Se sentes dores musculares até uma semana depois de exercício ou de outra atividade física, provavelmente provocaste a chamada febre muscular. Neste artigo vamos abordar como surge a febre muscular, quanto tempo dura, vamos analisar as suas causas e sintomas e, sobretudo, como te livrares dela o mais depressa possível e como preveni-la no futuro.
O que é a febre muscular e quais são os seus sintomas?
A febre muscular, designada em inglês pela sigla DOMS (delayed onset muscle soreness), é um estado bastante doloroso do corpo que surge após um treino exigente. Além de a própria dor ser uma experiência muito desagradável, a febre muscular pode limitar o desportista nas atividades desportivas e, por vezes, até nas atividades diárias comuns. Além da dor muscular, a febre muscular é acompanhada por outras manifestações, como uma flexibilidade reduzida e a sensação de «encurtamento» dos músculos doridos.1
Como e por que surge a febre muscular?
As dores musculares após o desporto surgem porque, durante o exercício, ocorre uma alteração na estrutura das fibras musculares (as fibras rompem-se para poderem regenerar mais fortes e maiores), o que provoca dor.
Para que surja a febre muscular, é preciso danificar excessivamente as fibras musculares. Uma rutura tão grande das fibras ocorre sobretudo ao realizar movimentos a que o corpo não está habituado ou durante um treino intenso, principalmente na fase excêntrica do movimento, ou seja, quando o músculo sob carga se alonga (por exemplo, no agachamento, quando descemos com a barra, na flexão de braços na barra fixa é a parte da descida a partir da barra até aos braços esticados, na elevação de halteres para bíceps é quando baixamos o haltere).1
Um dano significativo nas fibras musculares deveria, num mundo ideal, significar a recuperação para um estado significativamente mais forte e, portanto, um aumento significativo do músculo, mas infelizmente não funciona assim. O dano excessivo das fibras musculares provoca, de facto, um desequilíbrio de eletrólitos, stress oxidativo e a participação de células inflamatórias na cicatrização do músculo. Neste ambiente, o músculo cicatriza mais devagar e, ao mesmo tempo, são produzidas substâncias que atuam nos nociceptores (recetores da dor), e por isso essa rutura muscular dói mesmo vários dias depois do desporto.1
Quanto tempo dura a febre muscular?
Tipicamente, a febre muscular começa a manifestar-se 6-12 horas depois do exercício, a dor atinge o máximo no segundo ou terceiro dia e depois desaparece entre o quinto e o sétimo dia.1 A duração, a intensidade e o momento de maior intensidade da dor dependem da intensidade do treino, da duração do treino, do grupo muscular específico e do tipo de fibras musculares no músculo treinado. Um exemplo típico é quando, após um treino intenso de pernas, a dor é mais intensa apenas no segundo dia de descanso.
Como prevenir a febre muscular e como te livrares dela?
A prevenção e o tratamento da dor muscular podem sobrepor-se parcialmente, pois alguns passos de tratamento também podem ser usados para prevenir dores.
Uma medida puramente preventiva para o atleta é conhecer o seu corpo e ouvi-lo. Esta é uma capacidade muito útil se o desportista quiser eliminar o risco de lesões, overtraining ou precisamente também de febre muscular.
Outra prevenção importante é a criação progressiva de tolerância à carga. Não é o mais sensato começar o desporto logo a fundo, mas sim é sensato ir aumentando gradualmente as capacidades do corpo e o próprio desempenho, passo a passo.
