Post Running Muscle Soreness:
Is it an Injury or just DOMS?
Have you ever finished a big run and felt sore right after it? What about two days afterwards? Do you ignore it or have it checked out?
The most common causes of post-run pain are either a legitimate muscle injury or delayed onset muscle soreness (DOMS).
Tips to Determine if it is a Muscle Injury or is it DOMS?
Differentiating between a muscular injury and DOMs is essential to ensure you are not overlooking a potentially sport-limiting injury and you are getting the injury managed appropriately. Early identification is key!
What is DOMS?
Delayed Onset Muscle Soreness or DOMs for short, is an exercise-related muscle condition that arises after intense, unaccustomed, physical exercise. The condition gets its ‘delayed’ name as symptoms are not usually felt until 24 to 72 hours after the exercise, normally peaking at the 48-hour mark after exercise.
Research has demonstrated that DOMS is associated with tearing of myofibrils often at multitudinous junctions – best described as microtrauma. This process is followed by inflammation and a shift in intramuscular fluid and electrolytes. This process in combination with other local factors at the cellular and increased intramuscular pressure promote are what causes the soreness and stiffness experienced in DOMS.
Tenderness is typically felt at the end of the muscle (at the tendon) where it attaches down along the affected limb and then as the condition progress. This can be felt throughout the muscle belly itself. The swelling, inflammation, tenderness and pain that arises can manifest as decreased joint range of motion, decreased strength and a decreased ability to absorb shock while exercising.
This alteration is muscle function can last up to 10 days!
Acute muscle injuries are quite different in how they present compared to DOMS. Typically, pain and stiffness is felt immediately in the affected tissue or shortly after. A ‘pop’, twinge, feeling of being kicked – without anyone actually kicking you – or an immediate collapse to the ground. As expected, the amount of damage to the tissue with a muscle injury exceeds that of DOMS. Any general movement of the muscle will reproduce your symptoms and if the injury is severe enough – bruising can begin to develop with some associated swelling.
At the time of injury, following the RICE protocol (Relative Rest, Ice, Compression, and Elevation) is your best go-to treatment.
You should also avoid HARM factors. No heat should be applied to the affected area. You should also avoid alcohol consumption, running or other painful movements. Initially, it is a good idea to avoid massage until a professional has assessed the injury. All the HARM factors have the potential to increase bleeding, which may exacerbate your injury.
Research suggests no anti-inflammatory drugs following a muscle strain is the best way to go. If you are seeking pain relief, it is best you consult your regular GP or a pharmacist for pain relief options that don’t slow down your healing rates.
More info: How to Treat an Acute Soft Tissue Injury
Benefits of DOMS?
Thankfully yes! The body adapts to the physical exercise that was undertaken once the DOMS resolves. So when you go and perform the same exercise again, the chance of DOMS onset decreases! However, adaptation to the causative exercise occurs rapidly after DOMS resolves. This adaptation with repeated exercise is called the “repeated-bout effect.”
More info: Delayed Onset Muscle Soreness (DOMS).
How to Tell the Difference?
Your physiotherapist will be your best option for an efficient and accurate diagnosis between the two conditions, however, there are some simple factors to help piece together your injury when it comes to deciding whether or not to consult help.
DOMS is more unpleasant when commencing a movement but eases as the muscle is warmed up, whereas a muscle injury will reproduce pain with any movement of the injured muscle.
The most definitive factor is taking a detailed history of the injury. If pain was experienced during the event or immediately after, you are most likely looking at a muscle injury. If the pain is worst the day after and gets worse over the following days, you are most likely dealing with DOMS.
What to Do if You Have DOMS or a Muscle Injury?
If you suspect you have a muscle injury, it is best to consult your physiotherapist earlier rather than later. A thorough assessment is required to ascertain what exactly it is you have injured and start rehabilitation immediately to help minimise your time out of the sport!
If you suspect you have DOMS, you need to avoid therapeutic interventions that increase muscle pain (e.g. excessive stretching, deep tissue massage) and vigorous physical activity should be postponed until resolution of pain and restoration of function due to:
- Decreased shock absorption
- Decreased coordination of muscle sequencing motion
- Compensatory recruitment of uninjured muscle groups
- Increased relative work intensity of the affected muscles at the same workload
- Altered strength balance of agonist and antagonist groups
- Inaccurate perception of functional deficits
There is evidence suggesting that compression garments, remedial massage and heat packs that all aim to increase blood flow will decrease your pain.
If you’re unsure if it is a muscle injury or DOMS – we’re only a call away and our physiotherapists will happily answer your questions and establish the best plan of attack for you!
At PhysioWorks, our physiotherapists are highly experienced in giving an accurate diagnosis and establishing an individualised rehabilitation program. We will look at what caused it, how bad the injury is, treat the root cause and implement a plan to prevent it from coming back!
If you are in doubt or require more information, please don’t hesitate to contact your nearest PhysioWorks clinic.