Am I Sore or Injured—How to Tell the Difference
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Am I Sore or Injured—How to Tell the Difference

Find out whether your aches are just routine soreness or something more serious.

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By Kristan Dietz

At some point, soreness sneaks up on most people. You’ll rise out of bed and within your first steps you’ll feel creaky, tight and really achy. However, it can be tough to tell whether soreness is just a result of a more intense than normal workout or a symptom of a more serious muscle strain, sprain or injury.

How can you distinguish between the aches of a tough workout and pain that may require a doctor’s visit? According to Barrett S. Brown, M.D., an orthopedic surgeon at Texas Orthopedic Hospital in Houston, it depends on your baseline level of activity and the symptoms you are feeling.

Muscle soreness

2 / 5 Muscle soreness

Soreness can be a relatively normal part of an active lifestyle—but can also set in if you’ve started exercising after being inactive. Muscles may feel tender when touched or tired when you move around. They could feel tight and stiff, especially when you first wake up or after sitting for an extended amount of time.

This soreness could build up for a number of reasons. “When people want to try to start an exercise routine or change a level of fitness or even if they are using muscles that they may not typically use,” says Brown. Experienced exercisers may become sore when they increase the intensity or duration of their workouts or try something completely new.

These aches are likely the result of delayed onset muscle soreness (DOMS). It is believed that DOMS occurs in response to microscopic tears in muscles and surrounding connective tissue during exercise or other strenuous physical activity. These micro traumas cause muscle inflammation that leads to soreness, settling in 24 to 48 hours after physical activity. Although achy and uncomfortable, this type of soreness is not a cause for concern. In fact, DOMS is often felt because your muscles are adapting to a new level of fitness. You’re less likely to get sore the next time you perform the same activity at a similar intensity.

You may feel inclined to rest, but DOMS is usually alleviated by light exercise. An easy walk, a few gentle yoga poses, tai chi movements or a light swim are all ways to help your muscles recover. Whatever you choose, be sure to stick to exercises that are familiar and comfortable to you until soreness subsides. A proper warm up will also help you feel less sore during exercise, although you may find that your legs still feel tired. These minor aches should resolve within 24 to 72 hours of activity.

Strains and sprains

3 / 5 Strains and sprains

If your soreness does not subside or is accompanied by increasing pain, discomfort in a specific sport or pain that occurs suddenly, it could be caused by a muscle strain or a ligament sprain.

Strains are stretches or tears to muscles or tendons that occur when they are pulled during physical activity or an accident. This could be due to overuse, poor flexibility, quick starts and stops or physical impact during sports. They can happen in any muscle, but are commonly seen in hamstrings, quadriceps, back, neck and shoulders.

Sprains occur when ligaments, connective tissues that bind bones together around joints, are stretched or torn after moving in an unnatural way, typically around the ankle, wrist and knee. Symptoms include pain, swelling, bruising and stiffness. After a sprain, you may not be able to put pressure on the joint or move without sharp pain.

Minor strains and sprains can be treated at home using the RICE method: rest, ice, compression and elevation. Take a few days off until pain subsides and consider using a bandage, wrap or compression sock or sleeve to squeeze the muscles in the area of the strain. Ibuprofen or aspirin can be taken so long as it does not cause interactions with medications or other health conditions. If you are not sure if you should take an anti-inflammatory, ask your doctor.

A trip to your physician may also be necessary if pain associated with a strain or sprain does not improve with at-home treatment or lingers for over a week. It’s also recommended to visit a doctor if the pain is immediate, severe and impacts your ability to move. “If it went from a little bit of pain all of a sudden to a lot of pain, or if swelling is involved, that's typically something that would necessitate consideration for an evaluation sooner rather than later,” notes Dr. Brown. Your doctor may order diagnostic tests to rule out greater injuries or other medical conditions or refer you to a physical therapist as a course of treatment.

Overuse injuries

4 / 5 Overuse injuries

These types of injuries, which include tendonitis, bursitis, stress fractures and shin splints, tend to develop over time due to repetitive stress on the body without adequate recovery. They occur in muscles, tendons, joints and even lead to bone injuries.

This can be the result of poor technique, improper form or errors made in training. Too often people will jump into an activity with more intensity than their body can handle. Even exercising in unsupportive shoes, using old equipment or training on hard surfaces can cause an overuse injury.

Much like strains and sprains, the first line of treatment for overuse injuries is rest, ice, compression and elevation. Take an anti-inflammatory if you’re approved to do so by your doctor. Often these injuries will need the evaluation of a doctor, who can help you come up with a treatment plan and recovery schedule.

Prevention techniques

5 / 5 Prevention techniques

There are steps you can take to prevent soreness, strains, sprains and overuse injuries from occurring. If you’re beginning an exercise plan after being inactive, be cautious. Speak with your doctor about what types of exercise would be appropriate for your level of fitness. Incorporate cardio, strength and flexibility exercises into your training plan, but not all at one time. Current guidelines recommend 150 minutes of moderate cardiovascular exercise per week or 75 minutes of vigorous exercise, as well as at least two days per week of strength exercises. These are goals you can work up towards.

It also helps if you spread out your exercise over the course of the week, instead of concentrating all of your activity during the weekend. Even 10-minute increments throughout the day can help you build fitness without risking an injury.

Performing a warm up before exercise can help increase blood flow and prepare muscles, tendons, ligaments and joints for activity. Try a slow walk, paired with some dynamic or static stretches. Hold a stretch briefly—only up to 20 seconds­—and never stretch to the point of pain. Cool downs are also recommended. Decrease the intensity of your exercise over the last 10 minutes of your workout.

Everyone experiences muscle soreness at some point in their life. Pushing yourself a little harder than normal will likely result in a few minor aches but can also help you get into better shape. However, it’s important to listen to your body to avoid injury. And Brown notes that if you feel your body needs a day to rest, enjoy the down time before returning to physical activity.

“The way I typically put it to patients is use your good judgement. If something doesn't seem right, don't do it. Listen to what your body tells you.”