Why do my muscles get sore?

    Muscle soreness after exercise usually goes away quickly, but prolonged muscle soreness, otherwise known as Delayed Onset Muscle Soreness (DOMS), can last for days. Non-steroidal Anti-inflammatory agents (NSAIDs), light exercise, massage, and good nutrition can play a role in alleviating or preventing DOMS.

    What is soreness?

    Soreness in the muscle during and immediately following exercise manifests as mild pain and stiffness that makes it hard to continue exercising. Muscle soreness usually goes away relatively quickly.

    Prolonged muscle soreness is called 'Delayed Onset Muscle Soreness', or DOMS for short. It is more delayed in its resolution and can sometimes last for days. This is the soreness that somebody would feel after a hard run or leg session and be unable to easily walk up stairs the next day.

    What causes soreness?

    There are various things that contribute towards DOMS.[1] Including:

    • Neutrophil accumulation
    • Substance P
    • Aseptic Inflammation
    • Interstital Edema
    • Creatine Kinase

    Lactic Acid is commonly thought to induce muscle failure or soreness, but has not been shown to be the causative factor. It is highly correlated though[2], as lactic acid is produced when the muscle is sore; however its more of a fuel source than a soreness causing agent.[3][4][5]

    How can I get rid of soreness?

    There are various mechanisms of reducing DOMS.[6]

    Non-steroidal Anti-inflammatory agents (NSAIDs) like Aspirin (Acetylsalicyclic acid) or Ibuprofen (Advil) can reduce future DOMS when taken at around the time of exercise.[7][8]

    Some light exercise, or moving the affected joints and muscles, can also alleviate DOMS.[8][9] This may be due to merely moving the affected muscles, as 'whole-body vibration therapy' has recently been suggested to do similar.[10][11]

    Cryotherapy, or ice water submerging, has beneficial anecdotes by various athletes but has not been shown to be of much benefit in randomized controlled trials.[12][13] That being said, cryotherapy may hold some potential in cases of muscular trauma such as hamstring tears or intense muscular strains.[14][15][16] Cryotherapy's effectiveness may be closely tied in to the degree of muscular damage, and serve as a bridge between such anecdotes in high level athletes and a lack of results in novice trainees in intervention studies.[17]

    Athletic massage after exercise may also be effective in controlling DOMS[18], possibly via reducing how many neutrophils get to the site to induce soreness.[1]

    Proper pre-workout nutrition can also play a role in preventing DOMS, as BCAA supplementation has been shown to be beneficial[19] (and can be consumed through whey protein or protein-containing foods)

    Stretching (static) before or after exercise is not significantly effective in reducing DOMS from exercise.[20]

    References

    1. ^Smith LL, Keating MN, Holbert D, Spratt DJ, McCammon MR, Smith SS, Israel RGThe effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count: a preliminary reportJ Orthop Sports Phys Ther.(1994 Feb)
    2. ^Hultman E, Spriet LL, Söderlund KBiochemistry of muscle fatigueBiomed Biochim Acta.(1986)
    3. ^Westerblad H, Allen DG, Lännergren JMuscle fatigue: lactic acid or inorganic phosphate the major causeNews Physiol Sci.(2002 Feb)
    4. ^Cairns SPLactic acid and exercise performance : culprit or friendSports Med.(2006)
    5. ^Westerblad H, Allen DGRecent advances in the understanding of skeletal muscle fatigueCurr Opin Rheumatol.(2002 Nov)
    6. ^Cheung K, Hume P, Maxwell LDelayed onset muscle soreness : treatment strategies and performance factorsSports Med.(2003)
    7. ^Tokmakidis SP, Kokkinidis EA, Smilios I, Douda HThe effects of ibuprofen on delayed muscle soreness and muscular performance after eccentric exerciseJ Strength Cond Res.(2003 Feb)
    8. ^Rahnama N, Rahmani-Nia F, Ebrahim KThe isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle sorenessJ Sports Sci.(2005 Aug)
    9. ^Zainuddin Z, Sacco P, Newton M, Nosaka KLight concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exerciseAppl Physiol Nutr Metab.(2006 Apr)
    10. ^Aminian-Far A, Hadian MR, Olyaei G, Talebian S, Bakhtiary AHWhole-body vibration and the prevention and treatment of delayed-onset muscle sorenessJ Athl Train.(2011 Jan-Feb)
    11. ^Bakhtiary AH, Safavi-Farokhi Z, Aminian-Far AInfluence of vibration on delayed onset of muscle soreness following eccentric exerciseBr J Sports Med.(2007 Mar)
    12. ^Sellwood KL, Brukner P, Williams D, Nicol A, Hinman RIce-water immersion and delayed-onset muscle soreness: a randomised controlled trialBr J Sports Med.(2007 Jun)
    13. ^Paddon-Jones DJ, Quigley BMEffect of cryotherapy on muscle soreness and strength following eccentric exerciseInt J Sports Med.(1997 Nov)
    14. ^Mendiguchia J, Brughelli MA return-to-sport algorithm for acute hamstring injuriesPhys Ther Sport.(2011 Feb)
    15. ^Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DGHamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury preventionJ Orthop Sports Phys Ther.(2010 Feb)
    16. ^Kuenze C, Hart JMCryotherapy to treat persistent muscle weakness after joint injuryPhys Sportsmed.(2010 Oct)
    17. ^Hubbard TJ, Denegar CRDoes Cryotherapy Improve Outcomes With Soft Tissue InjuryJ Athl Train.(2004 Sep)
    18. ^Zainuddin Z, Newton M, Sacco P, Nosaka KEffects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle functionJ Athl Train.(2005 Jul-Sep)
    19. ^Shimomura Y, Inaguma A, Watanabe S, Yamamoto Y, Muramatsu Y, Bajotto G, Sato J, Shimomura N, Kobayashi H, Mawatari KBranched-chain amino acid supplementation before squat exercise and delayed-onset muscle sorenessInt J Sport Nutr Exerc Metab.(2010 Jun)
    20. ^Herbert RD, de Noronha M, Kamper SJStretching to prevent or reduce muscle soreness after exerciseCochrane Database Syst Rev.(2011 Jul 6)