DOMS Revisited

June 22, 2023

DOMS Revisited

Have you ever suffered from DOMS (delayed onset muscle soreness)? If so, you will know how sore and debilitating it can be. Most runners will have suffered from it at some point but may have just accepted it as a “side-effect of running”!! BUT, if not addressed, DOMS may lead to severe EIMD (exercise-induced muscle damage), and time out from training.

So….we are going to revisit the research and give you some nutrition and lifestyle tips and tools to help you recover effectively from DOMS.

If you are currently experiencing DOMS, or experience it regularly and find it frustrating and debilitating, then definitely listen in to find out more about the emerging nutritional approaches to support you. We will:

    1. Recap on the definition of DOMS and highlighting the typical signs and symptoms of its development
    2. Outline the current evidence-based nutritional approaches to supporting recovery from DOMS
    3. Discuss how to put these nutritional recommendations into practice

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DOMS Revisited


Defining DOMS (Delayed Onset Muscle Soreness) as:

A symptom of EIMD (Exercise-Induced Muscle Soreness) and is associated with a perception of severe soreness and discomfort. DOMS typically occurs 24 –72 h after unaccustomed and/or high-intensity eccentric muscle contractions e.g. running downhill.

Additionally, the soreness experienced is attributed to local inflammation caused by damage to muscle fibres. The ACSM (American College of Sports Medicine) states that the pain tends to peak at about one to three days after a workout, and then should begin to ease.

Signs and symptoms a runner may experience suggesting DOMS as an issue include:

  • Inflammation
  • Pain
  • Swelling
  • Decreased muscle function
  • Muscles that feel tender to the touch
  • Reduced range of motion
  • Muscle fatigue


Outlining some potential risk factors in the development of DOMS including:

  • Being new to running
  • Beginning seasonal training – whether at elite level or recreational
  • High intensity bouts of training or during competition
  • Overtraining (can produce skeletal muscle cell breakdown creating DOMS)
  • Age
  • Gender
  • Trail/mountain running
  • Training background
  • Genetics
  • Environmental conditions. For example: weather, terrain
  • Stressors –physical/emotional/psychological stress
  • Nutrition and Hydration status



See Below


Highlighting the phytonutrients to be discussed before moving on to discuss each in more detail:

  • Curcumin
  • Anthocyanins and flavonoids
  • Betalain
  • Quercetin
  • Isothiocyanate


Curcumin, the active component of Turmeric, supports recovery from DOMS due to its anti-inflammatory and antioxidant effects. Its anti-inflammatory effects are due to its ability to decrease the expression of pro-inflammatory genes. Additionally, curcumin is known to have analgesic effects (act as a painkiller) on both acute and chronic pain. Also, the efficient scavenging effects of curcumin are thought to reduce the risk of secondary muscle damage occurring.

Anthocyanins and Flavonoids

These are potent phytonutrients found in tart cherries having anti-inflammatory properties due to their ability to inhibit certain enzyme activity. It is thought that tart cherries may be able to maintain an APPROPRIATE inflammatory response to injury therefore improving recovery.


This phytonutrient is found in Beetroot. Beetroot is generally associated with nitrates and their ability to enhance the delivery of oxygen to muscle due to their vasodilation effects, but betalain is important too.

It is known to be the most potent antioxidant molecule found in beetroot and is a potent free radical scavenger, but it is also known to upregulate our internal (or endogenous) antioxidant enzymes. Additionally, betalain has analgesic effects, similar to that of curcumin.



Quercetin is found in many plant-based foods including; green tea, apples, peppers, blueberries and dark green vegetables and is well known for its anti-inflammatory and antioxidant properties. It is thought that quercetin may reduce the expression of many pro-inflammatory molecules and as a result may help to counteract inflammation associated with DOMS. Additionally, with increased bioavailability of quercetin comes reduced muscle pain immediately following training and improved time of recovery.


Isothiocyanate is an emerging phytonutrient therefore there is limited data available on this phytonutrient. It is found in many vegetables including the brassica family. For example: cabbage watercress, broccoli. It is also found in wasabi (a pungent Japanese spice). It is known to be cardioprotective and anticarcinogenic due to its antioxidant and anti-inflammatory effects. Regarding DOMS, it is thought to accelerate recovery time, however current research is mostly on animal models, although there has been one human pilot study to-date.


Considering ways of introducing these phytonutrients into a regular food plan to help limit the effects of DOMS. One way is through drinking pure and natural juices. For example: Beetroot Juice, Tart Cherry Juice.

There was a review paper published this year (2023) dedicated to pure juices as a “supplement” for muscle recovery from DOMS. Regarding beetroot and tart cherry juice their recommendations were:

Beetroot Juice:

Consume 125ml of Natural Beetroot Juice twice a day on the day of exercise and then for 3 days post-exercise – to help lower the perception of DOMS, including a reduction in pain.

BUT….it is worth bearing in mind that some other studies have found no positive effects of beetroot juice on an individual’s experience of DOMS.

