Night Muscle Soreness

Have you ever seen someone trying to walk after running a marathon? They are sore and stiff and they waddle around a bit like ducks. Well, they are probably suffering from delayed onset muscle soreness (DOMS). Night muscle soreness is the pain and stiffness that start a few hours after exercise and can last a few days. The soreness can be severe enough to prevent a good night’s sleep. The stiffness may prevent proper walking for a few days.

What Causes Night Muscle Soreness after Exercise?

Even though night muscle soreness is probably one of the most common causes of night leg pain, there is still much we don’t understand about it. This is despite over 120 years of research. Still, there are several theoretical causes:

• Inflammation induced by the repeat injury.
• Micro-tears in the muscle. These tears may cause soreness in two ways. First, directly. And second, because now there is increased tension on the remaining un-injured fibers.
• Build up of lactic acid. This theory is not a solid one, as lactic acid builds up rapidly, but the onset of pain is often delayed by a few hours after the activity.
• Buildup of electrolytes from within injured cells around the cells.
• A molecule called bradykinin. This molecule promotes inflammation. Disorders of bradykinin are linked to sensitivity to certain medications and to a tendency for uncontrolled inflammation or allergic reactions. It is possible that it also has a role in muscle soreness after activity.

Are there Advantages to Sore Muscles?

There are also theories about the possible advantages of this soreness. First, it can serve as a warning sign. Basically, your body is telling you not to repeat that kind of activity again any time soon. Second, we know that once the acute pain has resolved, your body may actually be able to tolerate activity better than before. This is called the repeated bout effect, and likely is the result of many factors coming together.

Preventing Night Muscle Soreness

The best way to prevent night muscle soreness is not to overdo it the day before. Basically, know your limits and don’t exceed them. Obviously, that is sometimes easier said than done. Sometimes we will just do things that will cause muscle soreness. There will always be that hike, that race or that hard training day. So what else can we do to prevent our muscles from aching over night?

Active Cooldown

Have you ever watched a cycling race, like the Tour de France or the Vuelta a Espana? Athletes go hard for hour day after day. Still, at the end of a long day of racing, athletes don’t rest. They always hop right onto a static bicycle and keep spinning. This is called active cooldown. The reason they do this is to prevent muscle soreness from setting in, so that they could race again the next day.

Plunge into an Ice Bath

If we believe that inflammation plays a role in night muscle soreness, then our goal should be to target inflammation to prevent the aches. One sure way to prevent inflammation is with cold. Think about how icing a bruised ankle helps keep the swelling down. After strenuous activity, cooling off the legs can be challenging. But one way to do so is with an ice bath. Of course, an ice bath is exactly what it sounds like. Fill a bath, pour buckets of ice into that bath. Now get in. And yes. It is as painful as it sounds.

Unfortunately, even though the theory sounds solid, the science isn’t there, at least not for everyone, and not after routine exercise. Still, many top-level athletes support the use of cold to prevent sore muscles. For instance, the now retired pro-cyclist, Phil Gamon, started a company to sell ice wraps. He promotes using these wraps after strenuous activity to promote recovery.

Stretch

People stretch before and after exercise. But does stretching actually help? In fact, there is quite a bit of controversy around stretching. Some types of stretches can reduce your ability to exercise. But what about muscle soreness? Well, the jury is out. There are data to support stretching. But it is low-quality. So it will not be correct to draw conclusions. In fact, a study that looked into the available data as of 2021 could not support stretching to prevent night muscle soreness.

Hydrate

Hydrating during activity keeps your muscles healthy. If you do not hydrate, this can lead to muscle damage. Sometimes, drinking enough water and electrolytes during an activity is all it takes to prevent night cramps and to prevent muscle aches later on.

How do I know I am drinking enough?

The easiest way is to keep tabs on peeing. If you are drinking enough, you will also pee. If your urine is bright, then you are probably hydrating well. But, if you are not peeing at all, or if your urine is dark, then you probably are not drinking enough.

A more sophisticated way, is to weigh yourself before and after activity. If you do this enough, you will start to understand your own body’s needs. Basically, you will know how much fluid you are losing for any particular activity.

The final way is the most involved. You can do a sweat test, like the one Gatorade has. Basically, you can place a special patch on your body during activity. After the activity is over, you can analyze the patch, and discover how much fluid and salt you lost.

