What to do and NOT to do for muscle pain 😣💪😣
Are you struggling to walk after doing physical exercise, experiencing delayed onset muscle soreness, (aka DOMS), or concerned that you have tendonitis or injured your fascia?
As many of us are enjoying the nice weather, doing extra yard work, bicycling with the kids, hitting the lake for water sports, painting the house, building a deck, or a number of other warm weather activities…..
Many patients call me or come into the office limping, barely able to walk, or complaining about sore muscles (shoulders, arms, foot, back, you name it), scared they have torn a muscle, or worse yet, really hurt themselves and don’t know what to do.
Today, we’ll take a look at what muscle, tendon, and fascia symptoms look like, what causes them, plus some DIY home remedies, and when it’s important to seek professional help.
Before we get started, if you missed last week’s blog on“Vacations - the good and bad - what the research says about them”, you can use this link, Here.
OK, let’s sort out when to get concerned about sore muscles and what you can do to minimize the discomfort….
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What is DOMS?
Delayed onset muscle soreness (DOMS) is stiffness and pain that you feel between 24 and 48 hours after doing high-intensity physical exercise that your body isn't accustomed to.
What exactly causes DOMS?
What causes DOMS? High-intensity exercise can cause tiny, microscopic tears in your muscle fibers. Your body responds to this damage by increasing inflammation, which may lead to a delayed onset of soreness in the muscles.
Why is DOMS worse the second day?
Typically, it's "untrained" muscles that ache days later, which is why you might be more likely to feel sore the second or third day after physical exercise you haven’t done in a while, or never done before.
How long will DOMS last?
DOMS will typically last between 3 and 5 days, yet you're likely to feel your muscles loosen up after the first couple of days.
Should I just relax and rest if I'm sore?
Although being active with DOMS pain may feel like the last thing you want to do, it can actually be good for your recovery. The term “active recovery” refers to continuing to move during a period of rest. It's a great strategy for those who need time to heal but also want to prevent stiffness and stay healthy. If you're ultra sore after hard physical exertion, skip the strenuous exercise and go for a walk instead.
These are just a few of the questions that come up when discussing muscle soreness with patients…..
It seems unfair that pain is the reward for putting ourselves through a hard physical workout. But in fact, DOMS can be a sign that you did something right!
The whole idea of resistance training is that you're creating micro-tears in your muscles, so that they recover stronger and firmer. The soreness you're experiencing shows your fitness is progressing.
DOMS has nothing to do with lactic acid, as it was once thought. It's actually all about blood flow and healing. DOMS involves a temporary inflammation around your overworked muscles, which is the reason for the soreness.
As the hours pass, blood cells rush to the inflamed area to heal the soreness. So it's normal for that creaky can't-get-out-of-bed feeling to get worse before it gets better. But after 48 hours, you're definitely on the road to recovery.
What's the best treatment for DOMS?
One solution is quick and easy, and won't cost you much: pour a cup of Epsom salts into a warm bath.
Epsom salts are rich in magnesium, a magic mineral that helps widen your blood vessels to boost your recovery, and soak soreness from your muscles. You can also buy special magnesium salts, but they're three times the price for basically the same thing.
Or, if you're feeling seriously brave (that's code for "desperate"), sit in a cold bath for as long as you can grit your teeth. Many professional athletes swear by ice baths because the cold helps combat the muscular micro-tears from intense exercise.
The ultimate solution: Contrast water therapy – alternate a hot bath with an ice-cold shower. Keep swapping between the two for 20 minutes.
What massage is best for DOMS?
Start with the foam roller. Foam rolling can soothe sore knots and release tight trigger points in your muscle fibers. Go slowly, rolling each limb in turn, from all angles. Breathing deeply as you roll will make the treatment more effective.
Is there a way to avoid DOMS?
Indeed there is, I recommend knee-high compression socks. You may not feel that sexy wearing them, but you won’t feel that sore either – you decide what matters most to you.
It's best to wear compression socks as soon as you finish exercise and keep them on for 24 hours. The latest research shows wearing compression socks significantly reduces DOMS.
Can I work out with DOMS?
Yes, doing gentle low-impact cardio like swimming is the best active recovery. I also advocate for light stretching and a restorative yoga class.