Frio
Tanto o frio como o calor são métodos preventivos e terapêuticos. A imersão dos músculos em água fria ajuda a acelerar a recuperação, porque o frio favorece a transferência das substâncias pró-inflamatórias e causadoras de dor do músculo para a circulação sanguínea, onde são mais facilmente eliminadas. De uma metanálise de vários estudos, conclui-se que os melhores resultados surgem da imersão dos músculos doridos em água a 11-15 graus durante 15 minutos. A crioterapia traz efeitos semelhantes (2-5 minutos passados numa sala arrefecida até menos 100 graus).2
A aplicação de pomadas refrescantes com mentol continua a ser um fenómeno inexplicado na investigação. Os desportistas gostam de as usar, porque sentem que ajudam a aliviar a dor. Numa comparação cega entre a pomada refrescante e uma pomada sem princípios ativos, os desportistas avaliaram a pomada placebo como a que melhor os ajudava a aliviar a dor. Isto sugere que se trata sobretudo de um efeito placebo ao aplicar qualquer pomada num músculo dorido. Ao mesmo tempo, no entanto, os saltadores e corredores com dor muscular, depois de aplicarem a pomada refrescante, mantiveram a sua força e desempenho no treino seguinte melhor do que os desportistas que usaram o placebo. Estes resultados não podem ser explicados de nenhuma forma, mas sabe-se que a pomada refrescante ajuda com a dor (embora apenas como placebo e não devido às substâncias contidas) e facilita a repetição mais rápida do desempenho de corrida ou salto após a febre muscular.5
Aplicação de calor
A aplicação de calor, sob a forma de sauna, jacuzzi ou compressas quentes, é recomendada apenas nas fases mais tardias da febre muscular. O calor só deve ser aplicado quando as dores começarem a diminuir (cerca do 4.º ao 7.º dia desde o início das dores), altura em que pode acelerar a recuperação e até ter um efeito positivo no volume muscular. Nos primeiros 3 dias, quando as dores ainda estão a intensificar-se, o calor pode piorar a resposta inflamatória.2
Compressão
O uso de compressão após o desporto (comprimindo o músculo sob carga) pode ou prevenir as dores, ou então aliviá-las e encurtar a sua duração. O facto é que a compressão do músculo durante o desporto não traz qualquer benefício, ao contrário da compressão depois do desporto.3
Muitos métodos conhecidos e recomendados há anos para acelerar a recuperação e aliviar a dor não se revelaram, nos estudos, comprovadamente eficazes na prevenção nem no tratamento da febre muscular. Alguns descrevem o seu efeito, enquanto outros o negam. Trata-se, por exemplo, do alongamento dos músculos depois do treino, do descanso ativo sob a forma de desporto ligeiro, da massagem vibratória dos músculos, do uso do rolo de massagem nem da eletroestimulação muscular, das massagens manuais ou da acupuntura. A minha humilde opinião é que, se alguma dessas coisas te ajudar por sensação, vale a pena fazê-la, e se não sentires diferença e não te satisfizer, não vale a pena continuar.2, 4
Medicamentos para a dor
O uso de medicamentos para tratar a febre muscular não é geralmente recomendado e deve ser a última opção. Os medicamentos anti-inflamatórios e analgésicos (do tipo ibuprofeno) até ajudam com a dor desagradável, mas não aceleram significativamente a recuperação muscular e, além disso, têm vários efeitos secundários indesejados quando usados a longo prazo.
Alimentos e suplementos alimentares
Alguns suplementos também apresentam um efeito positivo na febre muscular. Não se trata de uma terapia revolucionária, mas a suplementação destas substâncias pode trazer um ligeiro benefício na prevenção e no alívio dos sintomas de febre muscular. A febre muscular é aliviada pelo teor de BCAA numa bebida proteica depois do treino, pela cafeína depois do treino, pela vitamina D, pelo extrato de curcuma, pelo sumo de beterraba e pelos ácidos gordos ómega 3.2, 3, 4
Resumo final
A febre muscular é um estado doloroso dos músculos que surge após uma atividade desportiva intensa. Pode durar até uma semana e é bastante limitante. O melhor é preveni-la através de exercício sensato e, ao mesmo tempo, usar banhos em água fria, crioterapia e ligaduras de compressão. Tudo isto podemos complementar com suplementação.
Fontes
- Hotfiel, Thilo et al. “Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics.” “Delayed Onset Muscle Soreness – Teil I: Pathogenese und Diagnostik.” Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin vol. 32,4 (2018): 243-250. doi:10.1055/a-0753-1884
- 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
- 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.
- 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.
- Gillis, D Jason 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
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