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Muscle soreness is an extremely common phenomenon, with almost everyone experiencing some form of muscle pain at some point in their lives. This pain can be caused by various factors, including physical activity, stress, tension, injury, and certain medications. While muscle soreness is typically associated with physical exertion, it is essential to note that it can also be a symptom of more serious underlying conditions. For example, myalgia, or muscle pain, can be a sign of chronic fatigue syndrome, fibromyalgia, or statin drugs used to treat high cholesterol. Intense exercise can lead to delayed onset muscle soreness (DOMS), which occurs when there is not enough oxygen available during physical activity, causing the body to produce lactate, which then leads to the buildup of lactic acid. However, recent research has suggested that lactic acid may not be the primary cause of muscle soreness, and it is instead the muscle damage from intense physical activity that causes the pain.
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What You'll Learn
Delayed onset muscle soreness (DOMS)
Delayed-onset muscle soreness (DOMS) is muscle pain that begins after you’ve worked out, typically affecting multiple limbs. It normally starts 12 to 24 hours after a workout, peaking at one to three days, and then subsiding by seven days. DOMS is a familiar experience for elite and novice athletes alike, and it can occur in recreational athletes who sporadically participate in sports, as well as professional athletes engaging in intensified training after an injury. DOMS is also common at the beginning of the sporting season when athletes are returning to training after a period of reduced activity.
The pain is thought to be caused by eccentric exercises, which cause muscle lengthening and small-scale damage (microtrauma) to the muscle fibres. Eccentric exercises cause you to tense a muscle while simultaneously lengthening it. For example, the controlled, downward motion as you straighten your forearm after a bicep curl is an eccentric movement. The soreness has been attributed to the increased tension force from eccentric exercise. When microtrauma occurs to these structures, nociceptors (pain receptors) within the muscle's connective tissues are stimulated and cause a sensation of pain.
The severity of DOMS symptoms correlates with the intensity and duration of the activity. Symptoms can range from muscle tenderness to severe debilitating pain. In rare cases, patients with DOMS can develop severe swelling of the muscles, leading to a condition called compartment syndrome, which requires emergency medical attention.
While the mechanism of DOMS is not completely understood, it is generally considered a normal part of a new exercise program. Implementing recovery strategies after exercises that cause DOMS is vital for restoring muscular strength and performance levels. It is recommended to skip high-intensity cardio or power-lifting sessions when experiencing DOMS, as these activities may worsen and delay recovery. Instead, gentle movements, such as light concentric exercises, gentle yoga, low- to moderate-intensity walking, cycling, or swimming, can be beneficial. Additionally, treatments such as massage, nerve mobilization, hot baths, or sauna visits may help increase blood flow to the muscles and provide some relief.
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Microtears and inflammation
Delayed Onset Muscle Soreness (DOMS) is a common phenomenon experienced by many 24 to 72 hours after a workout. It is caused by microscopic tears in the muscle fibres, known as microtrauma, which are a normal part of the muscle-building process. This microtrauma is followed by an inflammatory response, which is the body's natural reaction to injury.
During exercise, skeletal muscles undergo tissue destruction and reconstruction, leading to the creation of microtears in the muscle fibres. This damage initially occurs as "tears" in the muscle membrane, destroying the integrity of the sarcolemma and reducing the connection of the muscle membrane to the cytoskeleton. This lack of connection with the cytoskeleton makes the muscle fibres more fragile and susceptible to further damage.
The body's inflammatory response to these microtears is a natural part of the healing process. It involves the activation of local macrophages and mast cells, which release inflammatory cytokines that stimulate muscle repair. Neutrophils are also recruited to the site of injury, further promoting the healing process. However, in some cases, the inflammatory response can become excessive and lead to myofiber necrosis instead of repair.
The symptoms of DOMS include reduced strength, loss of range of motion, stiffness, swelling, and altered movement patterns. While it is a normal part of the muscle-building process, experiencing DOMS can be uncomfortable and reduce performance. Therefore, it is generally recommended to reduce the intensity of workouts near competition or important events.
There are several ways to alleviate the discomfort associated with DOMS. Non-Steroidal Anti-inflammatory Drugs (NSAIDs) like ibuprofen have been shown to reduce inflammation and provide relief. Additionally, continued exercise, adequate rest, and proper nutrition are crucial for muscle recovery and reducing soreness.
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Lactic acid is not the cause
Lactic acid is a chemical your body produces when your cells break down carbohydrates for energy. It is a common misconception that muscle soreness after a workout is caused by a build-up of lactic acid in your cells. This idea was debunked in the 1980s.
Lactic acid is flushed out of your muscles quickly, so it does not cause cell damage or pain. Instead, muscle soreness is caused by microtears (tiny tears in your muscle fibres). This is actually a good thing, as repairing these microtears makes muscles grow bigger and stronger. If you are experiencing severe muscle pain, you may have an injury such as a pulled muscle.
Dr. Corbin Hedt, a physical therapist at Houston Methodist, explains that muscle soreness occurs because muscle and the connective tissue around it get damaged during exercise. This is normal and necessary for muscle growth, as the muscle is built back stronger during the repair process.
Furthermore, lactic acid may actually be beneficial for muscle regeneration. Dr. Hedt suggests that a build-up of lactic acid might act as a signal to your body that your muscles have been working hard and need to be repaired and rebuilt. Therefore, rather than trying to reduce lactic acid build-up, you may want to encourage it to signal to your body that the area needs attention.
