Understanding why you have pain is better than knowing you’ve got pain
We’ve all been there. We have a sneaky week off and return to training or have a really intense workout. The next day your stiff as a board getting out of bed, can’t bend down to put your socks on and cursing those heavy dead lifts you did yesterday. But how do you differentiate the typical soreness after training compared to the feeling of a true injury?
Delayed Onset Muscle Soreness (DOMS)
DOMS refers to muscle pain that follows exercise induced muscle damage. The intensity of soreness increases during the first 24-48 hours before subsiding (1).
The “muscle damage” is classed as micro trauma. Not large enough to cause a serious muscle tear, but enough to cause an inflammatory response. Resulting in the release of noxious chemicals that bind to pain receptors (nociceptors) causing sensitisation of that muscle (2).
Previously it was thought that the stress from lactic acid build up contributed to DOMS. This has been debunked based on the rate that blood-lactate levels return back to normal post workout (3).
Is it safe to train with DOMS?
The literature shows that exercise is the best modality for subsiding DOMS (4). Training should focus on a lower intensity and lighter loads until the pain subsides.
The minor risk of training with DOMS is a change in motor patterns. The soreness can reduce activation of desired muscles (5). Severe DOMS can decrease strength by up to 50% (6). This makes it even more important to reduce the intensity and load, while focusing on form and technique.
What to expect with a strain?
A strain is most common in a muscle or a ligament, this can be graded by partial, tearing of small fibers. Subtotal, like a partial tear. Or complete, which is a complete rupture (7).
When training pain is felt almost immediately if strained. It tends to not have the long 24 hour delay that DOMS has. Additionally the pain felt with DOMS settles around the 2nd-3rd day, with a strain the pain will go on for longer.
The type of pain differs from DOMS. With DOMS you will feel a tightness or a burn. An injury feels more like a sharpness or an ache. When resting; with DOMS you’ll be pain free until moving, but with a strain you may feel a dull ache when stationary.
Ignoring these symptoms and passing it off as DOMS is not the safest thing to do. Training with an injury and training with DOMS have two different strategies. If you’re experiencing these feelings of a strain get it assessed to ensure the injury recovers normally.
There is a great difference between knowing and understanding: you can know a lot about something and not really understand it.
- Bakhtiary et al, (2007), Influence of vibration on delayed onset of muscle soreness following eccentric exercise. Br Jr sprts med
- O’Conner et al, (1999), Exercise and pain: the neurobiology, measurement, and laboratory study of pain in relation to exercise in humans. Exerc Sport Sci Rev
- Schwane et al, (2016), Is Lactic Acid Related to Delayed-Onset Muscle Soreness? Phys and Sprts Med
- Sethi, (2012), Literature review of Management of Delayed onset muscle soreness (DOMS). Int J Biol Med Res
- Trost et al, (2012), Pain-related fear predicts reduced spinal motion following experimental back injury. Pain
- Paulsen et al, (2012) Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc. Immunol.
- Kerkhoffs et al, (2014) Acute Muscle Injuries. Springer