How to tell the difference between muscle soreness and injury.

Aug 9

Sometimes it can be hard to work out the difference between severe muscle soreness and an actual muscular injury. Especially if you are new to exercise or have changed your routine and what you are feeling is unfamiliar to you. In this blog, we will be discussing the difference, how to know whether you are just sore or injured and what to do in both cases.

Muscle Soreness

Exercise induced muscle soreness is pain felt in the muscles during or immediately following unaccustomed physical activity. Delayed onset muscle soreness (DOMS) is pain felt in the muscles that develops 24 – 48 hours after unaccustomed exercise. The pain severity is often worse after eccentric exercise – exercise where the muscle is getting longer whilst contracting. The exact cause of this soreness is not completely understood in the literature but is believed to be a result of microtrauma in the muscle and connective tissue followed by inflammation resulting in sensitisation of the nerve endings.

Exercise induced muscle soreness is often accompanied by muscle stiffness, mild cramping and aching. These symptoms often last for several hours after exercise is finished. DOMS is associated with tenderness to touch and stiffness with movement and usually peaks around 48 – 72 hours post exercise. It can take up to 10 days for the symptoms of DOMS to resolve. Symptoms can be mild to severe and usually depends on intensity, volume and type of exercise. Reduced muscle strength and power can occur which may affect physical performance and is usually the worst between 24 – 48 hours after exercise.

Muscle Strain

So how do you know if you are just really sore, or if you have actually injured a muscle? Let’s chat about what a muscle strain/tear is. A muscle strain occurs when there is excessive force within a muscle which cause the muscle fibres to fail and tear. Depending on the severity of the tear, symptoms can include: pain on active contraction of the muscle, pain when the muscle is passively stretched, reduced strength and range of motion and loss of function. These symptoms will be felt immediately and depending on the severity will stop you from doing the activity due to pain and loss of function.

There are three grades of tears which include:

Grade 1: Minor localised pain, no or minimal loss of strength, involves small number of muscle fibers
Grade 2: Greater level of pain, swelling and loss of strength, involves larger number of muscle fibers
Grade 3: Severe pain, complete loss of function, complete rupture of the muscle

Muscle soreness v. Muscle Tear

To summarise the difference, see the table below:

Management

Now that we know the difference between the two, let’s discuss what the different management is for each. Muscle soreness will resolve on its own with time and can be improved with light physical activity, foam rolling, a warm bath, cold water immersion, contrast therapy and compression garments. You can continue to participate in physical activity, with a good warm up and be guided by pain. On the contrary, a muscle tear first needs rest, ice, compression and elevation (RICE) to give the muscle time to heal, with some gentle range of motion. You want to avoid exercising that region of the body, stretching, massage and heat. These modalities will exacerbate the pain and slow the healing process. You can massage the surrounding muscles with a roller or trigger ball but not directly over the tear. Once the pain has subsided you want to begin a period of rehab to strengthen the muscle and reduce the risk of it happening again. Grade 1 tears usually improve quickly over a week if not exacerbated. Grade 2 and 3 can take longer and I recommend seeing a physiotherapist in your local area to assist with rehab and preventing it from happening again.

It is important to remember that muscle soreness is a normal adaptive process to progressive overload and exposure to unaccustomed exercise. It can feel debilitating at first if you are not used to planned physical activity, but it does resolve on its own and the more your body gets used to exercise the less you will be sore. If you are concerned, reach out to a Physiotherapist in your local area. Live Bright Physiotherapy can help you face to face on the Gold Coast, QLD and we also offer online consultations.