As I await my orthopedic appointment, I felt it is a great time to talk about the difference between a good workout and an injury. If you have ever taken a class with me, you have heard me give my 2 week rule of thumb. An acute injury should be better after two weeks of exercise modification, and if it is not you should see a doctor. Acute being a muscle or tendon strain, not a broken bone or sprain.
Good workout feeling
We all want to feel like we have done something in our workout. There is a level of soreness that helps us feel accomplished. When you strength and resistance train, you are putting micro-tears in your muscles. Your body responds by repairing the fibers to be bigger and stronger. The muscle fibers will swell (become inflammed), for protection and repair. Some people take anti-inflammatory medicine after a workout to deal with the soreness. I try to encourage people to work through the soreness. That way your body is able to learn how to repair itself faster. There has been studies that show while taking ibuprofen decreases immediate soreness, it does not repair muscles faster.
Stretching is important in making the good soreness manageable. We all want to be able to sit on the toilet and walk normally down the stairs the days after a workout. When you stretch, you relax your central nervous system, returning to homeostasis. An overworked biceps, for example, that isn’t stretched, becomes an arm that doesn’t fully straighten the next day.
Delayed Onset Muscle Soreness (DOMS)
The soreness from Monday’s workout that kicks in on Wednesday is called Delayed Onset Muscle Soreness. It is this delayed soreness that often has people reaching for NSAIDs. Which again, are affective in alleviating the pain but not in the actual repair process. To help treat the muscle “damage” stretching, massage, and electrical stimulation are all great options that will decrease the amount of soreness. Massage can include foam rolling, self massage, as well as a professional massage. Another effective method is to do some light exercise, as it helps to circulate blood flow throughout the body. I often encourage people to warm up with a hot shower, and then stretch, the day after strenuous exercise.
A few supplements have also been shown to help with DOMS, these are vitamin C, vitamin E, and branch chain amino acids. You will notice that many recovery drinks have both vitamins C and E, as well as BCAAs in them. Make sure you are looking at the other ingredients and taking your overall nutritional goals into consideration when choosing a post workout supplement. Often times the recovery drinks are full of sodium and sugar that your body may not need.
A traumatic injury, like when you slip down the stairs, is the easiest way to assess a need for a medical opinion. Bad form and general over use injuries can be a little harder to determine the need for a professional. As I mentioned earlier, my general rule of thumb is a two week break. It doesn’t need to be completely abstaining from exercise, just the ones that trigger the pain response in your body.
In class, I try to incorporate a variety of physical therapy type exercises. This allows people the opportunity to really focus on good form with a more simple, single joint exercise. It also gives self reflection, maybe it is the type of exercise you need to make a part of your daily routine. I strongly encourage you to seek a chiropractic office that includes some combination of massage therapy, physio therapy, physical therapy, or acupuncture and use things learned there in your daily routine.
Seeking a doctor
Seeing a chiropractor or physical therapist is seeking a doctor, but when do you need to get Xrays and consider an orthopedic? I am going to answer that by explaining where I am at. I have had problems with my shoulder for years. I also have arthritis, so most the time, I chalk up pain to my ailing body. The last few times my shoulder has started to bother me, it has gotten progressively worse. Instead of resting and foam rolling, I started needed massage therapy.Then a year ago, I put myself in physical therapy to work through my inability to perform certain movements. Currently, my pain is pretty constant all day, not just during physical activity. The swelling in my arm is noticeable to others, and my whole shoulder girdle is tender to the touch. I have greatly cut back on my exercise and activity, taken tylonel, and I’m using self massage techniques for the last week, with no difference in pain.
So I have called an orthopedic to have it looked at next week. I am hopeful that he can prescribe a stronger anti inflammatory and put me in some occupational therapy. I did choose a doctor that is truly surgery as a last resort, and only as minimally invasive as necessary. It sounds funny to write, I’m in pain but I want him to say everything is ok. Cross your fingers, send some energy healing vibes, light, or prayers, or whatever you believe to be helpful. I am sure there will be a follow up to this blog with what he says.
I’d love to hear in the comments from you. Have you ever had an overuse injury? What caused you to go have it looked at?