Can't Straighten Arms or Walk Right after Workout? (DOMs Help)

We’ve all been there. You’re having a great workout and decide to throw in an extra exercise, or a few more sets. The next day, you’re really feeling it, and the day after that, you’re walking around like Frankenstein, vowing never to step foot in the gym again.

So, what’s the reasoning behind it, and how can you prevent it?

Most likely, it’s due to the infamous delayed onset muscle soreness, or DOMS, for short. There are cases where it might be injury or, in much more extreme cases, rhabdomyolysis. We’ll cover what all these mean, along with some helpful tips to get you through to the other side.

The Mystery of Post-Workout Soreness

When you can’t fully straighten your arms after a workout, you’re likely dealing with DOMS. This type of soreness typically kicks in 24 to 72 hours after your workout and can range from a mild annoyance to unbearable discomfort. But is it just DOMS, or is there a more sinister culprit lurking behind your agony?

DOMS: The Usual Suspect

DOMS is a classic case of muscle discomfort that builds over time. It's often triggered by new or intensified workouts, especially those involving eccentric muscle contractions, which means the lengthening/stretching portion of the movement. Think of when you’re lowering the weight down on biceps curls, or opening your arms on a chest fly movement. The muscle fibers endure extra stress, leading to microscopic tears that result in that oh-so-familiar stiffness.

Interestingly, DOMS isn't considered a severe injury. It’s more like a muscle’s way of saying, “Hey, we just did something new!” The Munich consensus places it as a Grade 1B muscle injury¹, meaning it’s a functional disorder rather than a structural one.

Theories Behind DOMS: What's Really Going On?

So why do your muscles rebel so fiercely? Research is ongoing, but there are several theories on why DOMS occurs:

1. Muscle Damage

Some scientists point to tiny ruptures in muscle fibers, particularly around the Z-disk, as a major factor. These ruptures can disrupt muscle function and trigger soreness. Interestingly, stretching, which is often recommended to alleviate DOMS, could also contribute to this disruption.

2. Lactic Acid and Inflammation

Old theories pinned the blame on lactic acid, suggesting that it built up in muscles and caused pain. But that idea has been mostly debunked. Lactate levels drop quickly after exercise, and that doesn’t align with the the 24-72 hour window of DOMS.

Instead, inflammation might play a role.² Exercise-induced inflammation could cause pain and swelling, although the exact mechanisms remain debated. There was a study performed on whether or not inflammation was a cause of DOMS, with results leaning towards not.³

That’s not to say that inflammatory-related processes aren’t involved, with a study looking at bradykinin (an inflammatory mediator) suggesting that there is a very real correlation between preventing bradykinin from interacting with the B2 receptor to prevent DOMS from occurring.⁴

3. Neural Mechanisms

Some researchers suggest that DOMS might be a protective mechanism, a sort of early warning system against overexertion. But since DOMS surfaces days after the workout, it’s unclear how effective it is as a protective measure. Alternatively, compression of nerve endings within the muscle could also be at play.⁵

There are several theories discussed on what could possibly be going on in the previous study, but all need more research before a definitive answer can be given.

So, basically, no one is really sure how DOMS works yet, but we do know it will end up resolving itself after a little while. On the other hand, there’s a far more serious form of muscle soreness that you should be aware of: exertional rhabdomyolysis.

When Soreness Crosses the Line

While DOMS is a common and usually a relatively benign experience, there’s a more severe condition to be wary of: exertional rhabdomyolysis. This serious ailment involves the breakdown of muscle tissue, releasing muscle contents into the bloodstream and potentially leading to severe complications.⁶

It should be noted, while possible from extended strenuous physical lifting (usually new movements), this is more likely caused by a crushing injury, prolonged immobilization, or electrical/burn injury.

Some of the key symptoms to look for are:

• Severe muscle pain
• Weakness
• Dark red or brown urine (myoglobinuria)

Rhabdomyolysis may involve muscle cell breakdown, electrolyte imbalances, and even kidney damage. Treatment usually involves aggressive hydration and monitoring, and most people recover fully with proper care.

Don’t panic if you’re arms are hurting after your workout though. This is a relatively uncommon occurrence, only appearing in approximately 26,000 people in the USA per year.⁷

Managing DOMS: Tips and Tricks

So, how do you cope with DOMS? Those of us that have been in the gym for a while have grown to embrace DOMS as an old friend, but for those just starting out, just existing can be miserable. Luckily, there are some things you can do to help mitigate some of the symptoms of DOMS.

