Sunday, January 12, 2020

How to Deal When Post-Workout Muscle Soreness Is Actually Really Painful

These five tips might help ease your misery.
By Alexa Tucker




The great paradox of exercise is that muscles get stronger by breaking down first—the rebuilding process after a workout is where the real magic happens. Sometimes, that can leave your muscles feeling a little sore and achy, which is totally normal (albeit, uncomfortable). But there's normal sore, and then there's too sore.

I'm talking about that wincing-in-pain, what-have-I-done, I-can't-move kind of soreness that lasts for days. A few weeks ago, I became very familiar with this feeling after taking a seemingly innocent barre class that I hadn't been to in years. My calves definitely worked harder than usual because I spent so much time on my toes, but overall, I felt pretty good during the workout.

Fast-forward about 48 hours: I stepped out of bed and audibly gasped from how excruciatingly tight and pained my lower legs were—I couldn't bear my bodyweight standing on them. Yes, I'd been sore the day before too, but this was on another level. As someone who works out regularly, I was shocked at how brutal it felt.


The technical term for post-exercise soreness is DOMS, or delayed-onset muscle soreness.

DOMS usually peaks 48 to 72 hours after a workout, as your body really goes to work on the process to repair muscle fibers that were torn during exercise. There are varying degrees of pain depending on how much damage has been done (and other factors like genetics and how hydrated you are), but regularly experiencing an extreme level of soreness isn't something you should make a habit of.

"There's some research showing that the muscles can actually atrophy [or break down too much] when they get that sore—it's almost like the muscle was overworked, and it can't repair itself adequately," exercise physiologist Joel Seedman, Ph.D., owner of Advanced Human Performance in Atlanta, Georgia, tells SELF. So no, just because you're more sore doesn't mean you’re getting better results. Plus, since you need more time off to recover, it can throw a wrench in your workout plan and make you miss out on additional days of training.

Extreme soreness can happen occasionally, usually after you've done something your muscles aren't used to.

"Every now and then, you might get carried away, you might go to a new class, or you might have a [substitute instructor]," exercise physiologist and ACE-certified personal trainer and spokesperson Pete McCall, M.S., C.S.C.S., host of the All About Fitness podcast, tells SELF. When you’re suddenly using muscles in new ways or engaging smaller muscles that your typical workouts rarely touch, you stress the muscles way more than they’re accustomed to or prepared for. Basically, extreme soreness can happen anytime you do something your muscles aren't familiar with—even if that's just going extra hard in a competitive bootcamp class.

Workouts that include a lot of eccentric exercises are also more likely to leave you hobbling the next day. Strength exercises have two phases: the concentric (the lifting part) and the eccentric (the lowering part). The eccentric phase is where you're actually creating tears in the muscle fibers, and it's also where your muscles are working at their strongest. "You get this really high level of force production in the muscles, so you have a false sense of how much exercise you can keep doing because you haven't fatigued that much," says Seedman. (Unfortunately, this can make it tricky to tell when you're overdoing it.) Making an educated guess about my barre class, I think the many, many sets of slowly lowering my heels to the ground after being on relevĂ© (on my toes) might've been to blame for my major soreness, because the focus was on the eccentric part of the movement—and it’s not something I do regularly during my workouts.

The best remedy for soreness is time—but there are a few things you can try that might help ease the pain a bit.

Unfortunately, if you're already in the throes of monumental soreness, the only sure-fire remedy is time (generally, DOMS lasts about two to three days after the soreness peaks, says McCall). But there are a few things you can do to hopefully help ease the pain while you wait, and in some cases, maybe even speed the process along.


1. Get in some light movement.

Yes, this sucks. "But if you're really sore and you decide you're not going to get off the couch, that's the worst thing you can do," says McCall. This is because activity increases circulation, improving blood flow throughout the body.

“It’s thought that increased blood flow and nutrients to the muscles does, in fact, speed up the repair process, which in turn should reduce DOMS,” says Seedman. While more research needs to be done, we do know that blood carries nutrients and oxygen to muscle tissue, he explains—in particular, amino acids, which are the “building blocks” of muscle repair. The idea is that the faster these nutrients get to their destination (via blood flow), the faster they can get to work, and the faster you’ll feel better.

