Is it DOMS or an injury?
How to tell the difference between DOMS (post exercise soreness) vs Injury, and what to do about both.
How to tell the difference between normal post exercise soreness (DOMS), and injury, and what you can do about both.
DOMS (Delayed onset muscle soreness) is the normal muscle achiness you get after starting an unfamiliar exercise, coming back to training after time off, or after a particularly heavy or high rep training session.
At a microscopic level it is tiny tears of the muscle fibres which is the necessary evil (depending how you look at it!) to stimulate your body to adapt and come back stronger/fitter once the muscle has repaired.
If you’ve never felt it before, or sometimes after a particularly intense session, the discomfort can be so intense that you might start to worry that you might have done something else this time!
We’ve got you covered! Read through the checklists below for the difference between the common DOMS symptoms vs Injury and what you can do about both.
DOMS
TIME FRAME: Usually occurs ~12-24 hours after unfamiliar or intense training, begins to ease after ~48-72 hours. DOMS straight after training often feels more like “jelly-legs” that can still function but are not painful.
WARMS UP: The soreness should ease with continued movement or a warm shower.
LOCALISED PAIN: You’ll be able to find it by pressing the muscle group or area of your body that you trained (e.g. quads if you did squats, lats if you did pull ups). Usually the pain will be about equal on both sides of your body if you trained both sides.
MUSCULAR ACHE WITH USE: No pain at rest - you shouldn’t feel DOMS unless you are using the affected muscle group.
SORENESS WITH STRETCH: Usually you will feel DOMS in the movement direction that stretches that muscle - eg: straightening your elbows with bicep DOMS, walking down stairs with quad DOMS.
WEAKNESS OR ”JELLY ARMS/LEGS”: You might feel like your limbs give way with similar movement patterns as above (we call this eccentric movements), this might improve with warming up.
What you can do about it:
1. Keep moving! Generally DOMS warms up, so once you’re up and going or moving the area it should ease a little. A warm shower can help ease the symptoms too.
2. Wait it out. Don’t worry - it should start to ease up after about the 48 hour mark.
3. Don’t take anti-inflammatories. The inflammation associated with DOMS is a necessary process in adapting and getting stronger/fitter after the training session. Reducing this process can reduce the effect of all your hard work.
4. Don’t over stretch, not to ease the symptoms anyway, it won’t do a whole lot to speed up the recovery so you’re better off just using the time to move gently!
5. Gentle massage might help ease the symptoms slightly for a little while, but it won’t really speed up the process either.
5. Train gently, but don’t go too hard on the same area or with a similar workout, give your body time to adapt or you may end up overloading yourself and in the injury section.
INJURY
TIME FRAME: More severe pain felt during/soon after your training session, or 1-2 hours later once you cool down and doesn't begin to ease naturally. If it worsens after ~48-72 hours it is unlikely to be DOMS.
MIGHT NOT WARM UP: Some injuries won't improve or will worsen with continued movement/use of the painful part. Be careful as some tendon/muscle injuries or strains will also warm up, but then are likely to feel worse once cooled down.
WHERE IS IT: One side notably worse, or pain felt further up or down from the area is likely to not be DOMS. Pain that doesn’t feel like it’s in the muscle, or if it’s very obviously in the joints or tendons is also not normal DOMS symptoms.
TYPE of PAIN: Burning/shooting or sharp, deep throbbing pain at rest, or when the muscle is unloaded is not a DOMS symptom. Catchy, pinchy or clicky pains are also not typical of DOMS.
OTHER SYMPTOMS/NIGHT PAIN: Pins and needles/numbness, and severe resting/night pain that keeps you awake is not typical of DOMS.
WEAKNESS: More severe weakness in a concentric pattern (opposite direction to the muscle stretching), that has no associated pain is less typical of DOMS.
What you can do about it:
If your symptoms are mild you can try to wait-and-see for a few more days and just keep the area moving gently to give the area time to heal on its own.
If the niggling lasts longer than about 4-5 days after the training session in question, it may be worth getting it checked out.
For any severe symptoms, pins and needles/numbness or shooting pain, painful clicking and locking, or simply if you are worried its best to go and see your Physiotherapist or another health professional.
Check out our blog on managing Acute Injuries with “PEACE & LOVE”
Often when we catch and manage injuries early they are easy to manage and you’ll reduce your time off in the long run!
We’d love to hear from you and answer any questions if you are concerned. Or click through to book an appointment.
Formotion Physio is a boutique Physiotherapy practice based in West Perth , Joondalup & Osborne Park, Western Australia
4 Reasons You Can't Maintain your Mobility
There is more to flexibility than you might think.
4 Reasons You Can't Maintain your Mobility
“I stretch every day before bed but I never seem to get any more flexible?”
Sound familiar?
Here we’ll go into some other things you probably aren’t considering much in your flexibility/mobility routine - but they may have a bigger impact than you might think!
We’ll be using the terms flexibility and mobility interchangeably, as they are often both used to simply refer to how much your muscles, tendons, joints and nerves allow you to stretch and move freely.
1. You're only moving for 1 hour out of 24.
Possibly the most important one that we don't consider enough. Your body will adapt to what is continuously demanded of it. If the majority of your day involves being in one position - sitting at your desk or in an Uber, or standing at a checkout or reception desk, your body will change to allow you to do these things well. In this example, most likely tightening up the muscles that help to hold you in these positions like your hip flexors and glutes!
