Acute muscle soreness

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]


Acute muscle soreness (AMS) is a term used to describe muscle soreness felt during the muscle's use in an activity or shortly after its use (generally no longer than an hour). It is not connected to its longer counterpart, delayed onset muscle soreness, which can last up to 72 hours after muscle activity.


  • It is generally known to be caused by tears in the muscle fibers or fascia. Soreness can occur after trying a new muscle activity or exercise, exercising during or after a prolonged period of being sedentary (little or no exercise or movement) or a large change in your current exercise routine.
  • Exercise causes acute muscle soreness through various mechanisms that include decreased muscle oxygen, increased lactic acid, free radical production[1]exercise induced rhabdomyolysis[2], and tissue swelling within the muscle.
  • A new theory has emerged as to the cause of AMS which states that AMS is caused by ATP-derived hydrogen ions in the muscles. This deprivation lead to a pH and acidosis levels within the muscles. This decrease of levels within the muscles is what causes the soreness which is perceived by the patient.
  • Though AMS is now believed to be caused by ATP-derived hydrogen ions they may not be solely responsible. For instance, if other substances can drop the pH and increase acidosis in the muscles, then theoretically they can also contribute to AMS.


Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Influenza vaccine
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic Shin splints
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma Muscle tears, repetitive strain injury
Urologic No underlying causes
Miscellaneous Exercise, shin splints, strength training, stretch shortening exercise

Causes in Alphabetical Order

Natural History, Complications and Prognosis

AMS, in general, disappears quickly (hence the term acute). To speed the recovery period would be to stop the exercise or movement causing it. However, the soreness can last even after the muscle/s cease activity and can remain for up to an hour.


  • There are ways to quicken the recovery period and relieve the patient of the pain. This is achieved by the removal of all the ATP-derived hydrogen ions and so techniques to speed up the removal of these ions will shorten recovery time.


  1. Thompson D, Williams C, Kingsley M, Nicholas CW, Lakomy HK, McArdle F; et al. (2001). "Muscle soreness and damage parameters after prolonged intermittent shuttle-running following acute vitamin C supplementation". Int J Sports Med. 22 (1): 68–75. doi:10.1055/s-2001-11358. PMID 11258644.
  2. Heled Y, Zarian A, Moran D, Hadad E (2005). "[Exercise induced rhabdomyolysis--characteristics, mechanisms and treatment]". Harefuah. 144 (1): 34–8, 70. PMID 15719820.

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