You often hear stories of Olympic or professional athletes who heroically fight through pain or injury to secure a win. It’s not even uncommon to come across a story of your average marathon runner gritting their teeth through pain to cross the finish line. There’s no doubt that it happens, but should you really push through the pain during exercise? We spoke to Sarah Kennedy, D.O., a family and sports medicine physician on the medical staff at Texas Health Arlington Memorial, and at Sideline Orthopedics and Sports, a Texas Health Physicians Group practice, to figure out the truth.
Differentiating Soreness from Pain
Soreness is almost to be expected during rigorous activity, especially if you haven’t exercised in a while or you’ve recently increased the intensity of your workout. This sore or achy feeling is a result of micro-tears or mild inflammation in your muscles or tendons, which is normal. The muscle repairs the tears while you’re resting, and it helps the muscle to grow in size and strength.
You may even feel like your soreness doesn’t appear until hours or days after the activity. Kennedy says this phenomenon is called Delayed Onset Muscle Soreness (DOMS) and it usually starts 24-48 hours following the activity, resolving in, at the most, seven days.
“Anyone can experience DOMS, from elite athletes to someone just starting up a fitness routine,” Kennedy says. “It’s a sign that you worked your muscles, and that’s a good thing. That’s what you’re hoping to achieve. However, there are times it can be a sign that you pushed yourself a little too hard and need to take a step back.”
Symptoms to watch out for may include:
- muscles that feel tender to the touch
- reduced range of motion due to pain and stiffness when moving
- swelling or bruising in the affected muscles or joints
- muscle fatigue
- short-term loss of muscle strength
“My rule of thumb is If you have an achy pain that lasts for a couple of days then goes away, that’s fine, and will most likely lessen as you continue to get more fit. If it’s lasting longer than that, you should probably back off,” Kennedy explains. “If it’s a sharp, severe pain, as in you rate it a 7 out 10 or above on the pain scale, then that’s a no-go. If there are other factors like swelling or limping, things like that, that’s also a no-go. Any soreness lasting longer than a week is not normal and should be followed up on with your primary care or sports medicine physician.”
It’s alright to exercise if you’re experiencing soreness, and physical activity might help alleviate the ache.
“Start low and go slow,” she says. “For example, if you’re wanting to get back into running, maybe start off with a quarter of a mile or a half of a mile and see how your body responds over the next day or two, and then you can slowly progress. If you’ve got significant soreness, maybe dial it back a bit.”
Another thing to look out for is extreme soreness, tight/hard muscles, numbness, tingling and dark-colored urine. These symptoms can be due to muscle breakdown and a rare condition called rhabdomyolysis which warrants a trip to the emergency room.
While experiencing sore muscles is normal, pain is not. Pain represents injury; it’s our body’s way of letting us know something is not right. Pain during or after exercise can be a sign of overuse or too much stress placed on a muscle or tendon. When it’s a result of repetitive use or a single episode of overloading a muscle or tendon, it’s referred to as a muscle strain.
“Soreness is something that you should definitely be mindful of and it can help you inform your gameplan moving forward, however, you should never ignore pain,” Kennedy explains. “If your soreness turns into pain or pushes you past your comfort level, it is time to scale back. Also, if pain or soreness starts to dictate how you perform the exercise or if it causes you to modify the activity to compensate, you are doing too much!”
Signs of overtraining include:
- Sleep disturbances
- An increase in sickness
- Unresolved muscle soreness
If you’re suffering from any of these symptoms, Kennedy says it’s time to speak with your doctor about a referral to a sports medicine physician, physical therapist, or athletic trainer to go about setting a healthy workout schedule and nutrition plan.
Giving It a Rest
If you’re experiencing pain or extreme soreness, the best thing to do is to rest and give your muscles or tendon the time they need to recover. Kennedy suggests using ice for acute swelling or injury, and you can apply heat to the affected area for up to 72 hours following an injury.
She also suggests light stretching and range of motion exercises, as well as foam rolling, yoga and massage to help stimulate the muscle and increase blood flow.
“If you’re just dealing with soreness the next day, not pain, try some walking or a couple of turns on the stationary bike, and get in lots of stretching,” Kennedy says. “It’s probably going to be uncomfortable at first to stretch those muscles and get them moving again, but it’s going to go a long way in helping those muscles or tendons heal. We do know from multiple studies that by just moving a joint, you produce natural lubrication, and you recruit natural anti-inflammatory factors. So exercise, in itself, is medicine.”
The best way to prevent injury and pain is to ease into your workout. Performing dynamic stretches versus static stretching has been shown to reduce muscle tightness better. Dynamic stretching is movement-based instead of holding a pose in traditional stretching.
For instance, instead of holding a traditional lunge, try a walking lunge with a twist. Get into a traditional lunge then twist your torso toward the front thigh. Stand back up and walk out into a lunge on the other side and repeat, twisting your torso toward that leg.
Traditional stretching and foam rolling can be added at the end of a workout when your muscles are already warm.
“You never want to do stretches cold,” Kennedy stresses. “You want to get some light aerobic activity in there first, whether it’s with some gentle walking or a few minutes on the bike just to get the blood flowing and warming up those muscles that you’re about to stretch. When you stretch cold, you set yourself up for injury.”
Additionally, stretching after a workout will help prevent any soreness or tightness you may feel the next day.
If you’re dealing with some soreness but you still want to get active the following day, Kennedy suggests switching up your exercises to focus on a different muscle group.
“You can always change up what kind of activity you do,” she says. “For instance, if you did legs Monday, and you’re feeling it Tuesday, focus on your upper body or arms the next day to give your legs a chance to rest. You’re still getting active but you’re giving those tired muscle groups a rest. But there’s no harm in just fully resting, either. Just listen to your body.”
If at any point you experience pain, back down. It’s better to stop or modify an exercise than to further any injury.
“When starting a new exercise routine, take it slow,” Kennedy says. “Don’t expect change overnight. Small steps in the right direction will get you to your goals safely and hopefully injury-free!”
If rest and modification keep falling short of alleviating your pain, it may be time to see a specialist. For more information about Texas Health Sports Medicine or to find a sports medicine physician, visit TexasHealth.org/SportsMedicine.