You smashed a new gym class, reintroduced running after a break, or finally tackled that heavy garden project. The next day, your thighs feel like concrete and your shoulders protest every time you lift your arms. Is this normal post-exercise soreness that will fade with a hot shower and a gentle walk? Or have you actually injured something that needs attention?

Distinguishing delayed onset muscle soreness (DOMS) from an injury isn’t always obvious, especially when you’re keen to keep active or you’re returning after time off. Understanding the difference helps you recover faster, reduce the risk of making things worse, and know when to get professional help. As a GOsC-registered osteopath in Angel, London, I see this confusion every week. This guide explains how to tell DOMS from injury, what you can do at home, and how osteopathy can support your recovery and performance.

DOMS vs injury: what’s the difference and why it matters

DOMS, or delayed onset muscle soreness, is the normal ache and stiffness that follows unfamiliar or intense exercise—especially activities with lots of eccentric loading (for example, lowering weights, downhill running, or step-downs). It usually:

  • Starts 12–24 hours after activity
  • Peaks around 24–72 hours
  • Gradually resolves within 3–7 days

DOMS is a signal that your muscles are adapting to a new demand. It’s not caused by “lactic acid build-up”; rather, it’s linked to microscopic muscle changes, inflammation, and nervous system sensitivity after you’ve challenged your tissues. It’s generally safe to keep moving within comfort, and a smart approach to activity can help it settle.

An injury—such as a muscle strain or ligament sprain—often involves a more acute event or overload that exceeds a tissue’s capacity. Signs that point more towards injury include:

  • A sudden, sharp pain during activity (“pulled” or “twinged” feeling)
  • A popping or snapping sensation at the time
  • Immediate pain that makes you stop exercising
  • Visible swelling or bruising within hours
  • Difficulty bearing weight, lifting, or using the area
  • Persistent pain that doesn’t improve after a few days

Why does this distinction matter? Because the best next step is different. DOMS usually responds to gentle movement, active recovery, sleep, hydration, and a gradual return to training. An injury may benefit from targeted unloading, specific rehab exercises, and (sometimes) medical assessment to rule out more serious issues. If you know which you’re dealing with, you’re more likely to recover well and avoid setbacks.

How DOMS feels vs how injuries feel

Typical signs of DOMS

  • Generalised, dull ache and stiffness—not one pinpoint spot
  • Muscles feel tender or tight when pressed, stretched, or first moved
  • Both sides may be affected (for example, both quads after squats)
  • Symptoms often ease with a gentle warm-up and light activity
  • Improves day by day after a peak around day two or three

Typical signs of injury

  • Sharp, localised pain at a specific point
  • Immediate pain during activity; you may stop straight away
  • Swelling, bruising, or a feeling of instability/weakness
  • Pain that worsens with continued use and doesn’t ease after warming up
  • Lasts longer than a week or gets worse over time

Be mindful of nerve-related symptoms too. If you notice numbness, tingling, shooting pain, or weakness—especially with back pain (sciatica-type symptoms) or neck pain radiating down the arm—get a professional opinion sooner rather than later.

Quick self-checks: DOMS or injury?

These simple guidelines can help you decide how to proceed:

  • The “24–72 hour rule”: DOMS often peaks 1–3 days after exercise, then fades. If your pain keeps escalating beyond three days, think injury or overloaded tissues.
  • The “warm-up test”: DOMS usually feels better after 5–10 minutes of gentle movement. Injury pain often doesn’t improve with warming up and may worsen as you load the area.
  • The “stair test”: With DOMS, stairs may feel achy, but your legs work. With a significant injury, stairs might feel unsafe or produce sharp pain.
  • Pain scale: If your pain is more than about 4/10 at rest, interferes with sleep, or is accompanied by swelling/bruise, get it checked.

Common areas people confuse: back, neck, calves, and jaw

In clinic at Cura Rooms in Angel Islington, I often see people unsure if their soreness is normal or not, especially in these areas:

Back pain

Heavy deadlifts or a long day of DIY can leave you with a stiff, achy lower back—that can be DOMS. But sharp pain with bending, persistent spasm, or pain radiating into the leg (sciatica) may indicate irritated joints or nerve involvement. Osteopathy for back pain focuses on relieving pain, restoring movement, and gradually reloading the spine and hips safely.

Neck pain

After a tough upper-body session or long hours at a laptop, your neck and shoulders can feel sore. Gentle movement often helps. If you develop shooting pain into the arm, pins and needles, or weakness in grip, it’s time to be assessed. Osteopathy for neck pain can address mobility, muscle tone, and ergonomics to reduce recurrence.

Calf and hamstring tightness

Runners commonly get calf DOMS after hills or sprints. A sharp, sudden “ping” in the hamstring or calf mid-run suggests a strain, which benefits from graded rehab rather than just stretching. An osteopath can guide load management so you return to running with confidence.

