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Muscle soreness is a common occurrence after a workout, especially for those new to training or who have been inactive for a long time. While many gym-goers relish the pain as an indicator of a good session, it is important to distinguish between muscle soreness and a pulled muscle or injury. Telling the difference can be challenging, but with muscle soreness, the pain usually occurs a day or two after the workout, whereas a pulled muscle will result in immediate, sharp, and localized pain. Researchers have been working on ways to quantify muscle soreness, traditionally measured using a visual analogue scale (VAS), but there is no gold standard for measurement, and other techniques such as needle biopsies are invasive and painful.
| Characteristics | Values |
|---|---|
| Common Causes | Delayed Onset Muscle Soreness (DOMS) or Exercise-Induced Muscle Damage (EIMD) |
| Traditional Measurement Techniques | Visual Analogue Scale (VAS) |
| New Measurement Techniques | Thermal Imaging |
| Common Descriptors | Tight, Sore, Tender, Annoying, Pulling |
| Indicators of Pulled Muscle | Intense, Sharp Pain, Swelling, Bruising, Difficulty Moving Joints |
| Treatment for Soreness | Ice Packs, Massages, Stretching, Rest |
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What You'll Learn
Thermal imaging to detect skin temperature changes
Muscle soreness, known as Delayed Onset Muscle Soreness (DOMS), is a common sports injury. It is often the result of unaccustomed eccentric muscle action, causing a disruption of connective and/or contractile tissue. The soreness can lead to functional impairment, altered joint kinematics, reduced strength and power, and an increased risk of injury.
Traditionally, muscle soreness has been measured using the Visual Analogue Scale (VAS), where participants mark their level of agreement with a statement along a continuous line. However, this method is subjective and does not provide an accurate or reliable measurement of muscle soreness or damage.
Thermal imaging has been identified as a potential solution to the challenge of quantifying muscle soreness. This technique, known as infrared thermography, is a quick, non-invasive, portable, and patient/athlete-friendly method of assessing skin temperature. It has been used successfully to detect different types of diseases and infections since the 1950s, but its application in detecting muscle soreness is a more recent development.
Infrared thermography can detect subtle changes in the temperature of the skin above exercised muscles. This is based on the understanding that when muscles exercise, tremendous heat is generated due to the frictional forces of the muscle fibres and increased metabolism. Increased blood flow to the exercised muscle also contributes to the increased heat. Thermal imaging can detect these temperature variations, which may indicate the presence of underlying pathology or inflammation.
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Visual analogue scale (VAS)
The Visual Analogue Scale (VAS) is a pain rating scale that was first used in 1921 by Hayes and Patterson. It is a subjective measure of acute and chronic pain. It is often used in clinical research to measure the intensity or frequency of various symptoms. The scale has to be shown to the patient; otherwise, it is an auditory scale.
The VAS is a simple and adaptable unidimensional measure of pain intensity. It is used to record patients' pain progression or compare pain severity between patients with similar conditions. The scale ranges from no pain to worst pain possible, with higher scores indicating greater pain intensity. The VAS can be presented in a paper-based format or digitally. The patient makes a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain." Measurements from the starting point of the scale to the patient's mark are recorded in centimetres and interpreted as their pain level.
The VAS has been widely used in diverse adult populations, including those with rheumatic diseases, chronic pain, cancer, and allergic rhinitis. It is also used in patients with chronic inflammatory or degenerative joint pain to monitor changes in pain levels over time. In patients with rheumatoid arthritis, the minimal clinically significant change has been estimated as 1.1 points on an 11-point scale (or 11 points on a 100-point scale).
The VAS is a valuable tool for quantifying muscle soreness, which can be challenging for doctors and researchers. Traditionally, muscle soreness has been measured using the VAS, with participants marking their level of agreement to a statement along a continuous line.
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Distinguishing soreness from injury
Muscle soreness, or Delayed Onset Muscle Soreness (DOMS), is a common occurrence after a workout, particularly if you're new to training or have been inactive for a while. It usually presents itself 24-72 hours after exercise and can make you feel stiff, slow to move, and tender to the touch. The pain is typically dull and achy, and you may feel it across all the muscles involved in the activity. For example, you might feel it in your entire lower body after a run or cycle.
