Massage and its effect on D.O.M.S.

Massage and its effect on D.O.M.S.

It has been exactly one year since the province of Alberta declared its first COVID-19 case. With each provincial lockdown since, most people have stayed inside and for a lot of us, this has caused a significant struggle in being and staying active. Now with the recent announcement of fitness facilities being allowed to reopen, many people (myself included) are heading back to the gym to get ready for summer activities that are just around the corner. This sudden availability of equipment and workout space has created an increase in exercise which can also mean an increase in soreness post exercise.    

Technically known as Delayed Onset Muscle Soreness, DOMS is never a fun thing to experience, especially when either trying to get back into shape or at the beginning of a fitness journey. I know it is one of the biggest challenges I’ve faced while working out, so I thought I would discuss how massage can help alleviate some of this pain and/or discomfort and support a healthier lifestyle.   

Before we talk about how massage, however, let’s talk more about what DOMS is. While it is agreed upon in both the science and fitness communities that strenuous activity can lead to DOMS, not much is known about why strenuous activity causes it.   

The “Lactic Acid Theory” is widely accepted by most of the fitness industry, and it suggests that lactic acid is the cause of DOMS. This is because, according to some scientists who examined a group of people post exercise, high levels of lactate were found in the participant’s muscle. Lactate was thought to make muscles more acidic, and this acidity seemed to be produced only after exercise. Thus, the scientists concluded that lactic acid must be responsible for resulting pain or soreness (DOMS).    

Since those early studies, the lactic acid theory has been proven inaccurate as we learn more about lactate and cellular respiration. Instead, it is now believed that lactate is not the culprit for making the cells more acidic. Contrary to the first theory, lactate is a ‘base’ rather than an ‘acid’ because it lacks a proton. This lack of a proton means it can only accept protons, not donate them (meaning it can’t make the cell more acidic). When in the recovery phase of an exercise, lactate is turned into what is known as ‘pyruvate’ which is then converted into a fuel source (ATP) or flushed out of the cell*.  

Because of this updated understanding of lactate, scientists no longer believe in the lactic acid theory and its role in DOMS/muscle soreness. A newer theory called the “Muscle Damage Theory” is showing promise and explains that when we perform an exercise, specifically an eccentric exercise, damage to the muscle is created in the form of ‘micro-tears’. These micro-tears cause the body’s pain receptors (nociceptors) to register and send signals to the brain that there is damage to the muscle. The brain then interprets this signal of information and reacts in pain or discomfort. If you would like to know more about this subject, I was suggest checking out this article.   

As both theories still coexist thanks to their respective supporters, we cannot say for certain why pain and/or discomfort happens post-workout, only that it does, and that this can have an impact on our bodies. One thing that has been shown to have some effectiveness in decreasing DOMS is massage. A metanalysis*** conducted in 2017 examined this specifically and proposed three possibilities about massage and positive results it may have on DOMS.   

These include:   

  1. “The effect massage has on the parasympathetic nervous system.” – Massage has an effect on the parasympathetic nervous system (also known as the “rest and digest” system) by having a calming and lowering the effects of the sympathetic nervous system (“fight, flight or freeze”).
  2. “The effect massage has on increasing blood and lymph flow for clearing away biochemical markers of muscle damage.”  – Massage can have a demonstrated effect on the flow of blood and lymph. Skilled massage therapists with specialized training are able to increase the effect of lymph movement in the body. 
  3. “Psychophysiological response massage has on pain.” – The perception of pain is different for everyone and those who have psychological conditions especially, often have an over-stimulus of brain activity. Massage is said to decrease the perpetual focus on that pain and calm the body. A person may book a massage because they are in pain initially, but after the treatment ideally they should experience less pain because their body and brain are able to get relief.

Theralleve therapists know the importance of combining massage and homecare because we understand our clients’ desire to lead active lives, regardless of fitness level or goal. We know there will be times of pain and discomfort, and by understanding the various reasons behind this, we not only aim to treat, but to empower you with tools and knowledge that will provide you a role in your own recovery and overall health journey. Remember, we’re here to support you in and outside of the treatment room because life doesn’t stop after seeing us! 