Jaw (TMJ) soreness

After a new mouth guard, dental work, or stress-heavy week, the jaw can feel tight and achy, similar to DOMS. But persistent clicking with pain, locking, or headaches may need a targeted plan. Osteopathy for TMJ can include gentle manual techniques, postural advice, and home exercises for the jaw and neck.

How osteopathy can help with soreness and injury

As an Osteopath in Angel Islington, my approach combines hands-on treatment with practical, evidence-informed advice tailored to your goals—whether that’s pain relief, getting back to sport, or reducing recurrences.

For DOMS

  • Short-term relief: Gentle soft tissue techniques, joint articulation, and mobility work can ease stiffness and improve comfort while the body adapts.
  • Movement coaching: Tweaking technique, cues, or training variables can reduce excessive soreness after sessions without losing progress.
  • Load management: We’ll plan gradual progressions for strength, running, or classes so that your tissues adapt rather than rebel.

For injuries

  • Assessment and diagnosis: A thorough history and exam help us identify what’s irritated (muscle, tendon, joint, nerve) and how best to treat it.
  • Targeted manual therapy: Techniques such as joint mobilisation, soft tissue therapy, and, where appropriate, gentle manipulation can reduce pain and restore motion.
  • Personalised rehab: Specific exercises to rebuild strength, mobility, and tolerance—progressed sensibly to get you back to what you love.
  • Education that empowers: Clear explanations about your condition and a plan you can trust. No gimmicks, no scare tactics.

Real-world example: A client developed deep thigh soreness after starting lunges again. It peaked at 48 hours and eased with light cycling—classic DOMS. We used gentle quads and hip mobility work and set a two-week progression. No time lost. Another client experienced a sharp calf “ping” during a football match with bruising by evening—a mild strain. We started with relative rest, compression, and pain-free isometrics, then graded exercises over weeks. He returned to play stronger and wiser about warm-ups and loads.

Evidence, minus the hype

Hands-on osteopathic techniques can provide short-term pain relief and improved movement, creating a window for effective exercise and everyday activity. Sustainable change comes from combining manual therapy with load management, sleep, and progressive rehab. That’s the heart of my patient-centred approach at JJB Osteopath Cura Rooms.

Practical self-care for DOMS and mild niggles

If your symptoms feel like DOMS and are improving day by day, try:

  • Keep moving: Gentle walking, cycling, or swimming increases blood flow and reduces stiffness.
  • Active recovery: Choose light, pain-free ranges rather than complete rest.
  • Warmth or contrast showers: Comfort-based heat can ease stiffness; some prefer alternating warm and cool.
  • Light mobility work: Controlled stretches and range-of-motion exercises—avoid forcing painful stretches.
  • Massage or foam rolling: Brief, comfortable sessions can reduce perceived soreness; stop if it increases pain.
  • Sleep and stress: Recovery hinges on sleep quality and managing stress. Aim for consistent bedtimes and wind-down routines.
  • Hydration and nutrition: Adequate protein (spread through the day), colourful veg for micronutrients, and hydration support tissue repair.
  • Progressive overload: Increase one variable at a time—weight, reps, sets, or speed—by around 5–10% weekly, not all at once.
  • Warm-up smarter: 5–10 minutes of cardio, joint mobility, and rehearsal sets prepare tissues for load.
  • Avoid “no pain, no gain” thinking: Mild, manageable muscle soreness can be part of training. Sharp, escalating, or focal pain isn’t.

Early care for potential injuries

If your symptoms feel more like an injury—sharp pain, swelling, or reduced function—consider the PEACE & LOVE framework in the early days, adapted to your situation:

  • Protect: Briefly reduce aggravating loads to allow healing to start.
  • Elevate and Compress: Helpful if there’s swelling.
  • Educate: Understand what’s going on—fear can amplify pain.
  • Load: Gradually reintroduce pain-free loading as soon as it’s sensible—the right exercise promotes healing.
  • Optimism: A positive, realistic outlook supports recovery.
  • Vascularisation: Start gentle, pain-free cardio to promote blood flow.
  • Exercise: Progress from easy isometrics to more demanding movements as tolerated.

Note on anti-inflammatories: Guidance varies. For some soft-tissue injuries, early high-dose anti-inflammatories may not be ideal. If you’re considering medication, speak to your GP or pharmacist for individual advice, especially if you have other health conditions.

When to see a professional

Seek help if you notice:

  • Pain that is severe, worsening, or not improving after 5–7 days
  • Night pain that wakes you repeatedly
  • Swelling, bruising, or feeling of instability
  • Numbness, tingling, or weakness in a limb
  • Back pain with leg pain, pins and needles, or foot weakness (possible sciatica)
  • Neck pain with arm symptoms or grip weakness
  • Jaw (TMJ) pain with locking, restricted opening, or headaches
  • Unexplained weight loss, fever, or feeling generally unwell along with pain

Urgent care is needed if you have red flags like loss of bladder/bowel control with severe back pain, progressive neurological deficits, or if you suspect a fracture. If in doubt, call NHS 111 or seek emergency care.

