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Exercise-induced soreness or something more? Here's what to know
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Exercise-induced soreness or something more? Here's what to know

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If you experience severe and persistent pain, you may want to see a doctor.

Q: How can a person tell when a muscle ache is just from exercising and not from something else?

A: Soreness is the normal response to exercise stress, minor muscle injury, and then repair. But there is a good soreness and a bad soreness. In general, exercising should create a level of soreness that only lasts a day or two.

Good or “healthy” soreness comes from working your muscles to their limits. On a microscopic level, some muscle fibers may tear. Over the next couple days, your body repairs the damage. If the injury is mild, the muscle is broken down a bit and ends up stronger than before. For exercise like fast walking or workouts on a treadmill, expect the soreness to affect both sides of your body.

The goal should be to stay within limits that result in normal “healthy” soreness. When you experience mild to moderate muscle pain, ease the discomfort by following the RICE method.

Rest: Get off your feet; take the weight off the affected limb.

Ice: Apply an ice bag or gel pack wrapped in a cloth to the affected area for 20 minutes every two hours. Don’t apply ice directly to the skin.

Compression: Wrap the area in an elastic bandage.

Elevation: Raise the affected limb to a level above your heart.

The typical sign of “bad” soreness is pain in one particular area of the body that lasts for more than 48 hours. Does the pain in one leg or arm hurt enough to keep you awake at night? Do you need to take daily doses of an over-the-counter pain medication? These signs suggest muscle damage exceeding a healthy low-grade injury.

See a doctor if you experience severe and persistent pain, black-and-blue bruising, numbness or weakness. It may be an inflamed tendon (tendinitis) or even a tendon tear. Muscles can also tear severely enough that you can feel an imperfection in the muscle tissue.

To prevent muscle strains and sprains, ease into any activity gradually. No part of the body responds well to sudden unexpected stress. If you are going to hurt yourself, you are more likely to do so if you skip the warm-up phase of exercise.

Warming up means gradually increasing the intensity of exercise. For example, before a brisk daily walk, spend five to 10 minutes taking a leisurely stroll and increase the pace gradually. When you begin exercising on a treadmill or other gym machine, start on a low setting to allow the blood to flow and your joints to loosen.

Many people wonder about the value of stretching to prevent injuries or soreness, but the evidence is mixed. Stretching after exercise is safest and also OK if you have warmed up. But avoid vigorous, extreme stretching before exercise.

(Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)

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