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All In Your Head? How Your Mind Can Affect Muscle Soreness After a Workout

A runner using the addaday BioZoom massage tool

Maybe it was the first time you turned a jog into a run. Maybe it was that sprint you did at the end of your first 5K. Maybe it was the hill you ran up, panting. Whatever it was, we’ve all felt it: that raw muscle soreness that usually follows a change in the duration, type or intensity of our running.

One day you’re feeling great about a new running milestone; 24-72 hours later, you’re wincing while descending stairs. All runners have been there, and the common assumption is the pain comes from your muscles.

But could some of your muscle soreness after a workout be in your head?

Delayed Onset Muscle Soreness: Why It Hurts and How It Helps

For most runners, there’s no getting around the occasional bout of delayed onset muscle soreness (DOMS) when you’re running farther or faster.

In an email to Fleet Feet, University of Georgia kinesiology professor Dr. Patrick O’Connor says it can happen any time we push ourselves harder than we’re used to.

Any time a person performs “unaccustomed, eccentric muscle actions, minor injury occurs in the activated muscles,” says O’Connor. “An inflammatory process occurs and 24 to 72 hours later, the injury and inflammation causes muscle pain.”

As uncomfortable as DOMS can be, it serves a greater purpose. You may vow to never sprint uphill again when you’re hobbling around two days afterward, but if you do the same thing a week later, you’ll be less sore after, and even less sore the time after that. This is what scientists call the “repeated bout effect.”

Dr. Jarrod Call, a Department of Defense-funded investigator who researches muscle regeneration, told Fleet Feet in an email that structural changes in muscles occur when a person repeats an unaccustomed physical activity. The soreness you feel one day can be part of a process that leaves you stronger the next.

But what if some of that soreness isn’t coming from an adapting muscle, but from your own fear of pain?

New Research Links Psychological Factors to DOMS

A runner sits next to an addaday massage stick after a run

At the 2019 American College of Sports Medicine meeting, a team of researchers from the University of Haifa in Israel presented the results of a study examining the influence of mental traits on DOMS.

Researchers evaluated 32 subjects for psychological traits and pain sensitivity, and then underwent an exercise protocol; 17 subjects reported DOMS 24 hours later.

What was interesting about those 17 subjects? They also reported higher levels of anxiety, depression and stress from the outset. Moreover, they showed higher baseline pain sensitivity prior to the exercise protocol. These findings led the research team to conclude, “The endogenous ability to regulate pain has a significant impact on pain development in DOMS.”

Or, more simply, a person’s tolerance for pain might also affect how sore they feel after a hard workout.

Other studies have also demonstrated the profound influence of psychology on the perception of exercise-related pain: A 2015 study published in the Journal of Pain induced DOMS in 82 subjects through exercise on only one side of their bodies.

The study found the subjects who showed more pain-related fear and had a negative mindset toward the anticipation of pain reported feeling pain on both sides of their bodies the next day, rather than the one side that actually exercised.

Two runners using addaday massage tools

How Psychology and Physiology Affect Muscle Soreness

Chances are that the soreness you feel after joining a faster pace group is very real, not imaginary. But this research encourages a closer look at the nuances of how a person’s mental state affects their physical sensations.

Abby Douek, PT, MPT, is the owner of Run Raleigh PT, where she specializes in helping runners recover from injury and run without pain. Douek recommends that beginner runners avoid frequent DOMS by safely increasing mileage through interval training or running every other day. She says she and her team take a multi-faceted approach to pain prevention and treatment, including advanced gait analysis and VO2Max testing, which helps runners pace themselves and avoid the buildup of lactic acid.

But Douek also believes that “the mind is very powerful,” and she sees what the expectation or fear of pain can do to a runner.

“If you go out for a run expecting pain, your body may be tense and will hit the ground with more rigidity,” Douek says in an email with Fleet Feet. “This will also play into the inefficiency of muscles and cause pain.”

Taking Care of Your Muscles and Your Mind

Although more research is needed to delineate the link between mental traits and pain, this most recent study underscores the impact that mindset and attitude can have on training. DOMS will happen to most runners attempting to increase their speed, endurance or economy. But pain is perhaps best approached as a hurdle on the course to improvement, rather than as a problem to be feared.

As Dr. Call told Fleet Feet, “At first, DOMS seems terrible … but inflammation is a normal part of the recovery process for muscle. When the burning lungs or sore quads are not seen as a bad thing, but the body rebuilding itself better, one can turn the drudgery into a crowning victory.”

Of course, Call says there is still much that is unknown about muscle recovery and adaptation, but “The doubt and uncertainty are the really exciting parts of scientific investigation.”

The same could be said of those of us wondering just how far or how fast we might run tomorrow.


By Susannah Williams. Susannah has been running for fitness since she was 18. A freelance writer based in Raleigh, North Carolina, she uses her running time to think of the next paragraph of an article or the next idea for her creative nonfiction.

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