Managing Muscle Soreness After Workout or Massage
For immediate relief of post-workout muscle soreness, rest the affected muscles for at least one day, apply ice for 10-minute periods, and consume protein (0.2-0.4 g/kg/h) with carbohydrates (0.8 g/kg/h) within the first hour after exercise. 1
Immediate Post-Exercise Recovery (First Hour)
Hydration and Nutrition:
- Rehydrate by consuming fluids to replace 100-150% of body mass lost during exercise 1
- Include sodium in your hydration regimen to maintain total body water 1
- Consume protein (0.2-0.4 g/kg/h) combined with carbohydrates (0.8 g/kg/h) within the first hour after exercise to maximize protein synthesis and enhance recovery 1
Ice Application:
- Apply ice through a wet towel for 10-minute periods to reduce tissue metabolism and blunt inflammatory response 2
- This provides effective short-term pain relief 2
First 24-48 Hours
Rest Strategy:
- Allow at least one day of rest between exercise periods to permit gradual adaptation to stresses and strains 1
- Avoid complete immobilization, as this leads to muscle atrophy 2
- Continue activities that don't worsen pain while resting from aggravating movements 2
Active Recovery Options:
- Active exercise (such as shoulder shrugs with elastic resistance for 10 minutes) provides similar acute relief as massage, with greatest effects occurring immediately after treatment and diminishing within an hour 3
- Massage therapy may reduce pain at less than 2 hours post-exercise (reduction of 0.70 cm on a 10-cm pain scale), though evidence quality is moderate 4
Compression Garments:
- Wear compression garments for up to 5 days following intense exercise, as they have shown positive effects on reducing muscle soreness in multiple studies 1
Pain Management
NSAIDs (if needed):
- Oral NSAIDs reduce pain at less than 2 hours (reduction of 0.93 cm on a 10-cm pain scale) with moderate-certainty evidence 4
- Topical NSAIDs also reduce pain at less than 2 hours (reduction of 1.02 cm on a 10-cm pain scale) 4
- Acetaminophen alone reduces pain at less than 2 hours (reduction of 1.03 cm on a 10-cm pain scale) 4
What Does NOT Work
Stretching:
- Pre-exercise stretching reduces soreness by only 0.52 points on a 100-point scale, which is not clinically meaningful 5
- Post-exercise stretching reduces soreness by only 1.04 points on a 100-point scale, which is also not clinically significant 5
- Static stretching for 10 minutes showed no significant benefit for treating delayed onset muscle soreness 6
Other Ineffective Treatments:
- Whole-body cryotherapy has insufficient evidence to support its use, with very low quality evidence and potential hazards from extreme temperature exposure 7
- Topical arnica montana ointment and sublingual arnica pellets appeared to impede recovery of muscle function 6
When to Seek Medical Attention
Red Flags:
- Severe pain that is disproportionate to the exercise performed 1
- Significant swelling of the affected muscles 1
- Loss of function or inability to move the affected area 1
- Muscle soreness that persists beyond 72 hours without improvement 1
Prevention for Future Workouts
Progressive Training:
- Start slowly and progress gradually with any exercise program to allow time for adaptation 1
- Include proper warm-up with 5-10 minutes of repetitive low-intensity range-of-motion exercises before intense activity 4, 1
- Perform a 5-minute cool-down period with static stretching after exercise 4
Monitoring:
- Watch for signs of overexercising including chronic fatigue, inability to finish workouts, and persistent aches and pains 1
- Avoid excessive fatigue during training sessions 1
Common Pitfalls to Avoid
- Returning to intense exercise too soon can exacerbate muscle damage and prolong recovery time 1
- Ignoring proper hydration and nutrition after exercise delays recovery 1
- Relying on stretching alone for soreness relief, as it provides minimal to no clinically meaningful benefit 5
- Using NSAIDs prophylactically before exercise, as one study suggested they may impede recovery 6