In summary, lactic acid is not the cause of muscle soreness after exercise. Muscle soreness is caused by microtears and inflammation, which are a normal and beneficial part of the muscle growth process. Lactic acid may even play a role in signalling to your body that your muscles need to be repaired.
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Rhabdomyolysis (a rare condition)
Rhabdomyolysis, also known as "rhabdo", is a rare but dangerous condition caused by a direct or indirect muscle injury. It occurs when muscle fibres die and release their contents into the bloodstream. This can lead to serious complications such as renal (kidney) failure, as the kidneys are responsible for removing these components from the blood. If kidney function is compromised, waste products can build up in the body, leading to a life-threatening situation.
The classic symptoms of rhabdomyolysis include muscle pain, particularly in the shoulders, thighs, or lower back, as well as muscle stiffness and weakness. However, it is important to note that about half of those with the condition may not experience any muscle-related symptoms at all. Other signs to look out for include changes in urine colour, such as dark urine that appears brown, red, or tea-coloured. This is an indication of myoglobin, a protein that is released from damaged muscles, being present in the urine.
The condition can be caused by overexertion or intense workouts, particularly high-intensity interval training or CrossFit. It can also be caused by trauma, medications, underlying health conditions, or exposure to certain drugs, toxins, or high levels of alcohol. Some people may be at a higher risk, including marathon runners, athletes, and those working in high-temperature environments.
If you suspect you are experiencing symptoms of rhabdomyolysis, it is important to seek immediate medical attention. Treatment often involves hospitalisation and the administration of IV fluids to maintain urine production and prevent kidney failure. In some cases, dialysis treatment may be necessary to support kidney function.
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Treatment and prevention
Muscle soreness is a common phenomenon, and it is often caused by exposing muscles to a new or unusual form of stress. This stress can be from structured exercise or other physically straining activities. While this soreness is generally harmless, it can sometimes be indicative of a more serious condition.
If you are experiencing muscle soreness, there are several ways to treat and manage the pain. Here are some strategies to consider:
- Rest and Recovery: While complete rest might not be advisable, modifying your activities and taking a break from intense exercises can help. Listen to your body, and reduce the intensity or duration of your workouts until the soreness subsides.
- Light Exercise: Instead of remaining completely sedentary, try engaging in light exercises such as gentle yoga, walking, or swimming. Light exercises can increase blood flow to the sore muscles, providing them with oxygen and nutrients to expedite the healing process.
- Stretching and Warm-up/Cool-down: Incorporate stretching before and after your workouts. A proper cool-down routine consisting of 5-10 minutes of light aerobic activity can help eliminate lactic acid buildup and reduce muscle soreness.
- Hot and Cold Therapy: Applying ice to the affected area can help relieve pain and reduce inflammation. Use ice for the initial 1-3 days, and then switch to heat for any remaining soreness after 3 days.
- Hydration: Ensure that you stay adequately hydrated, especially when engaging in physical activities. Proper hydration can help reduce the severity of muscle damage.
- Anti-inflammatory Diet: Consume foods that have natural anti-inflammatory properties, such as watermelon, cherry juice, and pineapple. These foods may help alleviate some of the soreness.
- Protein Intake: Include sufficient protein in your diet, as it is essential for repairing and rebuilding damaged muscles.
- Gradual Progression: When introducing new exercises or increasing intensity, start with lower-intensity versions of the exercises and gradually progress. This gives your body time to adjust and reduces the risk of excessive soreness.
While these treatments can help alleviate muscle soreness, it is also important to listen to your body and seek medical advice if the soreness persists or is accompanied by other concerning symptoms.
Preventing Muscle Soreness
While there is no consensus on completely preventing sore muscles, you can take several measures to reduce the likelihood and intensity of muscle soreness:
- Pacing and Progression: Avoid overexerting yourself during workouts. Gradually increase the intensity and duration of your exercises over time, allowing your body to adjust.
- Warm-up and Cool-down: Always include a warm-up and cool-down routine in your exercise sessions. This helps prepare your muscles for activity and aids in recovery.
- Stretching: Regular stretching, both before and after workouts, can help prevent muscle soreness.
- Hydration: Stay adequately hydrated, especially on days when you are physically active.
- Regular Exercise: Engage in regular physical activity to promote optimal muscle tone and reduce the risk of excessive soreness.
By incorporating these strategies into your fitness routine, you can help reduce the occurrence and intensity of muscle soreness. Remember to always listen to your body and adjust your exercises accordingly.
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Frequently asked questions
Your muscles are likely sore because they have been exposed to stress they are unaccustomed to. This can be from structured exercise or other physically straining events such as gardening or household activities. The acute muscular stress causes small-scale damage to the muscle fibres, which we normally feel anywhere from 24-72 hours after exercise.
Light exercise, such as walking, can help to increase blood flow to damaged muscles, bringing oxygen and nutrients to them and expediting the healing process. Anti-inflammatory foods such as watermelon, cherry juice and pineapple may also help. Staying hydrated is important, as dehydrated muscles are more susceptible to damage.
No, this is a common misconception. While lactic acid is created as a byproduct when your muscles are making energy anaerobically, it generally clears out within an hour after exercise. The muscle soreness you feel is more likely caused by the pressure inside and between muscle cells increasing, stimulating nerve endings and causing discomfort.
Muscle soreness is extremely common, and often a result of too much stress, tension, or physical activity. However, in some cases, it can be a sign of something more serious. If you experience symptoms such as dark urine, muscle cramps or fatigue, you should seek medical attention as these could be signs of rhabdomyolysis, or rhabdo, a rare but dangerous condition.
