Learn · Soreness
DOMS treatment: what actually helps sore muscles
Sore for days after a hard or new workout? That's delayed-onset muscle soreness (DOMS). It goes away on its own,[1] but some things genuinely make it feel better sooner, and some popular ones barely help. Here's every common option, ranked by what the research actually shows.
General information, not medical advice. For an injury, or pain that is severe or not improving, see a doctor or physiotherapist.
In meta-analyses, massage is the most effective way to reduce DOMS.[2] Compression garments have a moderate effect,[3] cold water immersion a small-to-moderate one,[4][2] and foam rolling a small one.[5] Once soreness has set in, heat helped more than cold in trials.[6] Stretching makes no meaningful difference.[7] DOMS clears on its own within about 1–5 days,[1] and the best prevention is building up gradually.[8]
1. Massage: the most effective
If you can get a massage after a hard session, or in the day or two after, it's the best-supported way to feel less sore and less tired.
A 2018 meta-analysis of 99 studies compared recovery techniques and found massage was the most powerful technique for recovering from DOMS and perceived fatigue. Massage and cold exposure were also the most effective for reducing inflammation markers.[2]
2. Compression garments: a moderate effect
Tight-fitting compression tights or sleeves, worn after training, help you feel less sore and recover strength a bit faster.
A meta-analysis of 12 studies found compression garments had a moderate effect in reducing the severity of DOMS, and also improved recovery of muscle strength and power, measured 24–72 hours after exercise.[3] Note that these studies tested garments worn for hours, not short periods of compression.
3. Cooling: a small-to-moderate effect
Cold after a hard session helps you feel less sore over the next few days. Most of the research is on sitting in cold water.
A Cochrane review found cold water immersion reduced muscle soreness ratings at 24, 48, 72 and 96 hours compared with resting, although the evidence quality was low.[4] A 2016 meta-analysis found the best results with water at about 10–15 °C for 10–15 minutes.[10] Cold also slows nerve conduction and raises pain threshold.[11] Most studies used whole-body immersion, so evidence for cooling a single area is more limited.
4. Heat: helpful once soreness has set in
A day or two later, when your muscles are already stiff and sore, warmth can feel better than cold.
5. Foam rolling: a small effect
Rolling sore muscles on a foam roller after training helps a little with how much they hurt.
A meta-analysis of 21 studies found foam rolling after exercise reduced muscle pain perception (a 6% improvement, a small-to-moderate effect size) and slightly reduced the drop in sprint and strength performance.[5]
6. Active recovery: mixed results
Easy movement makes sore muscles feel better while you're moving, but the soreness tends to come back afterwards. It's worth doing because it feels good, not because it cures DOMS.
One meta-analysis found active recovery reduced DOMS,[2] while a review of active cool-downs concluded most evidence shows they don't significantly reduce muscle soreness.[9] Muscle activity eases DOMS temporarily, but the sensation returns.[1] More on active recovery →
7. Stretching: no meaningful effect
Stretching is great for flexibility, but it won't make you noticeably less sore, whether you do it before or after training.
A Cochrane review of 12 studies found post-exercise stretching reduced soreness by about 1 point on a 100-point scale the next day. Even a large trial of 2,377 participants found only a 4-point reduction in peak soreness over a week. The authors concluded stretching does not produce clinically important reductions in DOMS.[7]
Everything compared
| Option | Effect on DOMS | Best timing |
|---|---|---|
| Massage | Most effective[2] | After training and over the next day or two |
| Compression garments | Moderate[3] | Worn for hours after training |
| Cold water immersion | Small to moderate[4][10] | Soon after a hard session |
| Heat | More pain relief than cold in trials[6] | Once soreness has set in, never on a fresh injury[12] |
| Foam rolling | Small[5] | After training |
| Active recovery | Mixed[2][9] | Easy days |
| Stretching | No meaningful effect[7] | Use it for flexibility, not soreness |
| Time | Resolves on its own in about 1–5 days[1] | Always works |
A simple plan for DOMS
- Right after a hard or new session: cool the hardest-worked areas, and put on compression wear if you have it.[4][3]
- The next 1–3 days: massage or foam roll the sore muscles,[2][5] keep moving gently, and use heat if it feels better than cold.[6]
- Don't hammer the same sore muscles with another very hard session until most of the soreness has gone.
- Next time, build up more gradually. A first bout of a new exercise protects against soreness from the next, the repeated bout effect.[8]
When soreness isn't DOMS
DOMS is a dull, spread-out ache in the muscles you trained that improves day by day. See a doctor if the pain is sharp or in a joint, there's swelling or bruising, or it isn't improving after about a week. Get urgent medical help for severe muscle pain and swelling with very dark, cola-coloured urine: exertional rhabdomyolysis is considered the extreme form of exercise-induced muscle damage.[1]
This guide doesn't cover medication. Ask a pharmacist or doctor before using painkillers for muscle soreness.
