Muscle pain: Is it soreness or an injury?

CNET Technology 3 weeks ago

Everyone from fitness novice to elite athlete knows that when you workout hard, it hurts. Post-workout muscle soreness can sometimes be so debilitating you aren't sure if you'll ever hit the gym again. And on the flip side, some injuries are so minor that you might not know you're actually injured until it gets worse (looking at you, shin splints). 

In any case, you might have some hesitations when deciding whether you crush a workout or take it easy -- knowing the difference between soreness and injury is essential to keeping you in the game. Next time you can't tell whether you're just sore or you're injured, ask yourself these nine questions.

When did the pain start?

Depending on how tough your workout is, delayed-onset muscle soreness (DOMS), the kind of pain caused by microtraumas to your muscles, can set in anywhere from 12 to 24 hours after your workout. Peak soreness often hits around 48 hours post-workout -- that's why you always hear fitness people say "The second day is always the worst." 

Pain from an injury, however, usually sets in immediately after the injury occurs. If you feel immediate, sudden pain during or after a workout, you'll probably know right away that you've been injured. 

And if you're exercising with a prior injury -- say, a pulled calf muscle that hasn't completely healed but doesn't bother you too bad -- you'll likely feel pain immediately after your workout, whereas a sore calf muscle wouldn't become painful until about 12 hours later.

How long has the pain lasted?

DOMS peaks anywhere from 48 to 72 hours post-workout, but you might feel tight and slightly achy up to a week after the initial workout that made you sore. However, you should notice a significant improvement in mobility and exercise performance once you hit the three-day mark. You may also notice fluctuations in pain intensity over the course of the week that you're dealing with DOMS.

Pain from an injury usually persists longer than that, and tends to get more intense as days go by if left untreated. So if you didn't feel immediate pain during or after your workout, but you notice that the pain isn't subsiding like it should, that's a clue you have an injury. 

What does it feel like?

With DOMS, your muscles will feel tight and tender to the touch, with a consistent dull ache. It's annoying, but usually not so bad that you can't complete normal daily activities, like walking or getting in and out of a car. When exercising with DOMS, the pain may prohibit you from reaching your normal range of motion (for instance, not being able to squat to full depth) and you may feel like you reach your lactic acid threshold sooner (your muscles start burning earlier than they normally would). 

Injury pain is more often described as sharp or shooting, and associated with particular movements. For example, if you injured your hamstring, picking items up from the ground or doing a deadlift will probably cause a sharp pain in the back of your thigh. 

Muscle soreness is usually widespread, while injury pain is usually localized.

Where does it hurt?

Where you feel pain makes a big difference in determining whether you have an injury or you're just sore. If you can pinpoint the exact area of pain, or the pain involves a small area that hurts when pressed on, you may have an injury -- especially if the small area is on a bone, joint or tendon. 

DOMS, on the other hand, usually involves a broader area and is confined to your muscles, like the meaty part of your leg (quads or hamstrings) or your abdominal muscles. 

Some tricky areas, such as your shoulders and lower back, may make you think you're injured when you're not. In those cases, consider whether the pain is symmetrical. If both of your shoulders hurt, there's a good chance they're just sore. Same with your lower back. But if only one shoulder hurts, or you feel localized pain in your lower back, you may have an injury. 

Radiating pain from a localized area is another sign of injury, such as if your shoulder is the source of pain but the pain radiates down your arm or into your neck. These types of pain usually feel like a dull burning or tingling sensation and can signal nerve injury. 

Does resting help?

For the most part, remaining sedentary makes DOMS worse. The best way to find relief is to engage in light activity that gets your blood flowing, such as walking or rowing. Sitting for long periods of time with DOMS can increase tightness and further inhibit your range of motion. 

Injuries, however, benefit from rest and worsen with continued activity. One way to differentiate: How does the pain feel after you've started moving around? DOMS usually starts to let up once you get moving because blood flow helps. Injuries, however, don't get any less painful. So next time you go to the gym, note how the pain feels during and after the warmup. If it's gotten better, you're good to go; if it's gotten worse, you should take it easy. 

If you've injured your leg, resting should help. If your leg is sore, resting may make you even more stiff and achy.

Does stretching help?

While you can't get rid of DOMS once it's set in (only time will cure it), you may find relief with workout recovery techniques such as stretching, foam rollingheat therapy, massage and compression therapy. If these activities improve your range of motion and offer some temporary relief, you're just sore. 

If workout recovery techniques do nothing for your pain or make it worse, you should see a doctor because there's a good chance you're injured.

When do you feel pain? 

Muscle soreness, unless unusually severe, shouldn't cause pain when you are sedentary. That is, if you're sitting in front of the TV and aren't consistently changing positions, you should feel fine. If you're injured, you will most likely feel pain both while you're sedentary and during activity. 

Do you have swelling or redness? 

Swelling and redness are two major signs of inflammation, a key indicator that your body is trying to heal something. If you're injured, you'll experience swelling in a localized area, and it might be tender to the touch. The swelling may also be accompanied by a burning sensation.

You might experience some swelling with DOMS, but that usually only happens when DOMS is severe. Swelling after a workout is due to a build-up of fluids, including water and blood, as well as nutrients and other particles that your body sends to help repair the muscles. If you do experience DOMS swelling, it'll appear over a large area, usually the entire muscle that is sore. 

Did you hear any unusual sounds?

Injuries are usually, though not always, accompanied by sounds. This is not the case with muscle breakdown from DOMS. You may hear a popping or snapping sound if you tear a muscle or ligament, or a cracking sound if you injure a joint. 

However, your joints might make noise that does not signal injury. Crepitus, or any abnormal sound of a joint, refers to harmless cracking and popping without the presence of pain -- such as when you crack your back or knuckles. The release of gases from your joints is usually the cause of crepitus (and no, it doesn't cause arthritis).

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives. 

Tags: Fitness

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