Tart Cherry Juice (or Montmorency Juice)

The therapeutic recommended amount to take is either:

237ml per day for 5 days prior to an endurance training/event but also 237ml on the day and for 2 days following the event


2 x 355ml per day for 7 days prior to endurance training or event and also DURING endurance training or an event


Focussing on Turmeric and how it could be introduced into the diet regularly to support the effects of DOMS.

It is important to note that curcumin from turmeric is very poorly absorbed from the digestive system therefore bioavailability is low. BUT, there are two things that can be done to help increase its bioavailability:

  1. Consume it at therapeutic levels, which would mean taking it as a nutritional supplement
  2. Consume it alongside black pepper. PIPERINE, the active component of black pepper, is known to enhance absorption and bioavailability of curcumin

Studies on Curcumin have shown that between 200mg per day up to 1500mg per day may be required in order to have beneficial effects in reducing inflammation and DOMS post run training. 

So, how does that translate into a meal plan?

It may be that taking a supplement would be required if a runner is prone to DOMS OR if a runner is considering increasing running distance OR introducing more skill-based training into their plan.

If, however they are a casual or short distance runner, then adding turmeric to a food plan on a regular basis may be a supportive accompaniment to an everyday healthy meal plan. 

Ways Turmeric could be added to a food plan include:

Turmeric tea – let some fresh chopped turmeric steep in hot water for 5-10mins then strain and drink

Add freshly grated (or powdered) turmeric to scrambled eggs or scrambled tofu

Add some freshly grated turmeric to soups and stews or add to a smoothie

Use in a salad dressing

Make curries

NOTE: Turmeric is a very versatile spice and gives food a beautiful vibrant colour and flavour BUT it can stain hands, clothes and surfaces. So, handle with care!!


Highlighting foods containing Quercetin and how they could be introduced into the diet.

  • Green tea
  • Apples
  • Peppers
  • Blueberries
  • Dark green vegetables

How to add these foods into the diet:

Swap out one coffee a day for a green tea. Remember green tea still contains some caffeine

Apples and blueberries could be used as a topping on porridge, overnight oats, with yogurt and mixed nuts OR as a snack with a few nuts or seeds

Dark green vegetables could be added to soups, stews, salads, fresh juices and smoothies OR cooked to have as a side dish with a meal. Dark green vegetables include: spinach, kale, broccoli, watercress, rocket, spring greens

Peppers can be eaten raw as crudites with a dip. For example: hummus, guacamole OR added to a salad. They are also delicious roasted, either on their own or as part of a Mediterranean medley. Roasted pepper soup is another way of introducing them into the diet

How much quercetin is required for it to have a positive effect on DOMS?

Some studies suggest a 14 day intake of 1000mg could reduce the impact of muscle damage. Other studies recommend an 8 week intake of 500mg/d of quercetin combined with 200mg/d of vitamin C  could help reduce blood markers associated with muscle damage

Food sources of quercetin contain much lower quantities. For example: an apple (100mg) contains 4.4mg quercetin, 100g Kale contains 22.6mg, and 100g spinach contains 27.2mg of quercetin. So, to attain therapeutic levels of quercetin a supplement would be necessary BUT including these foods in the diet regularly could help to boost intake a little.



Take time to reflect on your own experience of DOMS and EIMD and consider WHICH foods or supplements you may need to consider. If therapeutic doses of these phytonutrients would be required then work with a professional to ensure the correct supplements and dosage are prescribed for your needs and goals.

Female Factors

DOMS Revisited

  1. Research is mixed regarding the susceptibility of DOMS in women besides men
  2. Some research suggests that women may be less susceptible to muscle damage from exercising than their male counterparts due to the influence of the hormone oestrogen
  3. Other studies show that women are MORE susceptible to muscle damage, BUT that they generally recover faster than men. For example: One study showed that after downhill running it took men 72 hours to recover from DOMS but for women, it took 24 hours only


DOMS Revisited

  1. DOMS is classed as a symptom of EIMD (Exercise-Induced Muscle Soreness) and is associated with soreness and discomfort. It typically occurs 24 –72 h following exercise
  2. There are many risk factors for the development of DOMS to be mindful of including:
  • New to running
  • Type of running
  • Age
  • Gender
  • Nutrition and Hydration status
  1. Many Phytonutrients found in plant foods have been researched for their antioxidant and anti-inflammatory properties known to help diminish or limit the effects of DOMS caused by EIMD. These phytonutrients include:
  • Curcumin
  • Anthocyanins and flavonoids
  • Betalain
  • Quercetin
  • Isothiocyanate

Isothiocyanate is “the new kid on the block” so data on this nutrient is limited…but looking promising

  1. Including these nutrients in your diet regularly and CONSISTENTLY through your food choices could help “top up” and maintain their levels
  2. The foods containing these phytonutrients could easily be incorporated into your daily diet through juices and smoothies or by adding them to salads, soups, stews, casseroles
  3. BUT if DOMS and injury are an issue then therapeutic levels of these phytonutrients may be required through supplementation. We highly recommend you work with a practitioner when consider nutritional supplementation to ensure levels are suitable and safe for your needs

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The suggestions we make during this episode are for guidance and advice only, and are not a substitute for medical advice or treatment. If you have any concerns regarding your health, please contact your healthcare professional for advice as soon as possible.

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