Dealing With the Aches of Post-Exercise Pain September 29, 2015 10:52



So, what to do about  post-exercise pain - often referred to as delayed onset muscle soreness (DOMS)?

It might sound counter intuitive, but one of the best ways is to keep moving, says Victor Ibrahim, a team physician for the soccer team D.C. United.

"Light movement - for example, a cool-down after working out - is very helpful," Ibrahim says.

In fact, one study says that exercise is the most effective means to alleviate pain during DOMS, which appears between 24 and 72 hours after exercise.

Which raises the question: What kind of exercise causes this pain and what exactly is happening in the body when the pain occurs?

"Generally, the more impact on the muscle, the more soreness," Ibrahim says. That impact will be more dramatic and jarring in a weakened muscle (makes sense!), which is why a sudden uptick in exercise can be quite painful.


"This is also the reason spring training camps are so painful. Having been involved in preseason training for NFL, NHL, NBA and MLS players, I can assure you even the elite athletes are not immune," Ibrahim says.

In terms of the type of impact, eccentric strain seems to cause the most soreness, says Matt Fitzgerald, a running coach, sports nutritionist and author of dozens of training books, including "The New Rules of Marathon and Half-Marathon Nutrition."

"Eccentric strain occurs when a muscle tries to resist its own lengthening," Fitzgerald says. For example, when you run, he says, the quadriceps (front thigh) stretches when the foot lands and at the same time resists the stretch to keep the knee from buckling.

"So, in essence, the muscle is being pulled in two different directions at once, which causes microscopic tearing of muscle fibers and subsequent soreness," he says.

The exact physiological cause of delayed onset muscle pain is still under debate, but most researchers believe it's a result of muscle trauma repair, Ibrahim says, adding that isometric (static) muscle exercise can also cause DOMS, while it seems that concentric (dynamic) contractions (such as the up phase in a biceps curl) do not.

Many things happen during muscle trauma repair, including inflammation (part of the body's healing process) - which is why taking anti-inflammatories can help with the initial pain reduction but does not seem to help in muscle repair long term.


But let's get back to you and your pain and ways you might get rid of it!

How about a massage, foam rolling and other ways to "rub out" the pain?

"Massage can be really helpful, especially if you get it early on," says Liz Puloka, a Washington massage therapist. "Massage increases the blood flow - it brings in fresh blood and lymph to the affected area."

She says Swedish massage - which uses five styles of strokes - is the most effective type of massage for DOMS because it is especially beneficial for improving blood circulation.

But Puloka says even though a massage is helpful, she would personally "attack the muscle soreness from as many angles as possible."

"I would encourage movement," she says, echoing Ibrahim. "Movement is essentially an internal massage for the body."

She also recommends applying heat, which has been shown to reduce soreness.

Ibrahim agrees:

"Improving circulation is helpful. A hot shower or hot tub does the trick for most of our athletes," he says, adding, "Always make sure you are well hydrated before hitting a hot tub post-exercise."