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Delayed Onset Muscle Soreness (DOMS) is a familiar experience to most people who exercise. It affects people who weight train and run particularly, and DOMS can produce anything from mild muscle soreness to debilitating pain and weakness. DOMS is caused by eccentric stress, where the muscles working to resist lengthening, such as lowering a weight or absorbing the landing forces of running. [[Downhill_RunningDownhill Running| Downhill running]] is a particular source of eccentric stress. DOMS not only produces delayed soreness, but immediate weakness that generally lasts a similar length of time. DOMS also produces swelling, tense muscles, reduced coordination and a limited range of motion. A key benefit of DOMS inducing exercise is that a bout of DOMS can give protection against similar future exercise, and the protection lasts for months. Running with the correct [[Cadence]] can help prevent DOMS, and [[Nutrient_TimingNutrient Timing| Taking taking protein]] after DOMS inducing exercise is one of the best treatments, though [[Why_compression_clothesWhy compression clothes| compression clothing]], [[Caffeine| caffeine]] and [[Massage| massage]] can also help.

|[[Nutrient_TimingNutrient Timing| Carbohydrate and/or protein]]

|[[Why_compression_clothesCadence]]|During|Some evidence of reduced soreness|Some evidence of reduced soreness|None|-|[[Why compression clothes| Compression Clothing]]

|None^c

|[[NSAIDs_and_RunningNSAIDs and Running| NSAIDs]]

The DOMS that follows an initial bout of eccentric exercise is much less on subsequent similar bouts. This is often called the Repeated Bout Effect (RBE)<ref name="Howatson-2008"/><ref name="Cheung-2003"/>. The initial bout does not have to cause significant soreness or damage<ref name="Clarkson-1987"/>. As few as 2-10 maximal eccentric repetitions can protect against a subsequent larger bout (24-50), but the initial bout must be close to maximal effort<ref name="Brown-1997"/>. By contrast, eight weeks of training with 50% of the maximal eccentric load did not provide protection against a subsequent maximal bout<ref name="Nosaka-2002"/>. There is some cross-over of protection between different forms of exercise. For instance, eccentric weight training protects against soreness and weakness in subsequent downhill running<ref name="Eston-1996"/>. The protection from the RBE is long lived. One study showed that while the initial weakness was not reduced by the RBE, the recovery of strength was much faster for up to 9 months, and soreness was less for up to 6 months<ref name="Nosaka-2001"/>. Another study showed that 30 minutes of downhill running provides protection for between 6 and 9 weeks<ref name="Byrnes-1985"/>. There is evidence that the RBE may rapidly start to provide protection from soreness and weakness<ref name="Mair-1995"/>, within 5 days<ref name="Ebbeling-1989"/>, and possibly as soon as within 24 hours post exercise<ref name="Chen-2001"/>.

* Most studies have shown that protein will reduce muscle weakness after DOMS inducing exercise<ref name="CockburnHayes2008"/><ref name="Valentine-2008"/> <ref name="CookeRybalka2010"/><ref name="Cockburn-2010"/><ref name="Etheridge-2008"/>, with only two studies showing no improvement<span style='color:#FF0000'><ref name="Wojcik-2001"/><ref name="Green-2008"/></span>.

Light training in the days following DOMS inducing exercise generally accepted to be one of the most effective ways of reducing muscle soreness, but unfortunately the reduction in pain is temporary<ref name="Armstrong-1984"/><ref name="Zainuddin-2006"/><ref name="Howatson-2008"/><ref name="Cheung-2003"/>.A study that looked at running 30 minutes/day after DOMS inducing downhill running shows that the extra exercise neither helped nor hindered with soreness, weakness or running economy<ref name="ChenNosaka2008"/>. (The study only looked at the 7 days following the downhill running, and it would be interesting to know if there are any longer term differences.)