Tuesday, December 21, 2010

Are You Hurt or Just Sore?

When we first begin a training program, we see a lot of improvement early. Things then level off and the rate of improvement slows down. The initial sky-rocket of improvement results from the brain learning how to coordinate the movements and recruit the muscles and energy needed to perform the new activities. This typically happens over the initial 1-2 weeks. The next 3-5 weeks are the slower, more physical adaptations that the body produces as a result of the specific activity (i.e. increased cardiac output, increased oxygen transport and use by the cells, or increased muscle fiber size, etc).

Whether you are a seasoned athlete or a beginner, whenever a new training activity is started, a common body reaction is known as “Delayed Onset Muscle Soreness” (DOMS). This is soreness that occurs 24-48 hours after activity and generally resolves within 3-7 days. Many studies have been performed to try and determine a cure for DOMS. Unfortunately, it is a natural response and a typical indication of when you’ve performed something new. The symptoms of DOMS can be decreased by performing a proper warm-up. When the muscles are “warm”, they are more pliable and responsive to activity. The best remedy for this normal muscle reaction, however, is to repeat the exercise activity. This “Repeated Bout Effect” is part of the adaptation process. Too often, we experience soreness and then wait a prolonged period before attempting to resume activity. By that time, the body considers the activity to be “new” again which results in more soreness. We then put off activity again or quit all together.

In order to see results from any training program, you have to challenge the body to a degree of stress that is greater than what it is normally accustomed. Too little, and you will see minimal or no improvement at all. Too much, may result in overtraining or potential injury. But, ultimately how much challenge your body can take, depends on your current fitness status. If you are just beginning a training program or you have had a long break, then you should start slower and with lower intensities to give your body time to adapt to the new stresses. If you are more fit, your body can handle greater challenges.

A couple of questions that I am asked frequently are “How can I tell whether what I am feeling is ‘normal soreness’ or the result of an injury?” and “How can I maintain my fitness when I am injured?”.

First, some typical symptoms that would signify an injury are:

- Swelling
- Numbness, tingling, or loss of joint motion
- Warmth to the touch
- Discoloration or bruising
- A twinge during a workout that becomes worse later
- Limping
- Pain that lasts more that 2-3 days
- Pain that increases over time
- Pain that interferes with normal activities

Second, an injury doesn’t have to sideline you for good. By following a few simple recommendations, it is possible to continue exercising, maintain your fitness level, and heal properly at the same time:

1. Listen to your doctor! - Your physician can provide you with appropriate exercises that can be done to promote healing and fitness. Most importantly, he/she can provide you with advice to avoid further problems.

2. Modify your workouts so that they don’t include the injured area. – For an upper body injury, focus on lower body training. For lower body injuries, focus on the upper body or maybe perform exercises while sitting. High impact activities (i.e. running) can be modified to low or no impact activities (i.e. stationary bike, swimming, etc).

3. If the injury continues to hurt, continue to modify your activities until you find something that doesn’t hurt. – Increased pain or swelling are signs of continued stress and occasionally, activity may need to be discontinued altogether in order to allow some healing first.

David Yeager, ATC, CSCS

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