DOMS vs Injury: What Your Body is Really Telling You

You crushed your workout and now your muscles are letting you know it. Now the question starts rolling around in your head: DOMS vs injury? Is this normal soreness or something more serious? As a physical therapist and former athlete, I’ve seen too many people ignore warning signs. And all too often enough, I see the other side where way too many people fear the wrong thing. Knowing the difference between DOMS (delayed onset muscle soreness) and injury pain is key to building strength sustainably. You also need this information to help you determine when it is safe to continue with activity and when it is appropriate to rest. This post will review exactly what delayed muscle soreness is, the sensations you may feel with both DOMS and an injury, and the red flags to watch out for.

**This is not medical advice. Please consult your medical provider for more information.

What Is DOMS?

DOMS stands for delayed onset muscle soreness. This is a normal response that occurs after exercise or any form of physical activity that takes the muscles beyond their current activity threshold. When you use your muscles and challenge them more than you usually do, this creates small microtears within the muscle fibers. Don’t be alarmed! This is completely normal. These microtears are what will lead to strength gains in the long run! During our resting periods and while we sleep, the body repairs itself. The microtears are repaired and the muscle grows in size. This can happen for up to 48 hours after you complete your activity.

What Does DOMS Feel Like?

DOMS is that sore feeling you get that is common after a gym workout. You might feel slightly stiff, tight, and your muscles might feel achy. They usually ache with movement or if you massage the sore muscle groups. DOMS can occur for a couple of hours up to a couple of days after an intense workout. Typically, I let individuals know that if their soreness lasts more than 48 hours, we probably did a little too much. If your soreness lasts longer than 48 hours, its not bad and it doesn’t mean you are hurting something. But know if you continue with your current workout program, you’re going to add on to the current situation you are in and it will probably get worse.

It’s important to understand that DOMS is not a bad sensation. It is a sign that your muscles are adapting. If you were to continue with the same workout over a length of time, you would notice that you no longer get sore. This is your body adapting to this current load and eventually it becomes easy for you. You will have to continue to progress yourself and your workouts in order to continue to build muscle mass and gain strength. This is why it is important to continuously challenge yourself during workouts. If you keep up with light workouts, there will be no progression.

What Does an Injury Feel Like?

There is a different between DOMS (soreness) and injury (pain). It is important to understand the difference between these two sensations not only for your common knowledge, but to also help you determine when to seek medical attention or when to know its time to rest/cut back on activity.

Sometimes it is really easy to know when an injury occurs. When you’re running and you feel a calf pull or your hamstring grab, its very evident that an injury occurred. It’s also easy to know when you roll your ankle or if you feel something pull as you’re throwing a ball suddenly. But its those steady aches and pains that make it more challenging to determine if you should keep going or rest.

Red flags you want to watch for are any sudden sharp, throbbing, or stabbing pains, especially if they don’t go away with rest. If there are any signs of swelling, bruising, or instability, you should stop exercising. Also, if you start to feel a pain and you keep working out and that pain continues to get worse, the exercise should be stopped.

DOMS vs Injury: How to Know the Difference

The main question always lies with this: “What is the difference between pain and soreness?” Not all pain is something to be worried about. For someone new to working out, it can be difficult to know the difference. All of a sudden, you wake up and everything hurts. Yeah, I would be worried too! Especially if you have never experienced that sensation before. My hope is that this clears up some of your concerns and suspicions around this topic.

The first think you want to think about is if this soreness came on either after your workout or the following day. This is most common. If your pain or soreness comes more than two days after your workout, then it wasn’t from your workout. But if you had a good workout the day before and you wake up sore the following day, this is definitely delayed onset muscle soreness.

Another thing to note is if you notice generalized soreness on both sides of your body or only one? Typically you will notice soreness on both sides of the body. Now, it is completely possible to have delayed muscle soreness one on side of the body if one side is much weaker than the other or if you purposefully only focused on one side of the body. The point here is to establish the difference between DOMS vs injury. Typically with injury pain, it tends to be one-sided.

