Muscle Soreness - What Is It?

There are two main types of muscle soreness experienced in trainers:

  • Acute Muscle Soreness
  • Delayed Onset Muscle Soreness (DOMS)

Acute muscle is considered a muscular strain in which the person experiences either stiffness, aching pain or muscular tenderness during or immediately after the exercise or training session. Symptoms are experienced only for a short period of time. In contrast, DOMS is a similar type of pain, sometimes even more intense but appears 24 hours post training with symptoms peaking around 72 hours and completely resolving in 5-7 days1.

Muscle Soreness - How Does It Occur?

Surprisingly, there is still very little consensus as to what exactly causes muscle soreness. At the moment, there are 6 major theories1 as to what causes exercise induced muscle soreness:

  • Lactic Acid Accumulation
  • Muscle Spasms
  • Microtrauma
  • Connective Tissue Damage
  • Inflammation
  • Electrolytes and Enzyme Efflux

What the scientists do agree on though is that the cause of muscle soreness is not a result of a single event, rather it is a combination of the above factors. The most widely used explanation at the moment is that with exercise, our muscle units are broken down. This causes a build up of calcium, which breaks the muscle unit down even further. To continue with the exercise places extra demands on our connective tissues. As a result of all these microtraumas – think of little tears in the muscle – our body responds to the damage through inflammation. During inflammation, molecules called cytokines are released and rapid changes in fluid and electrolytes movement occurs, all of which increase our perception of pain.

Muscle Soreness - Prevention & Treatment

There’s really not much you can do to prevent muscle soreness from occurring. A natural product of eccentric muscular movement, the only real way to avoid experiencing muscle soreness is to either do less intense exercise or none at all. Of course, by doing so you also wouldn’t be gaining any of the benefits of muscle damage including increased protein synthesis, muscular hypertrophy and other beneficial muscular adaptations. While complete abstinence from muscle soreness and DOMS inducing exercise is not recommended, there are several avenues that one can take to help reduce the severity of the pain and discomfort. In terms of physical treatment, one has several options:

Muscle Soreness & Manual Therapies

A recent study review has shown that stretching2 before and after exercise has been shown to help reduce the severity of the symptoms. Other strategies with potential benefits include heat therapy3,4, cold therapy5 including ice baths and ice treatment as well as acupuncture6, massage7, compression8 and vibration9 treatments.

Muscle Soreness & Drugs

Drug treatment with non steroidal anti-inflammatory drugs (NSAIDs)10 such as Voltaren, Nurofen and aspirin have commonly used by athletes for the treatment of muscle soreness and DOMS, however, there is a general consensus that these types of drugs really only help mask the pain rather than reducing the severity or the length of time that muscle soreness and its associated pain markers are present. This masking of pain in itself causes issues as it inaccurately gives the exerciser the notion that they are able to train again, which could put them at greater injury risk.

Muscle Soreness & Supplements

There have also been many studies looking at nutritional and supplemental strategies to help with muscle soreness, its symptoms and its effects on muscular performance. Following is a list of potentially helpful ingredients:

The best and most agreed upon method of reducing the impact of muscle soreness is to ironically enough, continue to exercise1. Movement helps to enhance blood flow and circulation which aids in providing our muscles with the necessary nutrition it needs to recover, but also helps to remove any wastes and metabolites which accumulate. The release of endorphins from exercise will also help with pain relief.

Muscle Soreness - A Necessary Evil

While muscle soreness and DOMS is by far one of the most unpleasant by products of exercise, it is however a good indication that the exercise is inducing enough muscle damage to lead to positive muscular adaptations and changes which are making your muscles bigger, stronger and more protective against further damage.

To best way to alleviate the symptoms would be to exercise at a reduced intensity and/or on different muscle groups for the next 2 days with concurrent use of a protein and carbohydrate supplement or any of the other supplements listed above and also using one or two of the manual therapies. By doing so, you’ll be staying active and making the most out of a bad situation.

* Especially eicosapentaenoic acid (EPA)


1. Lewis PB, Ruby D, Bush-Joseph CA. ‘Muscle soreness and delayed-onset muscle soreness.’ Clin Sports Med. 2012 Apr;31(2):255-62. Epub 2011 Nov 23.
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soreness after exercise. Cochrane Database Syst Rev 2011;7:CD004577
3. Petrofsky J, Batt J, Bollinger JN, Jensen MC, Maru EH, Al-Nakhli HH. ‘Comparison of different heat modalities for treating delayed-onset muscle soreness in people with diabetes.’ Diabetes Technol Ther. 2011 Jun;13(6):645-55. Epub 2011 Apr 2.
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7. Zainuddin Z, Newton M, Sacco P, et al. Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train 2005;40:174.
8. Kraemer WJ, Bush JA, Wickham RB, et al. Influence of compression therapy on
symptoms following soft tissue injury from maximal eccentric exercise. J Orthop
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9. Kosar AC, Putland J, Candow DG. ‘Potential beneficial effects of whole-body vibration for muscle recovery following exercise.’ J Strength Cond Res. 2011 Nov 29.
10. Donnelly AE, McCormick K, Maughan RJ, et al. Effects of a non-steroidal anti-inflammatory drug on delayed onset muscle soreness and indices of damage. Br J
Sports Med 1988;22:35–8.
11. Cockburn E, Stevenson E, Hayes PR, et al. Effect of milk-based carbohydrate-protein supplement timing on the attenuation of exercise-induced muscle damage. Appl Physiol Nutr Metab 2010;35(3):270 –7.
12. McBrier NM, Vairo GL, Bagshaw D, et al. Cocoa-based protein and carbohydrate
drink decreases perceived soreness after exhaustive aerobic exercise: a pragmatic
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13. Shimomura Y, Inaguma A, Watanabe S, Yamamoto Y, Muramatsu Y, Bajotto G, Sato J, Shimomura N, Kobayashi H, Mawatari K. ‘Branched-chain amino acid supplementation before squat exercise and delayed-onset muscle soreness.’ Int J Sport Nutr Exerc Metab. 2010 Jun;20(3):236-44.
14. Trombold JR, Reinfeld AS, Casler JR, Coyle EF. ‘The effect of pomegranate juice supplementation on strength and soreness after eccentric exercise.’ J Strength Cond Res. 2011 Jul;25(7):1782-8.
15. van Someren KA, Edwards AJ, Howatson G. ‘Supplementation with beta-hydroxy-beta-methylbutyrate (HMB) and alpha-ketoisocaproic acid (KIC) reduces signs and symptoms of exercise-induced muscle damage in man.’ Int J Sport Nutr Exerc Metab. 2005 Aug;15(4):413-24.
16. Arent SM, Senso M, Golem DL, McKeever KH. ‘The effects of theaflavin-enriched black tea extract on muscle soreness, oxidative stress, inflammation, and endocrine responses to acute anaerobic interval training: a randomized, double-blind, crossover study.’ J Int Soc Sports Nutr. 2010 Feb 23;7(1):11.
17. Houghton D, Onambele GL. ‘Can a standard dose of eicosapentaenoic acid (EPA) supplementation reduce the symptoms of delayed onset of muscle soreness?’ J Int Soc Sports Nutr. 2012 Jan 31;9(1):2.
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