The classic DOMS sufferer describes a dull muscle ache that develops 24 to 48 hours after the performance of a new or strenuous exercise. It is localised to the involved muscles and will result in muscle stiffness plus tenderness. Passive stretching will increase your symptoms which is one of the reasons why you feel stiff.
DOMS can also result in a short-term loss of muscle strength, a reduced joint range of motion and possibly swelling of the affected muscle groups. The good news is that once you start moving your sore muscles they will actually start to feel less sore. But, you will find walking downstairs troublesome if it’s your quadriceps that are suffering!
DOMS is a clinical diagnosis. Your physiotherapist is an expert in the diagnosis of DOMS and excluding other more significant injuries such as muscle tears, strains or ruptures. An ultrasound scan is unreliable in the diagnosis of DOMS but may assist determine a more significant muscle tear.
DOMS should be treated initially with active rest and anti-inflammatory measures such as ice. (Bleakley et al 2012). heat has also been researched on back muscle DOMS with a positive pain reduction. (Mayer et al 2006)
Gentle massage and pressure garments have been shown in research studies to provide a reduction in the duration and severity of DOMS. (Valle et al 2014, Hill et al 2013, Nelson N. 2014.) However, deep tissue massage should be avoided during the first 24 hours. Excessive muscle stretching in this early phase should also be avoided.
You should avoid aggressive exercise during the recovery phase. This is due to your muscles reduced capacity to cope with shock absorption, in-coordination, altered muscle recruitment patterns, reduced strength balance and contraction intensity. Cycling has been shown to temporarily ease DOMS pain. (Zainuddin et al 2005)