While soreness is a common and normal experience, it's important to distinguish it from an injury. Actual injuries can occur for a variety of reasons and often feel different from muscle soreness. For example, pain in your shins could be shin splints, while joint pain could signal a torn tendon or ligament.
- Type and intensity of pain: Muscle soreness typically presents as a dull, achy pain, while sports injuries often cause sharp, acute pain.
- Improvement with rest: Soreness often improves with rest, light stretching, and proper hydration. If your pain persists despite these measures, it may indicate an injury.
- Range of motion: With muscle soreness, your range of motion is generally unaffected or only minimally restricted due to discomfort. With an injury, you may experience a limited range of motion in the affected joint or muscle group, indicating potential ligament, tendon, or muscle damage.
- Swelling and bruising: Swelling is uncommon with muscle soreness, and there are typically no visible signs of tissue damage or inflammation. In contrast, sports injuries may present with swelling, bruising, or visible deformity, indicating tissue damage.
- Prolonged pain: If your pain persists for more than a few days, it's a good idea to seek a medical assessment to rule out any underlying injuries.
In summary, while muscle soreness is a common and typically harmless experience, it's important to be able to distinguish it from an injury. By paying attention to the type and intensity of pain, how it responds to rest and self-care measures, and any changes in your range of motion or physical appearance, you can better understand whether you're dealing with soreness or an injury that requires medical attention.
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Unidimensional pain instrumentation
The VAS is a simple, reliable, and valid measure of the quality and quantity of pain. It is also used to measure general muscle pain severity. However, it is not a perfect measure of muscle soreness. Pain is a multidimensional phenomenon, and the VAS does not capture its sensory, affective, and evaluative aspects.
The VAS has traditionally been used to measure muscle soreness because it is a quick and easy way to assess pain. It is also non-invasive, which is important for patients as other techniques, such as needle biopsies, are painful and uncomfortable.
Despite its widespread use, the VAS may not be the most accurate measure of muscle soreness. As mentioned, it does not capture the multidimensional nature of pain. Furthermore, the VAS is a subjective measure, and different people may have different interpretations of the same pain stimulus. This subjectivity may make it difficult to compare results between participants and draw meaningful conclusions.
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Multidimensional pain instrumentation
Muscle soreness, or Delayed Onset Muscle Soreness (DOMS), is a common sports injury, yet there is no gold standard for measuring it. Traditionally, muscle soreness has been measured using the Visual Analogue Scale (VAS), where participants mark their level of agreement to a statement along a continuous line. However, this method only measures the intensity of pain on one evaluative level.
Pain is a multidimensional phenomenon, and to capture multiple aspects of a patient's pain experience, multidimensional pain instrumentation has been developed. The most well-known multidimensional instrument is the McGill Pain Questionnaire (MPQ), which has been used to assess delayed-onset muscle soreness (DOMS). The MPQ assesses the present pain intensity (PPI), or magnitude of pain, based on a 0-5 scale. The Short Recovery and Stress Scale for Sport (SRSS) is another multidimensional instrument that has been used to quantify recovery and stress.
The most frequently selected DOMS descriptors in a study were "tight" (95% of participants), "sore" (86%), "tender" (86%), "annoying" (86%), and "pulling" (68%). These findings may help researchers and sports medicine professionals distinguish between delayed-onset muscle soreness and other more serious musculoskeletal damage.
While multidimensional pain instrumentation provides a more comprehensive assessment of pain, it can be cumbersome to administer in busy clinical settings. Therefore, it is important to select a pain measurement tool that best fits the practice and can be used consistently over time.
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Frequently asked questions
Muscle soreness usually appears a day or two after exercising, whereas a pulled muscle will be painful immediately. A pulled muscle will also be associated with other symptoms such as swelling, bruising, and difficulty moving the joints nearby.
Simple remedies for muscle soreness include using an ice pack, massages, stretching, and rest.
Muscle soreness should not last longer than five days. If the pain doesn’t subside after a week, seek medical attention as this could indicate a bigger issue.
Muscle soreness has traditionally been measured using the visual analogue scale (VAS), where participants mark their level of agreement to a statement along a continuous line. Researchers have also used thermal imaging to detect subtle changes in the temperature of the skin above exercised muscles.