Now, this doesn't mean you should go back to your regularly scheduled workout programming—we're talking gentle activity, like going for a walk or hopping on a recumbent bike at the gym. If you can manage it, Seedman also recommends some very light strength training. "Blood flow is huge, and that's why strength training is so productive—it's one of the best ways to get blood flow [directly] into those muscles," says Seedman.

But seriously, light means super light, since you don't want to do more damage to the muscle fibers. Seedman suggests using just 25 to 50 percent of the weight you'd normally use, or stick to bodyweight exercises.

2. Hydrate, hydrate, hydrate.

Step two: Drink water. “A brief body of research shows a correlation between dehydration and increased muscle soreness and DOMS,” explains Seedman. While more research needs to be done, “researchers and practitioners have postulated that if dehydration increases soreness, then increased levels of hydration can minimize it,” he adds.

The main theory here is that water helps flush out waste products, he explains. When muscles break down, they release waste products and toxins that need to be filtered out of the body (like hydrogen ions and an enzyme called creatine kinase), explains Seedman. These waste products (among others) are associated with increased soreness, Seedman says.

While your kidneys and liver are ultimately responsible for filtering out toxins (after all, it’s our organs, not anything we eat or drink, that detox our bodies) staying hydrated may help move along this process—and staying hydrated is always a good idea anyway.

3. Do some light stretching.

Again, the keyword is light. Stretching can be a great way to release tightness and increase your range of motion when you're sore—which can make you feel better, even though it’s not actually healing the tears in your muscles or making them repair any faster. But more isn't always more. "You have to be careful," says Seedman. "Doing some light stretching can be good, but trying to overstretch the muscle when it feels extremely tight can actually cause the muscle to come back even tighter because the body is trying to resist it," he says.

So how do you know how far is too far? "Stretch until it feels pretty tight, let up after 5 to 10 seconds, and then repeat that, without ever getting to the point where it feels unbearable," says Seedman. If it's too painful to even think about stretching, skip it—it's really just about getting some temporary relief if you can.

4. Make sure you're getting enough protein.

Protein is a critical nutrient for building and maintaining muscle, so it plays a huge role in helping your muscles recover from a tough workout.

While you should be eating enough protein all the time to prevent recurring or long-lasting soreness from your workouts, says Seedman, it can still be helpful to double check that you're eating enough protein after the damage is done. "You can almost make the argument that that's going to be as vital as light exercise [to recover]," he says.

This doesn't mean excessively high amounts of protein, necessarily. While needs vary, people who work out should aim for about 1.4 to 2 grams of protein per kilogram of bodyweight. For an active person who's 150 pounds, that's about 95 to 136 grams per day, split up between all your meals.

5. Try heat or ice to ease the pain.

The debate between heat therapy and cold therapy is ongoing, but when it comes down to it, it's really just about what feels good to you—for the most part, the effects are temporary. But when you’re super sore, any fleeting relief (as long as it’s safe) is worth it.

Ice can help reduce the swelling that sometimes comes along with extreme soreness, says Seedman. Bringing the swelling down can help reduce some pain-causing tension. Elevating your legs (if that’s where you’re sore) can also help with this.

However, heat can also minimize tension and pain signals, says Seedman. So if relaxing in a warm bath makes you feel better, do that. McCall also notes that this may help with circulation.
Overall, time will heal all soreness—as long as it's not something more serious.

While you're recovering, it's also important to watch for signs of something more serious. A syndrome called rhabdomyolysis occurs when over-worked muscle fibers die and release the protein myoglobin into the bloodstream, which can lead to kidney damage and even failure. This is a medical emergency, and along with extreme muscle pain, weakness, and swelling, the main sign is often cola-colored urine. If you notice these signs, get to a doctor ASAP.

If you experience sharp pain during your workout, or if the soreness doesn’t start improving after a couple of days, that can be a sign that you're actually injured and need to see a healthcare professional.

As for me, my barre-induced DOMS went away about three days after my soreness peaked. I spent that time taking my dog for walks (as painful as it was), switching between heat and ice treatment, and waiting for sweet, sweet relief. Eventually—mercifully—that relief did come.

reprinted from self.com

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