BUT, save your next dynamic workout for when your body feels back to normal – your muscles need a little rest before you launch back into a full workout.
Can I eat to beat DOMS?
You'll be pleased to know that eating well can speed up your DOMS recovery. Steak with spinach, sweet potato and red peppers is your ultimate muscle-repairing meal.
It's got all the key nutrients to help you bounce back. Plenty of muscle-boosting protein from the steak, lots of vitamin E from spinach and sweet potato, plus an energizing dose of vitamin C from the red peppers.
How to know if it's DOMS or an injury?
Characteristic symptoms are the best way to differentiate DOMS from injuries such as muscle strains. Most people suffering from DOMS will complain of a generalised muscular ache that comes on in the first 1-2 days after exercising. They will often say that they are generally stiff and have tenderness in those muscles that are affected.
The best ways to treat DOMS are an active cool-down, post-session massage, hydrotherapy, icing, non-weight-bearing exercise and epson salt baths.
SPECIAL NOTE: Medications, such as anti-inflammatories, won’t help to reduce sore muscle symptoms.
It is important that DOMS is not confused with muscle strains, tendinopathy, tendonitis, fasciatis or joint pathology.
In most cases when a muscle is strained (or torn) there will be sharp pain and reduced function of that muscle immediately. There may be swelling and bruising, however this may not be visible until the next day, and there will be isolated tenderness at the site of the tear. Moderate muscle strains can take up to eight weeks to heal.
Tendon injuries can occur from repetitive overload over months to years but can also become painful after a single exercise session where the tendon is overloaded too rapidly. Tendon pain is located near the muscle attachment sites close to joints – most commonly the achilles, the lateral and medial elbow, and the front of the knee. Tendon pain may be worse at the start of exercise or first thing in the morning, but improve once it warms up.
Tendinopathy is a degeneration of the collagen protein that forms the tendon. Tendonitis, on the other hand, is just inflammation of the tendon. While you're likely more familiar with tendonitis, experts believe that tendinopathy is actually more common. It's just not recognized and diagnosed as often as tendonitis is.
Tendinitis usually resolves in a few days to a few weeks. Unfortunately, it may take from two to six months to heal from a long-term tendinopathy. Many tendon injuries turn into chronic problems that gradually get worse because the person continues activity despite the nagging pain.
You might attribute a painful neck or a backache to tired muscles or stiff joints. But these symptoms can also be caused by a part of your body you probably haven’t heard of: the fascia. Until recently, this network of tissue throughout the body received very little attention despite its major role in every move you make.
What is fascia?
Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. The tissue does more than provide internal structure; fascia has nerves that make it almost as sensitive as skin. When stressed, it tightens up.
Although fascia looks like one sheet of tissue, it’s actually made up of multiple layers with liquid in between called hyaluronan. It’s designed to stretch as you move. But there are certain things that cause fascia to thicken and become sticky. When it dries up and tightens around muscles, it can limit mobility and cause painful knots to develop.
Fascia-Related Muscle Pain and Stiffness
Healthy fascia is smooth, slippery and flexible. Factors that cause fascia to become gummy and crinkle up (called adhesion) include:
A lifestyle of limited physical activity (too little movement day after day)
Repetitive movement that overworks one part of the body
Trauma such as surgery or injury
Is it fascia pain?
Determining whether your pain is due to muscles, joints or fascia can be difficult. In general, muscle injuries and joint problems feel worse the more you move. Fascia adhesions tend to feel better with movement and also respond well to heat therapy, which helps bring back the tissue’s elasticity.
For some people, adhesions can worsen over time, causing the fascia to compress and contort the muscles it surrounds. This can result in hard, tender knots in the muscles, called trigger points. Myofascial pain syndrome is a condition in which those trigger points cause pain to occur:
During movement
When pressure is applied
In seemingly unrelated parts of the body (referred pain)
Treatment focuses on relieving pain and getting tight fascia and muscle fibers to relax. Read more about DOMS and fascia-oriented methods and techniques in this PubMed article, Here.
How to Keep Fascia Flexible
Keeping your fascia healthy has many benefits. You’ll move more easily, have better range of motion and experience less pain. Things you can do to prevent fascia problems include:
Move more: In addition to a consistent but varied exercise routine, it’s important to be active throughout the day. Have a desk job? Take at least a two-minute break every hour to stand up and move around, which helps fascia stay supple. Consider walking meetings or stand up and walk while participating in conference calls.
