Living an active life is great for physical and mental well-being but sometimes it is with a cost. Initiating exercise is usually accompanied by discomfort since the point of exercise is to stress the body in hopes of exacting change. While this is true for traditional exercise, soreness and pain can also result from less strenuous or even everyday activities. The difficulty lies in deciding if the discomfort you feel is just plain muscular soreness resulting from exercise, or pain that signifies an injury. 

Our physical therapy team helps patients of all activity levels identify and overcome pain and injury. Athletes are accustomed to soreness and aches and pains, but how do you know when soreness is a more serious problem that could indicate an injury?

Below, our expert team at Ventura Orthopedics share tips on determining the difference between soreness and pain, and learn when a visit to your physician or physical therapist is necessary.

Post-Activity Pain vs. Soreness

After strenuous exercise, or exercise after a hiatus from physical activity, it is natural to experience muscle soreness. Typically, muscles are tender to the touch or burn slightly with movement. During exercise, we fatigue our muscles, and the effects usually are not generally felt until a day or two afterward. Micro tears in the muscle occur during exercise, which is what causes the dull aches, soreness and muscle weakness. Most people feel a peak of soreness the following day, and the discomfort gradually goes away. A red flag indicator of injury is when discomfort and sharp pain are persistent, whether you are resting or active. If the pain persists past one to two weeks, or is immediate and severe, you may have damaged muscles, tissues or joints

Soreness or Delayed Onset Muscular Soreness (DOMS) is the result of small, safe damage to muscle fibers.  Muscular soreness usually peaks after about 24 to 72 hours of physical activity. When you exercise, the muscle fibers experience a “safe” form of damage that might result in some aching. This damage helps your muscles build up during the recovery time but your muscles might be tender to touch or feel tight later that day or a couple of days following the exercise. Movement will likely be uncomfortable at first, but if you move and gently stretch your muscles, this can decrease your soreness. 

Pain, however, is more subjective. Unlike soreness, pain is not a natural response to physical activity. With pain, you can feel a sharp, achy or tingling sensation located in your muscles or joints. While muscle soreness is temporary, pain often lingers even after a period of rest. The intensity of pain is very subjective and intensity may feel like it is worsening as time progresses. If you push through the pain, you will likely only further injure yourself. In cases where pain is extreme or does not resolve after 7 to 10 days, you should consult with a healthcare professional. They will be able to properly diagnose your condition and suggest appropriate treatment and care.

How to Tell the Difference

One of the easiest ways to tell the difference between muscle pain and soreness is to pinpoint when the discomfort started. Did the discomfort start slowly following a particular movement? Typically with soreness, discomfort can start following the repetitive motion. However, this discomfort usually lasts for a short period and dissipates. An intense strength training session using heavy weights or extreme movements can cause muscle soreness, which may last for a couple of days. If the discomfort lasts longer than a short period of time (5-10 seconds) the discomfort is often referred to as Delayed Onset of Muscle Soreness. This is often referred to as DOMS. The tight and achy feeling that you get from DOMS typically goes away after 24-48 hours.

Symptoms of Soreness:

  • Temporary
  • Slow onset
  • Burning feeling in muscles
  • Muscle tightness

Conversely, pain is in a completely different category. Pain is a signal that tells your body that something is not right or you should stop doing a particular movement. Pain typically develops very quickly and is characterized by a sharp, persistent, annoying feeling. Pain usually lasts longer than a couple of days without any improvement. 

An important thing to remember about pain is that it does not automatically mean that there is an injury. It could simply be your body’s way of telling you that you need to slow down or change up your routine. Pain is an actual signal that is sent to your brain as a warning. Therefore, if you feel pain, do not ignore the signals. Pain is your brain trying to protect your body. 

Symptoms of pain:

  • Quick onset
  • Sharp feeling
  • Aching
  • Persistent
  • Does not go away after a couple of days
  • No improvement of discomfort

What Is ‘Good’ or Acceptable Pain?

Acceptable pain can be specific to each individual. Although, as a general rule, it can be classified as a rating of 0–3/10 on the visual analogue scale of pain. This can range from an awareness of a certain area of your body, mild discomfort or pain that does not interfere with your activities, and pain that is slightly distracting but tolerable.

Acceptable pain may be a lower level of discomfort you experience as you are rehabbing an injury, or it may be a level of discomfort that your physiotherapist is happy for you to work through when completing your home or gym-based rehab exercises. One classification of good pain is the delayed onset of muscle soreness.

Recognize the Signs of Bad Pain

Bad Pain can occur when your body is exposed to excessive amounts of stress. These stresses might happen during a single workout, like trying to lift too much weight when you’re not ready. Sometimes there is a specific moment where you feel/hear a pop or snap, and you immediately know something is wrong. 

But stress can also build up over time. Training too many days in a row is a great example of this delayed stress – your body needs time to recover. Often, athletes do not immediately notice the damage they are doing, and they keep on moving.

For beginners, it is recommended to start out slowly and gradually increase the intensity of the exercises as you progress. A slight burn that goes away after the muscles stop working is normal. The same goes for next-day stiffness or soreness. 

A lingering ache, however, is Bad Pain. It is a sign that you have overdone it during your workout or activity. You should immediately take time to rest and stop over-exerting yourself to prevent worsening the injury. It is better to cut your workout short and be in good shape the next day. Pushing too hard could leave you out of commission for weeks while you heal. 

Have You Considered Physical Therapy?

When it comes to persistent pain that does not dissipate in one to two weeks, it is best to identify the problem as quickly as possible by visiting with a physician or physical therapist. Physical therapy can help you identify the body mechanics that led to the injury, help you manage pain and learn ways to overcome injury and prevent future injury. A physical therapist will work with you to create a recovery plan that suits your needs and focuses on conditioning and strengthening your muscles and joints.

Your physical therapist, in consultation with your surgeon, will be able to tell you how much activity you can do depending on the type of knee surgery (such as total knee replacement) you undergo. Your therapist and surgeon also might have you participate in physical therapy prior to surgery to increase your strength and motion. This can sometimes help with recovery after surgery.

Following surgery, your physical therapist will design a personalized rehabilitation program for you and help you gain the strength, movement, and endurance you need to return to performing the daily activities you did before.

To learn more about physical therapy at Ventura Orthopedics or to schedule an appointment with one of our hip replacement specialists, call us at 800-698-1280.

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