What to expect at your appointment with Jeremy (JJB Osteopath Cura Rooms)

Finding a registered osteopath near me can feel daunting. As a GOsC-registered osteopath based at Cura Rooms in Angel, London, my consultations are designed to be thorough, collaborative, and reassuring.

Your first visit

  • Listening first: We’ll discuss your symptoms, training, lifestyle, and goals in detail. Your story guides the plan.
  • Assessment: Posture, movement, and functional tests help identify what’s irritated. If needed, neurological or orthopaedic tests clarify nerve or joint involvement.
  • Clear explanation: You’ll understand what’s likely happening (DOMS vs injury, or a mix) and why. We’ll agree on a realistic plan together.
  • Hands-on care: Where appropriate, I use techniques such as joint mobilisation, soft tissue work, stretching, and gentle manipulation to relieve pain and improve movement.
  • Targeted exercises: You’ll leave with simple, tailored exercises and a step-by-step progression you can follow at home.

Follow-ups

We track progress, adjust your plan, and introduce more challenging rehab when ready. The goal is confidence and self-sufficiency, not endless appointments.

Conditions I commonly support

  • Osteopathy for back pain and sciatica-like symptoms
  • Osteopathy for neck pain, tension headaches, and posture-related issues
  • Osteopathy for TMJ (jaw) pain and related neck/face tension
  • Sports-related strains and sprains—shoulder, hip, knee, ankle, calf, and hamstring

If you’re searching for an Osteopath Angel London or an Osteopath in Angel Islington, you’ll find me at Cura Rooms, moments from excellent transport links. Appointments are unhurried, evidence-informed, and tailored around you.

Training smarter: avoid needless DOMS and reduce injury risk

You don’t have to choose between progress and comfort. A few smart tweaks to your routine can reduce excessive soreness while still building strength and resilience.

  • Gradual progression: Increase sets, reps, weight, or running volume by 5–10% per week.
  • Mind your eccentric load: Eccentrics are great for strength but can spike DOMS. Add them gradually.
  • Vary intensity: Mix hard sessions with easier days to allow tissues to adapt.
  • Plan deloads: Every 3–6 weeks, ease intensity for a week to consolidate gains.
  • Technique matters: Good form spreads load more evenly across tissues.
  • Respect recovery: Sleep, nutrition, hydration, and stress management are training variables too.
  • Replace all-out stretching with mobility: Use controlled range-of-motion and active drills before heavy work; save longer static stretches for after or separate sessions.

A simple decision guide for your next workout

  • Soreness 0–3/10, easing with movement: Train as planned or slightly easier.
  • Soreness 4–5/10, still improving: Do a lighter session, reduce volume/intensity, or cross-train.
  • Pain 6+/10, sharp or worsening: Skip high-load work; consider assessment.
  • Sharp, focal pain that doesn’t warm up or is associated with swelling/bruising: Treat as an injury and get it checked.

Why choose JJB Osteopath at Cura Rooms

  • Registered and reputable: GOsC-registered osteopath with experience treating a wide range of musculoskeletal issues.
  • Patient-centred: We agree goals together; you’ll understand your diagnosis and the plan.
  • Evidence-informed, practical care: Hands-on treatment supported by targeted rehab and clear advice.
  • Convenient location: Based at Cura Rooms in Angel, London—ideal if you’re looking for a registered osteopath near me.

Ready for clarity and a calmer body?

If you’re unsure whether your soreness is normal DOMS or something more, let’s figure it out together. Whether it’s back pain after lifting, neck pain from desk work, a niggly calf from running, or jaw tension that won’t ease, you don’t have to guess your way through recovery.

Book an appointment with Jeremy at jjbosteopath.co.uk, or get in touch to ask a question. As a trusted Osteopath Angel London, I’m here to help you move comfortably, train smarter, and feel more at home in your body.

Frequently asked questions

Is it OK to exercise with DOMS?

Generally, yes—light to moderate activity can help DOMS settle more quickly. Keep the intensity lower, focus on good form, and avoid pushing through sharp or escalating pain. If a session makes soreness much worse during or after, ease back and recover.

How long should DOMS last?

Most DOMS peaks within 48 hours and improves over 3–7 days. If soreness persists beyond a week, is severe, or is associated with swelling, bruising, or weakness, it’s worth getting it assessed.

Can an osteopath help sciatica or TMJ pain?

Yes. Osteopathy for sciatica-like symptoms and TMJ issues can involve hands-on techniques, movement advice, and a personalised rehab plan. Treatment aims to reduce pain, improve function, and support long-term self-management.

Do I need a GP referral to see an osteopath?

No referral is required to see an osteopath privately. If we feel imaging, GP input, or referral to another specialist would help, we’ll guide you through the next steps.

If you’re looking for a supportive, professional Osteopath in Angel Islington, visit jjbosteopath.co.uk to learn more or book an appointment at Cura Rooms.