Stretch regularly: Stretching is essential to good health. It reduces the risk of inflammation and structural problems in the body.
Focus on posture: Slumping over a desk or a phone or walking in an awkward way to compensate for an injury can cause fascia to tighten. Try to maintain good posture while sitting or standing.
Ways to Relieve Muscle, Tendon & Fascia Pain
There are various strategies that work to loosen up painful muscles, such as:
Heat & cold therapy: Apply a heating pad to the affected area or take a warm bath, followed by icing the area or cold shower.
Chiropractic: Schedule chiropractic adjustments to relieve spinal misalignments and muscle tension.
Foam rolling: Try a foam roller, a cylinder of hard foam that you roll your body over to release tension. It’s a form of self-massage. You can also do this with a lacrosse ball.
Massage therapy: Schedule therapeutic massage sessions with an experienced therapist who can find and apply pressure to release knots and tension.
Acupuncture: The insertion of acupuncture needles into trigger points can cause tense tissue fibers to relax.
Treating muscle, tendon, and fascia pain often requires using more than one therapy. A patient’s treatment plan may include a combination of things such as cold/heat therapy, an anti-inflammatory diet, message therapy and chiropractic adjustments.
When Not to Use Active Recovery
Pain that exceeds normal soreness means that you may need rest or medical care. Besides taxing the muscles, exercise can put stress on bones, tendons, and cartilage. Pain in these areas is likely to be due to an injury. Active recovery strategies could make the injury pain worse.
See a doctor if you have any of these symptoms after exercise:
Pain that is constant, sharp, or worsening
Pain in the area of a previous injury or surgery
A painful area that looks deformed, bruised, or swollen
Pain that doesn't improve with rest, icing, or anti-inflammatory foods
Pain combined with fever, chills, nausea, or vomiting
Pain that interferes with sleep
If pain is felt suddenly during exercise or if there are signs of inflammation, such as swelling and bruising, or if the pain does not improve after 3-7 days, you should speak with a medical professional to accurately diagnose your problem. When in doubt, come into the office so we can check it out.
THE BOTTOM LINE
“Believe in yourself and all that you are. Know that there is something inside you that is greater than any obstacle."
“The more you exercise it, the stronger it gets. Positivity is like a muscle: keep exercising it, and it becomes a habit. Courage is very important. Like a muscle, it is strengthened by use.”
“Your body is your most priceless possession. Take care of it.”
“Fitness starts in your head. You must choose to eat clean, exercise regularly, and treat your body with respect.”
🤩 😎 🤩
Regardless of whether you are a serious athlete or an occasional weekend exerciser, you've probably felt the pain of muscle soreness after a hard workout or fun spontaneous activity.
Delayed onset muscle soreness (DOMS) is stiffness and pain that you feel between 24 and 48 hours after doing high-intensity physical exercise that your body isn't accustomed to.
Typically, it's "untrained" muscles that ache days later, which is why you might be more likely to feel sore the second or third day after physical exercise you haven’t done in a while, or never done before.
DOMS will typically last between 3 and 5 days, yet you're likely to feel your muscles loosen up after the first couple of days.
It is important that DOMS is not confused with muscle strains, tendinopathy, tendonitis, fasciatis or joint pathology.
In most cases when a muscle is strained (or torn) there will be sharp pain and reduced function of that muscle immediately. There may be swelling and bruising, however this may not be visible until the next day, and there will be isolated tenderness at the site of the tear. Moderate muscle strains can take up to eight weeks to heal.
If pain is felt suddenly during exercise or if there are signs of inflammation, such as swelling and bruising, or if the pain does not improve after 3-7 days, you should speak with a medical professional to accurately diagnose your problem. When in doubt, come into the office so we can check it out.
The Functional Medicine approach to your health allows us to treat your overall health by not merely treating the symptoms, but solving the underlying problems!
How are your muscles feeling?
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Make an appointment and come talk with us if you are having doubts or questions about your family’s health. We will give you the honest truth, and the clinical research that supports it.
To make an appointment with me use this link: HERE.
Or, you can always give me a call at (973) 210-3838
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