Muscle Soreness: How to Understand it and Help Student Athletes Cope

Veena Chawla, MD, family and sports medicine doctor, Kaiser Permanente

It’s common to feel stiff or sore after painting a room, shoveling snow, or trying a new workout. When we perform activities that are outside of our norms, the achiness that can result over the next few days is known as DOMS, or delayed onset muscle soreness. DOMS occurs at the level of the muscle fiber: When fibers are damaged, proteins break down, which can lead to inflammation and soreness.

While we often associate DOMS with adults, children and teens experience it too—especially youth engaged in group sports. Here's how to recognize DOMS and understand when your young athlete needs medical attention.

What are the symptoms of DOMS?

As its name suggests, soreness is a main sign of DOMS. Other symptoms may include:

• Cramping
• Muscle twitching
• Stiffness
• Limitations in joint motion

DOMS vs. Injury?

While discomfort from DOMS generally starts 48-72 hours after exercise, pain from an injury usually starts immediately after a triggering activity and may last more than a week. Pain from an injury is usually more intense—it can cause an inability to bear weight, for example.

How to Treat DOMS

Soreness will ease if the affected area is allowed to rest, but here are some other tips for quick recovery:

• Stretch gently. Stretching can help loosen tight muscles and aid in regaining range of motion.
• Ice the area. Icing reduces inflammation and swelling.
• Apply compression. A compression wrap may help blood flow to the area and limit swelling.
• Eat an anti-inflammatory diet. Focus on serving fruits, vegetables, whole grains, nuts, beans, legumes, and lean proteins. Avoid high sugar foods. Helpful supplements or herbs include curcumin, tart cherry juice, beetroot, and ginger. (Check with your child’s doctor before starting supplements.)
• Stay hydrated. Encourage your child to drink plenty of water before, during, and after exercise.
• Rest. Make sure they take rest days and focus on different muscle groups on alternate days.

When to See a Doctor

Please seek medical attention if your child experiences these symptoms: severe pain, persistent swelling, bruising, or severe muscle spasms.

Remember that exercise is vital to longevity and improved quality of life, and typically DOMS merely signals the start of a new challenge and a reminder to listen to our bodies.

Kaiser Permanente partners with The St. James to support healthy athletes.

Kaiser Permanente delivers pediatricians and pediatric specialists who are committed to keeping your child’s health and development on track. Connected by your child’s medical record, they can track vaccines that are needed, review test results, and medication, and communicate seamlessly with one another to provide both the routine and targeted specialty care your child requires.

Learn more about Kaiser Permanente’s sport medicine program and becoming a member.

Dr. Veena Chawla is a family and sports medicine doctor.