When does muscle soreness become an injury – and what to do about it

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Two common questions we get asked are “How can I tell the difference between a potential injury or just muscle soreness after I exercise?” and “When should I seek treatment?”.

Post-exercise muscle soreness (commonly known as Delayed Onset Muscle Soreness – or DOMS) will settle by itself whereas a muscle injury won’t.


Here are a few facts about DOMS which will help you make an informed decision on whether you need to seek some advice from our Physio team.

    • Muscle soreness or Delayed Onset Muscle Soreness (DOMS) generally presents itself as a diffuse pain that is present within a complete muscle or muscle group eg. the whole quad muscle.
    • It particularly occurs after unfamiliar or strenuous activity and the soreness peaks at about 36 hours post exercise. So, if you train on Saturday – you’ll feel bad Sunday morning and often worse Monday morning!
    • It is reversible (i.e. gets better by itself)
    • There may be some associated weakness and loss of range of motion which may last up to one week.
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    • A muscle tear, on the other hand, will present as more point tenderness and is often associated with an incident when you feel the muscle “go”. It will not start to get better by itself after 36 hours and further medical attention is often needed to guide its recovery. You should see your Physio if this is the case.


So, if I’ve got sore muscles – what do I do?
DOMS is relatively benign and there appears to be less soreness and tissue damage with repeated bouts of the unfamiliar exercise, which indicates some degree of muscle adaptation to muscle soreness with training. My advice would be to increase training gradually to avoid muscle soreness. And once you are used to your new regime, you should be ok further down the track.

The nature of exercising and trying to gain strength or fitness means that you will often feel fatigued and sore during periods of heavy training. Overloading our musculoskeletal system and allowing it to recover is how we make gains and get stronger.
The fine line is that if we don’t allow adequate recovery and keep training then we get injured.
Your individual threshold for how much training load your body can handle before injury will depend upon your athletic history (how long you have been consistently training for), your biomechanics and your genetic make-up.
The longer you have been training at a consistent level the better your musculoskeletal system will have adapted to tolerating a higher training load, the better your biomechanics are the more efficient you will move and you will have a corresponding reduced risk of injury, and if you inherited good connective tissue and bone genes from your parents you will have a lower risk of injury.
Unfortunately, we can’t do much about who your parents are but we can control the other factors to a certain extent.


As a general rule:
– If it’s general muscle soreness from a change in training program or exercise then have a couple of days easy training or rest
– If it’s a new niggle that you haven’t felt before get it checked out- you don’t want to miss anything nasty
– If it’s an old niggle that you have been able to self-manage in the past with guidance from your Physio then you are OK to continue to train eg. recurring shin splints that you have been able to settle in the past with icing, stretching and massage
– If you continue to train and it’s not improving or getting worse then see your Physio team


So sore muscles are mostly ok – what about sore joints?
Whilst sore muscles are part of the process of getting stronger and fitter, sore joints are NOT. Damage done to muscles in training trigger a process of repair where the muscle gets stronger as a result. Joint soreness is often indicative of overload in the joint tissues i.e. cartilage, tendons, ligaments, most of which are unable to repair themselves if this continues to happen.
Rest and ice are advisable to begin with and use pain as a guide to see if cross training with another sort of exercise will be ok. The problem with these sorts of injuries is that as soon as you recommence your exercise that pain will return.
If it does return, it is time to seek the advice of a Physio before continuing.


SquareOne are experts in diagnosing injuries from exercise and making the necessary changes to allow you to return to training and achieve what you set out to achieve.
If you’d also like to reduce your injury risk and improve your performance we’d love to show you how.

Call 9968 3424 or book online www.squareonephysio.com.au to make an appointment today.


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