Recovery Strategies:

• Soft Tissue Work: Techniques like stretching, massage, foam rolling, and alternating heat and cold therapy can offer some relief, though their effectiveness varies.⁸
• Training Adjustments: Regular exercise can reduce DOMS severity through mechanisms like Exercise-Induced Analgesia and the Repeated Bout Effect. Gradual increases in training intensity and volume are key.⁹
• Protein Intake: Maintaining adequate protein levels (around 1.4 to 1.6 grams per kilogram of body weight per day) can support muscle recovery, though it doesn’t seem to have a direct impact on DOMS.¹⁰
• Stay Hydrated: Water helps flush out toxins from your muscles and keeps everything moving smoothly. Sip water throughout the day, especially after a tough workout.
• Gentle Stretching: Light, gentle stretching can help ease tension and improve blood flow. Think of it as gently coaxing your muscles back to their full range of motion.
• Rest and Sleep: Your body does a lot of its repair work while you sleep. Make sure you’re getting enough rest so your muscles can recover fully.

Prevention Tips:

• Assess Your Training Load: Evaluate the volume and intensity of your workouts. Avoid massive jumps in intensity and consider leaving a few reps in the tank to prevent overexertion.
• Keep Moving: Staying active, even at a reduced intensity, helps alleviate soreness.
• Progressive Loading: Gradually increase the difficulty of your workouts to build strength and resilience.

Wrap Up

Delayed Onset Muscle Soreness is a common, though uncomfortable, part of intense training. While its exact causes are still under debate, understanding its mechanisms can help manage and mitigate its effects. Embrace gradual changes in your workout routine and maintain a balanced approach to training and recovery.

If you’re struggling with persistent soreness or aren’t seeing the results you want, adjustments to your program could be the key to overcoming your fitness hurdles. Finding a fitness level appropriate workout routine could make the difference from feeling pleasantly sore to crying in pain to scratch your nose.

If you’re really in a bind, an OTC pain reliever such as ibuprofen can help ease some pain, and a heating pad or hot shower can give you some temporary relief.

Remember, the majority of the time, the pain will subside. The best thing you can do, is get back in the gym and get moving!

References:

1. Mueller-Wohlfahrt, Hans-Wilhelm, et al. “Terminology and Classification of Muscle Injuries in Sport: The Munich Consensus Statement.” British Journal of Sports Medicine, vol. 47, no. 6, 18 Oct. 2012, pp. 342–350, bjsm.bmj.com/content/47/6/342, https://ift.tt/5d8Aeor.
2. MacIntyre, Donna L., et al. “Delayed Muscle Soreness.” Sports Medicine, vol. 20, no. 1, July 1995, pp. 24–40, https://ift.tt/P7Tli5b.
3. Kuipers, H., et al. “Influence of a Prostaglandin-Lnhibiting Drug on Muscle Soreness after Eccentric Work.” International Journal of Sports Medicine, vol. 06, no. 06, Dec. 1985, pp. 336–339, https://ift.tt/CWhDBny.
4. Murase, S., et al. “Bradykinin and Nerve Growth Factor Play Pivotal Roles in Muscular Mechanical Hyperalgesia after Exercise (Delayed-Onset Muscle Soreness).” Journal of Neuroscience, vol. 30, no. 10, 10 Mar. 2010, pp. 3752–3761, https://ift.tt/F3TkGdW.
5. Sonkodi, Balazs, et al. “Have We Looked in the Wrong Direction for More than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage rather than Muscle Damage.” Antioxidants (Basel, Switzerland), vol. 9, no. 3, 5 Mar. 2020, https://ift.tt/kWA2gR0, https://ift.tt/rmflGIM.
6. Torres, Patrick A, et al. “Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment.” The Ochsner Journal, vol. 15, no. 1, 2015, pp. 58–69, https://ift.tt/TB1KImE.
7. Cleveland Clinic. “Rhabdomyolysis.” Cleveland Clinic, 4 Dec. 2019, my.clevelandclinic.org/health/diseases/21184-rhabdomyolysis.
8. Cheung, Karoline, et al. “Delayed Onset Muscle Soreness.” Sports Medicine, vol. 33, no. 2, 23 Oct. 2012, pp. 145–164, pubmed.ncbi.nlm.nih.gov/12617692/, https://ift.tt/QE2s8dO.
9. Cheung, Karoline, et al. “Delayed Onset Muscle Soreness.” Sports Medicine, vol. 33, no. 2, 23 Oct. 2012, pp. 145–164, pubmed.ncbi.nlm.nih.gov/12617692/, https://ift.tt/QE2s8dO.
10. Pasiakos, Stefan M., et al. “Effects of Protein Supplements on Muscle Damage, Soreness and Recovery of Muscle Function and Physical Performance: A Systematic Review.” Sports Medicine, vol. 44, no. 5, 17 Jan. 2014, pp. 655–670, link.springer.com/article/10.1007/s40279-013-0137-7, https://ift.tt/OeqNuFp.