If you're just beginning an exercise program or getting back into it after a long hiatus, you're probably prepared for the muscle tenderness that often shows up a day or two after your workout. Post-workout muscle pain is often accompanied by swelling that may register as a few extra pounds on the scale. While some water retention is common in the early phases of your training program, severe swelling could signal a serious condition requiring medical attention.
Delayed Onset Muscle Soreness (DOMS)
Delayed onset muscle soreness, or DOMS, is a common occurrence after physical activity. Characterized by tenderness in the belly of the muscle and at the tendons of the joints, DOMS usually manifests within 12 to 24 hours after your workout, with the greatest perceived soreness occurring between 24 to 72 hours after exercise. The pain and tenderness is usually gone within three to five days. According to the authors of the fifth edition of "Physiology of Sport and Exercise" DOMS is the result of microscopic structural damage to muscle fibers, incurred mostly during the eccentric, or muscle-lengthening, phase of exercise.
DOMS and Inflammation
One of the side effects of tissue damage is inflammation, or swelling, within the muscle tissue. The inflammation coincides with muscle tenderness and usually resolves itself as muscle pain subsides. Because inflammation is characterized by fluid retention within and between the muscle cells, DOMS is often accompanied by a weight gain of up to 5 pounds or more. When the fluid is flushed from your system, your weight returns to its pre-exercise value. According to exercise scientists at the University of New Mexico, swelling usually disappears completely within 10 days.
Non-steroidal anti-inflammatory drugs, or NSAIDs are a commonly used treatment for water retention associated with DOMS. NSAIDs can be found in the over-the-counter forms of ibuprofen and naproxen. However, according to the IDEA Health and Fitness Association, NSAIDs are not the best option for treating DOMS. Their effectiveness is questionable, and excessive use of NSAIDs can lead to gastrointestinal distress and hypertension. A general warmup for your entire body and a specific warmup for the muscles you will use before exercise have been proven effective for mitigating the severity of DOMS. Warming up and gradually increasing your workload over time are the best strategies to avoid tenderness and water retention after your workout.
While most cases of DOMS are benign and resolve themselves within a few days, excessive damage to muscle tissue can lead to a more severe condition known as rhabdomyolysis. Symptoms include severe swelling, reduced range of motion at the joints, extreme pain in the muscles and joints and dark-brown urine associated with kidney damage. If you are experiencing these severe symptoms, you may be in danger of kidney failure. Seek medical treatment immediately.
- American College of Sports Medicine: Delayed Onset Muscle Soreness (DOMS)
- Canadian Medical Association Journal: Delayed Onset Rhabdomyolysis After Intense Exercise
- Human Kinetics: Delayed-Onset Muscle Soreness
- IDEA Health and Fitness Association: DOMS Treatment
- University of New Mexico: Treating and Preventing DOMS
Michelle Matte is an accomplished fitness professional who holds certifications in personal training, pilates, yoga, group exercise and senior fitness. She has developed curricula for personal trainers and group exercise instructors for an international education provider. In her spare time, Matte writes fiction and blogs.