If you really want your 30min/day mobility gains to stick, you need to put your body in those positions as often as possible or it won't bother to maintain them. Things like an interchangeable sit/stand desk and taking regular breaks to move or walk can help. If your work makes this difficult you'll need to make sure that every chance you get to move or put your body in different positions outside of work is used.
2. You have nervous nerves.
Your nervous system (Including the brain, spinal cord, and peripheral nerves) is what allows your joints and body to move - it also serves as a protective mechanism by preventing movement if it senses that what you are doing is unsafe or risks causing you injury. In terms of mobility and range of motion - there is a threshold of when your nervous system starts to sense something as "risky" and it subsequently tries to protect you by doing things like tightening up the muscles so you don't move any further, or perceiving a movement as uncomfortable or painful so you stop the action.
Your nervous system can begin to reign you in earlier (i.e. lower the threshold) when it is sensitised or feels out of control - things like overloading in training with back to back difficult, heavy or repetitive sessions without adequate recovery time can cause neural sensitivity or pain. Think of that feeling in your hamstrings/lower back when you try to touch your toes after a heavy deadlift session.
Image: firepowerteams.com
By foam rolling an already overly sensitive structure, or trying to "stretch through the pain", all you are doing is playing tug of war with your own neural system and adding to the sensitivity.
One of the ways you can avoid excessive sensitivity is by discussing optimal training loads and recovery times with your instructor, coach or Physiotherapist.
3. You're not in control.
Uncontrolled or unstable movements can also stress out your nerves to the point they revoke your movement privileges. Your nervous system will allow movement in joints when it feels there is enough stability further up the chain to make that movement safe. For example hamstring "tightness" can often be caused by poor lower back and pelvic control and similarly poor shoulder range of movement can be caused by poor scapular stability.
Image: angliahandling.co.uk
Imagine a crane trying to raise a heavy cement block to the top of a building when its base has not been properly secured and stabilised. It would most likely reach a point where the torque would topple it over. In the case of the human body our sensory system aims to stop us before this point of fail.
By working on your proximal control and stability (joints closer to your midline), you can improve the achievable range of movement in the joints further away. This is a principle that is used often in disciplines like Pilates and Yoga, as well as the bracing techniques taught in weightlifting.
4. You're not cementing movements.
Image: kingofthegym.com
So you've done all the right things - kept moving throughout the day, ensured your loading and recovery is correct, stabilised proximally to the joint you're working on, and have spent hours doing all the cutting edge stretches and mobility exercises you can find. Yet you are still pulling up a couple of days later feeling just as stiff?
The last point to consider is cementing. If you are not strengthening and training into this new range of movement soon after, your body isn't going to bother maintaining it. For mobility routines I generally encourage the steps of active mobilisation, specific strengthening and then application into your training; the cement!
By being strong into the new range you will be able to use the movement as you are able to move into it actively under load during your training. You will also calm the nervous nerves by showing them that you are in control of this new range and are therefore not at risk of any injuries.
In closing remember that improving mobility is a long process and your body needs time to change and adapt to new movements and exercises (weeks to years!). So as cliché as it might sound, patience and commitment to the process is what will allow you to reach those goals in the end.
Please get in touch if you need advice that is specific to you.
Formotion Physio is a boutique Physiotherapy practice based in West Perth & Osborne Park, Western Australia
Lucia Tennant
Physiotherapist and Founder of Formotion Physio
BSc Physiotherapy
3 Reasons to Include Gymnastics Rings in Your Training
Because we all know healthy fun is the best fun!
3 Reasons why Jason, our Physiotherapist, Gymnastics Coach and elite gymnast includes Gymnastics Rings in his training, and why he thinks you should too!
1. It’s a Lot of Fun!
It’s easier to do exercise when you enjoy it! I do gymnastics simply because it’s fun. A huge part of why people stick with their sport or exercise is because of enjoyment.
When training gymnastics rings, I love how improving my strength or mobility can lead to achieving difficult skills. The purposeful nature of training to learn new things is what is most enjoyable for me. With rings the skills are fun and exciting. There is always more to learn. When you’ve been training for a while these skills can be put together into routines. This is a great test of your endurance and keeps training interesting.
Below is a video of my rings routine from the Australian Gymnastics Nationals back in May, 2019.
2. Injury prevention
Holding positions on the rings require you to use stabilising muscles in your shoulders to maintain the position. The main stabilising muscles in your shoulders are your rotator cuff. This group of muscles are essential for good shoulder health. Weak rotator cuff muscles puts you at risk of shoulder, arm and other injuries. Bullet proof your body by improving your stability and strength through gymnastics rings exercises.
3. Transferable skills
The strength and skills from Rings training can help with other sports or similar skills - like a bar muscle up in CrossFit. Learning to break down skills like the strict ring muscle up into small, manageable parts, strengthens you through all sorts of movements you might not have known existed! Putting them back together teaches your body important co-ordination and learning skills. Rings training also uncovers unexpected weaknesses like poor wrist strength and mobility which can make a world of difference to any sport that needs similar movements!
This just touches on the reasons I love to train rings! I teach rings classes that will allow you to achieve all of the above and give you guidance in incorporating gymnastics rings into your training.
They are appropriate for all levels. Each class involves a thorough warm up, rings specific training scaled to your current ability and a strength circuit. For more info click the button below of feel free to contact me at jason@formotionphysio.com
Jason Ciccotosto
Physiotherapist & Gymnastics Coach
B.Sc Exercise and Sports Science
B.Sc Physiotherapy