Where Recoolvery+ fits
Recoolvery+ is not an ice pack. It's a cooling recovery wrap that puts two of the options above, cooling and adjustable compression, on a sore area at once, hands-free, for 15–60 minutes.
To be clear about the evidence: the studies above tested whole-body cold water immersion and compression garments worn for hours, not this product. What Recoolvery+ adds is the cooling medium: HypoCarbon® pads measured at 35.0 W/m·K in in-house testing,[13] against about 2.3 for ice.[14] Session length and use are from the product specification.[15]
Questions
What is the best treatment for DOMS?
In a 2018 meta-analysis of 99 studies, massage was the most effective technique for reducing DOMS and perceived fatigue. Compression garments, cold water immersion and foam rolling also help, to a lesser degree.
Does stretching help DOMS?
Not meaningfully. A Cochrane review found stretching before or after exercise reduced soreness by only about 1 point on a 100-point scale, which the authors concluded is not clinically important.
Is ice or heat better for DOMS?
Cold water immersion soon after a hard session reduces soreness over the following days. Once soreness has already set in, trials found a heat wrap gave more pain relief than cold.
How do you get rid of DOMS fast?
Massage, compression garments, cooling soon after exercise, foam rolling and gentle movement can all make DOMS feel better sooner. It still resolves on its own within about 1 to 5 days.
Do compression garments help DOMS?
Yes. A meta-analysis of 12 studies found compression garments had a moderate effect in reducing DOMS and improved recovery of strength and power.
How can I prevent DOMS?
Build up gradually when starting a new exercise or increasing load. One bout of a new exercise protects against soreness from the next, known as the repeated bout effect.
References
- Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Medicine & Science in Sports & Exercise, 1984. pubmed.ncbi.nlm.nih.gov/6392811/
- Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B. An evidence-based approach for choosing post-exercise recovery techniques to reduce markers of muscle damage, soreness, fatigue, and inflammation: a systematic review with meta-analysis. Frontiers in Physiology, 2018. doi.org/10.3389/fphys.2018.00403
- Hill J, Howatson G, van Someren K, Leeder J, Pedlar C. Compression garments and recovery from exercise-induced muscle damage: a meta-analysis. British Journal of Sports Medicine, 2014. doi.org/10.1136/bjsports-2013-092456
- Bleakley C, McDonough S, Gardner E, et al. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database of Systematic Reviews, 2012. doi.org/10.1002/14651858.CD008262.pub2
- Wiewelhove T, Döweling A, Schneider C, et al. A meta-analysis of the effects of foam rolling on performance and recovery. Frontiers in Physiology, 2019. doi.org/10.3389/fphys.2019.00376
- Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine, 2015. doi.org/10.1080/00325481.2015.992719
- Herbert RD, de Noronha M, Kamper SJ. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database of Systematic Reviews, 2011. doi.org/10.1002/14651858.CD004577.pub3
- McHugh MP. Recent advances in the understanding of the repeated bout effect: the protective effect against muscle damage from a single bout of eccentric exercise. Scandinavian Journal of Medicine & Science in Sports, 2003. doi.org/10.1034/j.1600-0838.2003.02477.x
- Van Hooren B, Peake JM. Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries and the long-term adaptive response. Sports Medicine, 2018. doi.org/10.1007/s40279-018-0916-2
- Machado AF, Ferreira PH, Micheletti JK, et al. Can water temperature and immersion time influence the effect of cold water immersion on muscle soreness? A systematic review and meta-analysis. Sports Medicine, 2016. doi.org/10.1007/s40279-015-0431-7
- Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. British Journal of Sports Medicine, 2007. doi.org/10.1136/bjsm.2006.031237
- NHS. Sprains and strains. www.nhs.uk/conditions/sprains-and-strains/
- HypoCarbon® thermal conductivity (35.0 W/m·K): Global Healthcare SG in-house testing of the proprietary formulation. Unpublished company data, available to clinical and trade partners on request.
- Slack GA. Thermal conductivity of ice. Physical Review B, 1980. doi.org/10.1103/PhysRevB.22.3065
- Recoolvery+ product specifications and care guide: session length, refreeze time, pad life and materials. recoolvery.com/products/recoolvery-wrap
Recoolvery+
Cooling for your recovery routine
Not an ice pack. Freezable HypoCarbon® pads in a hands-free wrap for the knee, shoulder, elbow, ankle and back. HypoCarbon® conducts heat 15× better than ice. Cold only, no heating.
See the Recoolvery+ Wrap