To discuss your goals for health and fitness and how massage may help, please book in an appointment or send us an email at We look forward to hearing from you!  



Metanalysis: a large review of current research to gauge accuracy and understanding of information presented.***  

Eccentric: An exercise where you are lengthening a muscle while under tension/load. Example: when you are bringing your arm down from a biceps curl.  

DOMS: the soreness typically experienced after a strenuous activity. Usually felt 12-24 hours post-activity, but it can last up to 72 hours.   


*Poindexter, C., & Hernandez, C. (2018). DOMS: Why do your muscles hurt days after exercise?  

**Guo, J., Li, L., Gong, Y., Zhu, R., Xu, J., Zou, J., & Chan, X. (2017). Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis. Frontiers in Physiology, 8(747). Retrieved from

Massage misconception #2: water and toxins and massage – oh my!

Massage misconception #2: water and toxins and massage – oh my!

Drinking water is, without question, one of the best things you can do for your body. Not only are we made of it (roughly 60-70% depending on which health journal you read), but water provides many other benefits to the body including:  

– Maintaining homeostasis (the self-regulation of internal processes),  

– Supporting and enabling digestion,  

– Delivering oxygen to the body’s numerous cells,  

– Lubricating joints, and   

– Aiding in the recycling of waste 

It is not surprising then that many massage therapists will advocate the importance of water consumption to their clients. However, two statements that often get caught up in the mix (and taken in support of drinking water) are:

  1. a client should always drink lots of water after a massage and
  2. that “drinking water helps flush out any toxins that were released during a massage.” 

Both of these statements will be explored below because both are, to varying degrees, massage misconceptions.   

Let’s start by talking briefly about the role of our kidneys. When the kidneys are doing what they do best, this can include the regulation of pH levels, excretion of waste, production of hormones, as well as movement of extracellular fluid to keep blood flowing to other vital organs*. In simplest terms, the kidneys (as well as organs like the liver and other bodily systems) filter out the bad and recirculate the good. 

Though there is nothing inherently wrong with wanting to encourage prime bodily function, it must be reminded that water consumption (and absorption) is not the same for everybody. While some people can drink 1L without batting an eyelash, others are running to the washroom after two glasses. There are many reasons why a person can only handle so much, and context can be everything. That is why, as therapists, additional care must be exercised when telling our clients to “drink plenty of water today” post massage. One client might take our advice to mean “the more water the better” and try to drink a gallon of water on the way home. This may sound extreme but with results ranging from a mild headache to that of kidney overwhelm known as hyponatremia***, it is worth the call for caution. And please know, I reference this extreme scenario not as a scare tactic to deter anyone from drinking water after a massage, or anytime really, but that there are many factors around water consumption, and it is crucial that we recognize them and not generalize.

Next, we have the sometimes-popular belief that declares massage and water consumption to be the “dream team” for toxin removal. According to some, which can include some massage therapists, one benefit of massage is explained as helping to release toxins from the tissues with water being the ideal exiting vehicle. This is simply not true. 

Two main reasons being first, there is still little consensus as to what a ‘toxin’ is (which is quite fundamental to the argument for it) and second, there is even less evidence to explain how a massage technique can aid in a toxin’s specific expulsion. If we consider caffeine to be a toxin for example, to suggest that a massage will magically expel this from one’s body through touch alone (no matter the pressure) is an exaggeration and oversimplification of science. It also adds extra fuel to any fire that says massage therapy is not on level with the rest of the health industry if we continue to defend such claims**.  

As a massage therapist, I know the value of massage and for that same reason I have great hesitancy (and disbelief) in stating that a toxin – which is synonymous with ‘poison’  can be so easily got rid of. There is just not enough evidence to support this. 

So, if we (the therapist) must say anything about water consumption, as I learned in school, we should encourage our clients to “stay hydrated” and please stop talking about toxins.   




*** This happens when the sodium is too low in the bloodstream which causes an imbalance that can dangerously overwhelm the kidneys.