Delayed Onset Muscle Soreness (DOMS): What It Is and How to Manage It
DOMS is the stiffness and pain experienced 24 to 72 hours after intense exercise. This soreness is a result of microscopic muscle damage, which leads to inflammation and discomfort. While unpleasant, DOMS is a normal part of muscle adaptation, helping the body build stronger tissues over time. However, improper management can prolong soreness and impact future performance.
How to Ease DOMS
- Active Recovery – Engage in low-intensity movement like walking or swimming to boost circulation and promote healing.
- Foam Rolling & Massage – Helps increase blood flow and relieve muscle tightness.
- Hydration & Nutrition – Drink plenty of water (at least 33ml/kg body weight) and consume adequate protein to support muscle repair.
- Gentle Stretching – Avoid bouncing or overstretching; instead, hold stretches for 20–30 seconds.
- Ice Baths – While ice may not directly reduce muscle inflammation, it can help with short-term relief by numbing pain.
- Gradual Progression – Avoid overtraining by easing into workouts, preventing excessive muscle damage.
🔹 When to See a Physio? If muscle pain lasts more than 7 days, is severe, or affects joint movement, you might have a more serious injury requiring professional assessment.
To Ice or Not to Ice? The Latest Research on Injury Management
For decades, ice has been the go-to remedy for injuries, forming part of the RICE protocol (Rest, Ice, Compression, Elevation). However, recent research challenges the idea that ice speeds up recovery.
Why Ice May Not Be Ideal for Healing
🔹 Inflammation is Part of the Healing Process
Ice slows down the body’s natural response to injury. When we get injured, inflammatory cells release Insulin-like Growth Factor (IGF-1), which helps remove damaged tissue and initiates repair. Applying ice may delay this process, leading to longer recovery times.
🔹 Ice is Only a Temporary Pain Reliever
While ice numbs pain, it does not reduce muscle temperature deeply enough to impact healing. Research suggests its effect is superficial, helping only with short-term comfort rather than actual tissue repair.
🔹 The Evolution of Injury Management Protocols
Over the years, the approach to injury care has shifted:
- 1978: RICE (Rest, Ice, Compression, Elevation)
- 1990s: PRICE (Protection added)
- 2010s: POLICE (Optimal Loading introduced)
- 2019: PEACE & LOVE (Protection, Elevation, Avoid Anti-Inflammatory Drugs, Compression, Education, Load, Optimism, Vascularization, Exercise)
The newest PEACE & LOVE method emphasizes movement over rest and encourages controlled exercise to promote blood flow and tissue repair.
When Can Ice Still Be Used?
🔹 Ice may still be useful in cases of excessive swelling that restricts movement, such as:
- Severe ankle sprains
- Post-surgery swelling (e.g., ACL reconstruction)
However, in most cases, early movement, gentle loading, and active recovery are now the gold standard for faster healing and injury prevention.
Key Takeaways for Post-Injury Recovery
✅ For DOMS: Keep moving with gentle exercise, hydration, and stretching to ease soreness.
✅ For Injuries: Prioritize gradual loading and movement over ice to support long-term recovery.
✅ Use Ice Selectively: If swelling is severe and limiting mobility, ice may help in the early stages only.
💡 Bottom Line? Healing happens best when we support the body’s natural processes rather than suppress them. Movement, circulation, and proper nutrition are the real game changers for effective recovery!