The Latest Science on Soreness and Recovery Strategies
DOMSRecovery

The Latest Science on Soreness and Recovery Strategies

Delayed Onset Muscle Soreness (DOMS) is to many a familiar experience following intense exercise that can impact athletic performance and even daily function. While traditionally managed with rest and anti-inflammatory drugs, recent scientific advancements have unveiled a diverse array of non-pharmacological interventions offering relief and faster recovery.

Published: November 28, 2025

DOMS: Beyond Lactic Acid

Delayed Onset Muscle Soreness (DOMS) is a post-exercise ache that for decades was attributed to the buildup of lactic acid in muscles. However, scientific consensus more recently refuted this theory, recognizing it as an outdated concept. Modern research, including a comprehensive review by Di Lorenzo et al. (2025) [1], now paints a far more intricate picture of mechanisms behind DOMS. Today, we understand DOMS as a complex, multifactorial response to intense or unfamiliar exercise, particularly activities involving eccentric muscle contractions (muscle lengthening under tension). Clinically, DOMS typically manifests 24 to 72 hours after exercise, characterized by localized muscle tenderness, stiffness, and pain. This transient condition can lead to temporary declines in muscle strength, range of motion, and overall athletic performance.

Multiple mechanisms contribute to the occurance of DOMS. One of the main factors is tissue damage; Microscopic damage within the muscles, specifically sarcomere disruption and cytoskeletal breakdown, which are the fundamental contractile units of muscle fibers, are micro-injuries that are central to DOMS development. But also beyond the muscle fibers themselves, damage to the surrounding connective tissues, such as the perimysium and fascia, plays a crucial role in the pain and stiffness associated with DOMS. These micro-injuries trigger a cascade of inflammatory processes, involving the infiltration of immune cells and the release of pro-inflammatory cytokines. This is often reflected in elevated levels of biochemical markers like creatine kinase (CK) and leukocytosis (an increase in white blood cells). The inflammatory response, coupled with tissue damage, leads to the sensitization of pain-detecting nerve endings, particularly within the fascia (the web-like tissue encasing muscles), which can prolong pain perception even after structural healing has begun. Current scientific evidence also highlights the significant role of oxidative stress in the development of muscle soreness and reduced functionality.

With a clearer understanding of DOMS's underlying mechanisms, contemporary research has shifted focus towards developing more effective, non-pharmacological recovery strategies.

Effective Recovery Strategies

The primary aim of the work by Di Lorenzo et al. was to critically review the latest evidence on non-pharmacological strategies for managing DOMS, using clinical studies published between 2020 to 2025. The metrics used to quantify recovery included pain levels, range of motion, biomarkers like creatine kinase and interleukin-6 (which indicate muscle damage and inflammation) and neuromuscular activation. The key findings from the clinical trials underscore the benefits of a multimodal approach to dealing with DOMS:

  • Percussive massage therapy applied for 30–40 minutes, significantly improves pain, neuromuscular activation, range of motion, and functional performance, outperforming static stretching or shorter durations.
  • Whole-body cryosauna sessions, particularly when administered 48–72 hours post-exercise, demonstrate significant reductions in muscle stiffness, leukocyte count, and creatine kinase levels. Also cold water immersion consistently reduced subjective soreness
  • Active recovery, involving low-intensity aerobic or neuromuscular activity, can reduce DOMS discomfort.
  • Nutritional support from polyphenol-rich supplements and branched-chain amino acids (BCAAs) demonstrated promising effects in mitigating DOMS symptoms and aiding recovery, though further large-scale trials are needed to confirm efficacy and optimal dosing.

Conversely, some commonly used methods showed limited efficacy. Static stretching protocols were found to offer no meaningful clinical benefits for DOMS management. Similarly, electrical stimulation did not yield significant improvements compared to placebo. While foam rolling can improve tissue tone and flexibility, its impact on pain reduction is not consistently observed.

Optimizing Recovery: Personalized Approaches

Optimizing recovery from DOMS is best achieved through multimodal, personalized strategies. This means combining various of the above-mentioned interventions tailored to an individual's specific needs, rather than relying on a single treatment. Such integrated approaches have proven superior for alleviating symptoms and enhancing performance restoration, likely due to their synergistic effects on the complex processes underlying DOMS. For instance, a personalized plan might incorporate mechanical therapies like percussive massaging, thermal treatments such as cold water baths, and nutritional support through polyphenol-rich foods or BCAA supplementation. Additionally, practices active recovery protocols can further support recovery. Static stretching is not recommended as primary strategy given its limited clinical benefits. Instead, experimenting with multiple science-backed protocols to form an individualized regimen is far more effective at recovering from DOMS.

References

  1. Di Lorenzo L et al. "Advances in Non-Pharmacological Strategies for DOMS: A Scoping and Critical Review of Recent Evidence", Journal of Functional Morphology and Kinesiology 10 (2025) 452. https://doi.org/10.3390/jfmk10040452