“There is a difference between pain—sharp, stabbing unwanted pain—and soreness,” Cicero said. “Soreness, muscle fatigue—that is a normal function of the body; you did work. Pain is sharp, stabbing, unwanted. … Pain is your body telling you, ‘No.’’
Let’s first consider soreness. Who among us has not done Karen —150 wall-ball shots for time—and then woken two days later to find limited ability to get off the toilet unassisted?
This is the product of delayed onset muscle soreness (DOMS), muscle tenderness or discomfort observed 24-72 hours after exercise. Scientists don’t agree on its origins—lactic acid, muscle spasms, connective-tissue damage, muscle damage, and inflammation, among other things, have been suggested as causes—but many agree that exercise is the most effective way to diminish its effects, possibly due to the “break up of adhesions in the sore muscles, increased removal of noxious waste products via an increased blood flow or an increased endorphin release during activity,” wrote the authors of “Delayed Onset Muscle Soreness: Treatment Strategies and Performance Factors.”
Somewhat counterintuitively, exercise can also prevent DOMS. Though elite athletes who train regularly still experience it, DOMS is more common among new athletes who are unaccustomed to training—as well as those of us who’ve taken a few too many consecutive “rest days.”
Referring to what’s called the “repeated bout effect,” researchers wrote that “even a single bout of eccentric exercise has a protective effect against exercise-induced muscle injury, DOMS, and loss of strength from exercise undertaken up to 6 months later.”
And if you’ve already made the mistake of skipping one too many workouts and are now suffering the consequences?
“Instead of going in and doing another workout, you can go in and mobilize,” Cicero said. “You’re not resting the body; you’re doing active recovery.”
Just Keep Moving
Injury, however, is not sore quads after a lengthy squat session. Injury is sharp, shooting pain—and it’s indicative of a greater problem.
“Something that’s functional, something that’s body weight, should not hurt if you’re doing the movement correctly,” said Cicero, now a trainer at Seven Devils CrossFit in Helena, Montana. “If there’s a pain in a squat … something has to be wrong.”
Pain means you should stop doing the thing that hurts and go see a professional, he continued. But it doesn’t mean you should stop doing things altogether. Cicero described how some patients who came to him after sustaining an injury ceased activity for several days or weeks and found they were no better for it.
“There’s a dysfunction in there that is causing the problem, and you’re not doing anything about it—that’s why you still have pain,” Cicero explained. “If you rest and the body is out of its normal alignment, you’re not gonna get any better. Yeah, it will start to feel better as the muscles relax, but when you go to do something again, the muscles are just gonna tighten back down because they’re not in the right position. You have to fix the problem.”
Athletes should seek the help of a medical professional in the event of injury, Cicero said, but the key to effective recovery is to remain active and continue to use those muscle groups as much as possible.
“If you don’t use them, they’re gonna tighten down. They’re gonna become atrophied,” he said. He noted that athletes are at increased risk for further injury upon return to training if the muscles have been weakened.
Cicero’s philosophy is backed by research. Kyle Cicero, doctor of physical therapy and owner of Ascension Physical Therapy.
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