Treatment of Night Muscle Soreness

Once night muscle soreness happens, it is hard to shake off quickly. I would love to summarize treatments that are proven to work. But there aren’t many that were tested properly. Still, there are treatments out there. Most of these are natural remedies and most are rather safe. So you might want to try and see what works for you. Here are a few things you can do:

Epsom Salts

Epsom salt is magnesium sulfate. They are used in soak baths. Unfortunately, there is only low level data to support using Epsom salts to treat night muscle aches. But the data that do exist are positive. So, if you woke up after a night of muscle aches, consider soaking in a bath with Epsom salts.

Foam Rolling

Anyone who has ever done foam rolling knows that it feels right. True, it might hurt while you are doing it. But for some reason it feels like “good pain”. But is this feeling based on fact? Will using a foam roller prevent night muscle soreness? It seems like the answer is “yes”. There are some data that support foam rolling to prevent muscle aches after exercise.

By the way, for those of you who hope foam rolling will improve your exercise ability, there data do not support that.

Massage

Similar to foam rolling, massage therapy is the classic solution for sore muscles. Professionally, there are many kinds of massage. For example vibration therapy, cryotherapy, ultrasound assisted massage and others. There is some evidence that all of these are beneficial. But because the science was not great, it could also be that these therapies just did not get in the way of the normal process of healing.

Curcumin for Night Muscle Soreness

Dietary supplements are popular. Many claim to have positive effects on inflammation and on reactive oxygen species. These effects might be beneficial to treat muscle pain and soreness. But does this pan out in reality? For a full answer, you may want to read this review. But the upshot is that most dietary supplements do not work once the soreness kicks in. Still, curcumin stands out. Sort of…

Curcumin is extracted from turmeric. The European Medicines Association published that there are enough data to support using turmeric to help with mild digestive symptoms. There is no such approval for muscle symptoms. Still, there is some evidence that curcumin reduces inflammation and also helps with pain. So, it can make sense to use it to treat muscle aches.

Many studies have examined curcumin for muscle symptoms. These studies looked at multiple types of athletes who were performing many kinds of activities. In the end, results were mixed. It turns out that for curcumin to work, you had to take it before the exercise, and for a while after exercise. In other words, the effect is not so impressive.

Rest

No one likes forced rest. Especially people who are active enough to suffer from night muscle soreness. But sometimes rest is the best approach. Rest does not need to mean staying in bed all day. But if you woke up after a night of aches, maybe a day off is not such a bad idea. Use the day to hydrate, get your electrolytes in and stretch. Chances are that a relaxing day will let you keep going harder and longer later on. If that is not enough, remember: Failing to rest might just bring on injury. So do the smart thing.

Ineffective Treatments for Night Muscle Soreness

Some treatments seem like they should work, but in reality, they probably do not.

Dietary Supplements that don’t Work

As I wrote, if you already have muscle pain, chances are that dietary supplements will not do the trick anymore. Still, some supplements have the reputation of helping with muscle pain. But what are the facts?

Tart Cherry Juice

Tart cherry juice is made from tart Montmorency cherries. Because tart cherry juice has potential effects on inflammation and reactive oxygen species, then in theory it has a potential to improve the symptoms of night muscle soreness. Unfortunately, despite it’s promise, it seems like tart cherry juice does not have a strong effect on muscle aches. This is especially in highly trained people.

Ginger

The data around ginger for muscle soreness are disappointing. Taking ginger for a few days before an intense exercise might improve strength. But the data to support reduced pain and stiffness after exercise are very limited.

Beetroot Juice

Beetroot juice improves athletic performance. This is true even in people who have muscle aches. But it does not improve the pain or stiffness of night muscle soreness.

Ice Baths. Again?

Many athletes use ice baths to prevent muscle damage after exercise or to improve function. But can the cold also help treat nighttime muscle soreness once it has already happened? The fact is, that once muscle aches are present, people have tried both cold and heat treatment. Unfortunately, no one has really examined the effectiveness of these therapies properly.

Compression Stockings

Compression stockings are woven in such a way that they press more at the ankle and less at the top of the calf. This creates a gradient from the ankle to the calf. Usually, we use compression stockings to prevent leg swelling or to treat heavy legs.

In the context of muscle aches, we know that wearing compression stockings immediately after exercise result in better recovery and less soreness. For instance, cyclists who wore compression stockings immediately after exercise, reported lower levels of soreness and were able to perform better the next day. But can compression stockings improve night muscle soreness once it has appeared? Sadly, probably not.

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