Also, if you injure yourself, it pretty much happens immediately. You injure it with a motion or action you do, right? So then, the pain will be there as soon as the injury occurs. With delayed onset muscle soreness, the soreness usually comes 1-3 days after your workout. They key is the delay part. The only way an injury will show up later with time is if it comes on gradually from overuse. When this happens, pain usually starts off light and continues to get worse with time or just doesn’t go away.

How to Move Forward Safely

If you suspect you have DOMS, make sure to take your time warming up and cooling down. This light activity, including walking, can help ease the sore sensation. Make sure to not overdo it in your next lifting session. While you can still workout even if you are still sore, this is not the time to increase your load. Either stick with the same load as prior or modify it a little.

Now if the pain is quite intense or involves the sharp, stabbing pain described earlier, a rest day may be necessary. A gentle mobility day or a complete recovery day will be fine. If uncertain, speak to your physical therapist.

The Red Light, Green Light Method

I like to use the red light, green light method for determining when is the appropriate time to push through soreness or pain. For this method, use the numerical pain scale with these guidelines here:

• Zero (0/10) is no pain.
• Five (5/10) will keep you up at night
• Ten (10/10) is the worst pain you’ve ever felt and you’re going to the emergency room.

Green Light

Your pain levels are minimal (0-3/10 pain). You can complete an exercise without worsening pain and it stays within the 0-3/10 level. It might start at 3/10 pain an during your workout, even drops down to 0/10. It an also stay the same at 3/10 or anything in between. With some rest or stretching the pain may also go away. This gives you the green light to keep your activity level and workouts going.

Yellow Light

Your pain levels are moderate (4-6/10 pain). When you exercise, your pain is definitely still present. You can complete an exercise without worsening pain that does not go beyond 6/10. There may be occurrences or sharp pain here or there, but it is not the majority of your pain. You still have some achy soreness that is present. With rest, the pain may linger a bit, but it either reduces or goes away with longer rest breaks. This is where you proceed with caution. It may be safe to continue workout out, but you are treading a fine line between the “red zone” and this current zone.

Red Light

Your pain levels are severe (7-10/10). Pain is usually sharp or stabbing in nature. This pain does not go away with rest. This is your no-go. Your body needs rest and in severe cases or when injury is apparent, medical attention may be necessary. If you started off in the lower pain levels during your workout (0-6/10) and your pain continued to increase to >7/10, you should also stop your workout.

Other Related Articles on Building Strength

• Why Strength Training for Runners is Important
• How to Strengthen Your Deep Core
• How to Strengthen Knees for Function and Performance
• Weak Ankles Running? Stabilization and Strengthening for Pain Free Running
• 5 Best Shoulder Strengthening Exercises for Healthy Movement and Stability
• 7 Physical Therapy Strengthening Exercises for the Full Body

When to Seek Help

If you are unsure of when to seek professional help, consider these scenarios:

1. Pain persists more than seven days, even with rest.
2. You have a serious injury like a torn muscle, severely sprained ankle, or suspect a fracture.
3. Pain interrupts your sleep and/or daily life.

These are not the only times you should seek medical assistance, but this is a starting point. Always remember, if you aren’t sure, please speak with your doctor or other healthcare professional.

DOMS vs Injury: When to Stop vs Keep Going

Learning to listen to your body doesn’t mean avoiding discomfort altogether. It just means you have to understand it. DOMS is a normal part of getting stronger and building muscle. Knowing when that soreness “ache” crosses into the injury pain territory is what keeps you progressing instead of sidelined. You don’t need to panic over every ache nor should you push through every pain sensation. With the right awareness, you can train smarter, recover quickly, and rebuild trust in your body again.

TL;DR

DOMS, or Delayed Onset Muscle Soreness, is a common and temporary side effect of working out—especially after new or intense movements. It usually feels achy, tight, and improves with light movement, peaking 24–72 hours post-workout. Injury pain, on the other hand, tends to come on suddenly, feel sharp or localized, and may include swelling or instability. If the discomfort persists, interferes with daily life, or worsens with movement, it’s best to get it checked out. Learning to tell the difference between soreness and injury helps you stay safe, consistent, and strong.