Muscle fever and muscle pain after exercise - symptoms and treatment

If you're experiencing muscle pain for up to a week after exercising or other physical activity, you've probably contracted what's known as muscle soreness . In this article, we'll discuss how muscle soreness occurs, how long it lasts, its causes and symptoms, and most importantly, how to get rid of it as quickly as possible and prevent it in the future.

What is muscle fever and what are its symptoms?

Muscle soreness , also known as DOMS (delayed onset muscle soreness) , is a very painful condition that occurs after a hard workout . In addition to the fact that the pain itself is a very unpleasant experience, muscle soreness can limit athletes in sports activities and sometimes even in normal daily activities . In addition to muscle pain, muscle soreness is accompanied by other symptoms such as limited flexibility and a feeling of “shortening” of the sore muscles. ¹

How and why does muscle fever occur?

Muscle pain after sports occurs when the structure of muscle fibers is disrupted during exercise (the fibers are torn so that they can regenerate larger and stronger), which causes pain.

Muscle soreness requires excessive damage to muscle fibers . Such extensive tearing of fibers occurs mainly when performing movements that the body is not used to or during intensive training, mainly in the eccentric part of the movement, i.e. when the loaded muscle is stretched (e.g. in a squat, when we go down with the barbell, in a push-up, it is the part of the descent from the barbell to the outstretched arms, in a dumbbell lift to the biceps, when we lower the barbell down). ¹

In an ideal world, significant damage to muscle fibers should mean regeneration to a significantly stronger state, and therefore significant muscle enlargement, but unfortunately it does not work that way. Excessive damage to muscle fibers causes electrolyte imbalance , oxidative stress and the involvement of inflammatory cells in muscle healing . In this environment, the muscle heals more slowly and at the same time substances are produced that act on nociceptors ( pain receptors ), which is why such a muscle tear hurts for several days after sports. ¹

How long does muscle soreness last?

Typically, muscle soreness begins to manifest itself 6-12 hours after exercise , the pain peaks on the second or third day and then subsides between the fifth and seventh days. ¹ The length, intensity, and duration of the peak pain intensity depend on the intensity of the training, the length of the training, the specific muscle group, and the type of muscle fibers in the muscle being trained. A typical example is when, after a heavy leg workout, the pain is most intense on the second rest day .

How to prevent muscle fever and how to get rid of it?

Prevention and treatment of muscle pain may overlap to some extent, as some treatment steps can be used to prevent pain.

A purely preventive measure for an athlete is to know their body and listen to it . This is a very useful skill if the athlete wants to eliminate the risk of injury, overtraining, or even muscle soreness.

An important prevention is also the gradual creation of tolerance to stress . It is not wise to go into sports full-on right away, but on the contrary, it is wise to advance the capabilities of your body and your performance step by step.

Cold

The use of cold and heat is a preventive and therapeutic method . Immersing muscles in cold water helps speed up regeneration , because the cold helps move pro-inflammatory and pain-causing substances from the muscle into the bloodstream, where they are more easily eliminated. A meta-analysis of many studies shows that the best results are obtained by immersing sore muscles in 11 to 15 degree water for 15 minutes . Cryotherapy (2-5 minutes spent in a room cooled to minus 100 degrees) also has similar effects. ²

The application of cooling ointments containing menthol is still an unexplained phenomenon in research. Athletes like to use them because they feel that they are helping with pain . In a blinded comparison of a cooling ointment with an ointment without active ingredients, athletes evaluated the placebo ointment as the one that would help them get rid of pain better. This suggests that it is more of a placebo effect after applying any ointment to a sore muscle . At the same time, jumpers and runners with muscle pain after applying a cooling ointment maintained their strength and performance during further training better than athletes who applied a placebo . These results cannot be explained in any way, but it is known that cooling ointment helps with pain (although only as a placebo and not because of the substances contained) and facilitates a faster repetition of running or jumping performance after muscle soreness. ⁵

Heat application

Heat application in the form of a sauna, hot tub or hot compresses is recommended only in the later stages of muscle fever . Heat should be applied only when the pain subsides (approximately from the 4th to the 7th day after the onset of pain), when it can accelerate regeneration and may even have a positive effect on muscle volume. In the first 3 days, when the pain is still increasing, heat could worsen the inflammatory response. ²

Compression

Using compression after sports (contracting the loaded muscle) can either prevent pain or alleviate it and shorten its duration . The fact is that compressing the muscle during sports does not bring any benefit, unlike compression after sports. ³

Many well-known and recommended methods for accelerating regeneration and relieving pain have not been proven effective in preventing or treating muscle fever in studies . Some describe their effect, while others deny their effect. These include, for example , stretching muscles after training , active rest in the form of easy sports, vibrating muscle massage , using a massage roller or muscle electrostimulation , manual massage or acupuncture . My humble opinion is that if something helps you emotionally, it is worth doing it, and if you do not feel a difference and it does not fulfill you, then there is no point in continuing with it. ^{2, 4}

Painkillers

Taking medication to treat muscle soreness is generally not recommended and is only a last resort. Anti-inflammatory and painkillers (such as ibuprofen) may help with the discomfort, but they do not significantly speed up muscle regeneration and have a number of side effects when used long-term.

Food and dietary supplements

Some supplements also have a positive effect on muscle soreness . Although this is not a breakthrough therapy, supplementation of these substances can bring a slight benefit in preventing and reducing the symptoms of muscle soreness. Muscle soreness will be reduced by the BCAA content in a protein drink after training, caffeine after training , vitamin D , turmeric extract , beetroot juice and omega 3 fatty acids . ^{2, 3, 4}

Summary at the end

Muscle soreness is a painful condition of the muscles that occurs after strenuous exercise. It can last up to a week and is quite debilitating. It is best prevented by exercising sensibly and using cold baths, cryotherapy, and compression bandages. All of this can be supplemented with supplementation.

Resources

1. Hotfield, Thilo et al. "Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics." "Delayed Onset Muscle Soreness – Teil I: Pathogenesis und Diagnostik." Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin vol. 32.4 (2018): 243-250. doi:10.1055/a-0753-1884
2. Heiss, Rafael et al. "Advances in Delayed-Onset Muscle Soreness (DOMS) - Part II: Treatment and Prevention." "Delayed Onset Muscle Soreness – Teil II: Therapie und Prävention." Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin vol. 33,1 (2019): 21-29. doi:10.1055/a-0810-3516
3. Tanabe Y, Fujii N, Suzuki K. Dietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans. Nutrients. 2021 Dec 24;14(1):70. doi: 10.3390/nu14010070. PMID: 35010943; PMCID: PMC8746365.
4. Afonso J, Clemente FM, Nakamura FY, Morouço P, Sarmento H, Inman RA, Ramirez-Campillo R. The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol. 2021 May 5;12:677581. doi: 10.3389/fphys.2021.677581. PMID: 34025459; PMCID: PMC8133317.
5. Gillis, Jason D et al. "Influence of Menthol on Recovery From Exercise-Induced Muscle Damage." Journal of strength and conditioning research vol. 34.2 (2020): 451-462. doi:10.1519/JSC.0000000000002833