Source credit: Based on a PubMed-indexed review in Skeletal Radiology, “Imaging characterization and differential diagnosis of delayed-onset muscle soreness (DOMS) in athletes”. DOI: 10.1007/s00256-026-05292-2.
Short Summary
A new review focuses on how delayed-onset muscle soreness can show up on MRI and ultrasound after hard or unfamiliar training, especially eccentric work. The authors argue that recognizing the typical timing, activity history, and muscle-pattern clues can help clinicians and athletes separate normal post-training soreness from strains, exertional compartment syndrome, rhabdomyolysis, inflammatory muscle disease, or other problems that need a different response.
For lifters, the practical takeaway is not that every sore muscle needs imaging. It is that imaging can create confusion if the scan is interpreted without the training context. DOMS often appears 24 to 72 hours after a hard session and usually reflects microscopic muscle damage rather than a torn muscle with disrupted architecture.
Why it matters for lifters
Heavy eccentrics, new exercises, long layoffs, and unusually high volume can all leave athletes sore enough to worry that something is wrong. This review supports a more precise recovery conversation: soreness patterns, sport-specific loading, and symptom timing matter before anyone labels the issue as a true injury or delays return to training unnecessarily.
The review also cuts both ways. Severe pain, swelling, weakness, dark urine, neurological symptoms, or soreness that does not behave like a normal training response should not be waved off as routine DOMS. Those are situations for qualified medical evaluation.
What to watch next
Expect sports medicine and radiology groups to keep refining return-to-play language around post-exercise imaging findings. For coaches and lifters, the useful next step is better session logging: exercise selection, eccentric load, volume spikes, soreness timing, and performance changes can all help clinicians interpret what they are seeing if imaging is ever needed.
This article is for informational purposes only and is not medical advice. Anyone with significant pain, suspected injury, unusual swelling, dark urine, or ongoing symptoms should consult a qualified health professional.