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Perspectives on Diabetes Care

This is the official blog of the Association of Diabetes Care & Education Specialists where we share recent research and professional opinions on diabetes care and education.


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If you're looking for professional opinions on diabetes care and education, you're in the right place. Perspectives on Diabetes Care is the official ADCES® diabetes care and education blog that shares helpful views on diabetes care and education. 

This is where you'll find practical tips on working with people affected by prediabetes, diabetes and related cardiometabolic conditions and the latest research and viewpoints on issues facing diabetes care and education specialists and the people they serve.



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Beware of DOMS

Mar 23, 2016, 04:35 AM


recently woke on a Saturday morning, after sleeping in without setting an alarm. I felt rested after a good night of sleep. As I made the bed, I felt pain in my back. Hmmm, maybe I slept too long or in a bad position. Then, I realized that my triceps were also painful. Light bulb! I had Delayed-Onset Muscle Soreness (DOMS).

Two days earlier, I taught a session to the physical therapy students about the use of Pilates exercise for rehabilitation. We did several exercises on the Pilates equipment which I demonstrated for them, including some that I hadn’t done in a while that were pretty challenging. I casually mentioned to the group that they may be a little sore in a day or two; they may experience DOMS, which is what I had!

DOMS is muscle pain/soreness that comes on 12 to 24 hours after doing strength training.

This made me reflect on the last post I wrote—Strength Training-No Equipment Required!—and a warning that we should discuss with those who are going to start strength training (as well as novel or forceful aerobic exercise): they may get DOMS. DOMS is muscle pain/soreness that comes on 12 to 24 hours after doing strength training, is strongest one to three days after the exercise, will generally ease on the second to third day, and should be totally gone in three to five days. This is a common, normal response to good-quality strength training.

What is acceptable muscle soreness?

  • Starts about 12-24 hours after doing an exercise (rather than during exercise)
  • Is mild to moderate in intensity
  • Involves the muscle/muscle groups being exercised
  • Doesn’t limit how we perform our normal daily activities
  • Is gone in about three to five days

What is not acceptable?

  • Muscle pain/soreness accompanied by feeling ill
  • Pain that is severe enough to alter normal movements and activities
  • Pain in or around a joint
  • Increased pain in an area where there is a known injury

How can DOMS be minimized?

  • Start an exercise program slowly
  • Perform strength training with at least one day of rest for a particular muscle group between sessions
  • Perform a warm-up before, and a cool-down with stretching after, strength training
  • Use ice or massage on areas that have pain/soreness

It is important for us to mention the possibility of DOMS as we talk about exercise. Knowing that DOMS can be a normal response to exercise should help lower concern and increase the benefit of exercise as an individual works to move toward better health!

Karen KemmisAbout the Author

Karen Kemmis is a physical therapist, exercise physiologist, certified diabetes educator, and also holds certifications in Pilates for rehabilitation and exercise for aging adults. She is based out of SUNY Upstate Medical University in Syracuse, NY and splits her time between a Joslin Diabetes Center affiliate, an outpatient rehabilitation department, and a PT program where she is an adjunct professor.

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