Muscle Soreness and Recovery

Almost everyone has been sore before – perhaps you completed a big run or hike, went skiing for a whole day, did too much shoveling, lifted heavier weights at the gym, or simply tried a new exercise. Delayed-Onset Muscle Soreness (DOMS) is muscle tenderness caused be exercise peaking approximately 24 to 48 hours after completing the exercise. The severity of DOMS is variable depending on the intensity and duration of exercise, your individual conditioning level, your age, and the specific exercise/activity that was done. DOMS can last for a week or two, but it usually dissipates after a few days.

DOMS is more likely after completing eccentric activities than concentric. Eccentric exercise is when force is applied as a muscle lengthens – for example, walking down a hill or lowering a heavy weight. Eccentrics can be thought of as putting on the breaks and controlling against gravity. Concentric exercise is when force is applied as the muscle contracts – for example, lifting weight up during a biceps curl or leg extension. Eccentric contractions are more demanding on our muscles than concentric. For runners, this helps explain why you would have more muscle soreness after the Boston marathon (a net downhill race) verses a relatively flat marathon.

Here are the best ways to decrease muscle soreness and speed up recovery:

  • Gradually increase your exercise intensity and volume: Our bodies respond best to steady progressions instead of sudden bursts of exercise. Build up to a longer hike or heavier weight at the gym. Try to spread out your shoveling over the course of a couple days instead of doing it all at once. If you are a walker or runner, slowly increase you speed and distance instead of immediately going all out.
  • Complete a warm-up and cool-down: Do an active warm up and slowly build up to your steady speed and max weight for the day. At the end of your activity, do some light movement and stretches before stopping. This is so important, especially if you are getting into a car to drive home because otherwise you will stiffen right up and make things worse. By cooling down, you decrease blood pooling in your muscles and help move out any lactic acid that may have built up. Our muscles do not turn on and off like a light bulb.
  • Try ice, ice baths, and/or contrast baths: You can read about ice and heat here, but contrast baths are another way to reduce soreness. Contrast baths involve icing and then quickly following that with heat. My favorite way to do this is taking an ice bath and then getting right into a hot shower. The contrast causes vasoconstriction (closing of the blood vessels) and then vasodilation (opening of the blood vessels) – a mechanism thought to help flush the muscles and remove waste products.
  • Perform light activity: Easy, light exercise is a great way to get your blood flowing and loosen you up when you are sore. As a physical therapist, I get so frustrated when people call to cancel their PT or exercise appointment because they are sore. I tell them one of the best things they can do is to get moving again and not sit on the couch. You don’t want to do the same intensity as what caused your soreness, but some light walking or easy spinning can do wonders in making you feel better. Even in the days after a marathon, it is great to go for 15-20 minute walks to help with soreness. While rest is important, sitting on the couch all day will not help resolve anything.
  • Use compression stockings: If your soreness is in your lower legs, try using compression stockings. These are great to wear the rest of the day after a big workout. There is little to no evidence showing they improve exercise performance or decrease soreness when worn during the activity, but they can help with blood flow afterwards. There are many different brands and styles, but my favorites are CEP and ProCompression.
  • Massage: This doesn't have to be at a fancy spa – utilize your significant other or get on your foam roller to help with blood flow and reduce stiffness. If you have a lot of tenderness, this may be too painful at first. Slowly increase the pressure, but do not provoke pain! I also love my R8 Roller because I can do it in sitting and I have control over the amount of force applied.
  • Eat well and hydrate: Right after heavy exercise, you want to try to eat and drink something within 30 minutes to start the recovery process. Then, you should have a full meal within a couple hours. Make sure you have plenty of high quality protein and carbohydrates to help refuel your muscles. If you exercise over an hour or two, try to take in some food and fluids during the event as well. Hydration is especially important in preventing dehydration if the exercise was performed on a hot day and/or you produced a lot of sweat.
  • Sleep: Sleep is ultimately when our muscles repair themselves and our bodies build up stronger than they were before. Getting quality sleep is essential not only every night, but especially when you are sore. If you have the opportunity, a nap will suffice too!

How do you help speed up recovery when you are sore? Let me know in the comments!

Ice baths and compression stockings are my go-tos. Walking the dog and then napping on the porch is one of my favorites too :)

Ice baths and compression stockings are my go-tos. Walking the dog and then napping on the porch is one of my favorites too :)