How to treat muscle soreness

Muscle soreness 24 to 48 hours after you exercise is a good sign. It means that you have challenged your muscles and are getting stronger. This is called delayed onset of muscle soreness, or DOMS, and everyone experiences it, even elite athletes. Here's how to handle DOMS:

•Heat may relieve some of the soreness by bringing more blood to the site. After exercise, take a hot shower or bath, jump in the sauna or hot tub, or apply a hot pad to the site.

•Avoid taking an anti-inflammatory medication when you have DOMS. This includes Motrin, ibuprofen, Aleve, Advil and prescription Celebrex. Studies show that anti-inflammatory medications can delay recovery.

•Continue to follow your regular exercise schedule. Skipping exercise may prolong your recovery; research shows that active recovery works best.

•Before your next exercise session, do a five-minute warm-up.

•If general muscle soreness prevents you from participating in your regularly scheduled workout, consider this a red flag. You have pushed yourself too hard and need to dial back your level of exercise. Do not quit completely, however.

Aches and pains that go beyond muscle soreness need to be handled differently. Before these lead to chronic overuse injuries, there are several things you can do to troubleshoot and treat them.

First, try to identify the activity that produced the soreness, and avoid it for two weeks. If you engage in a number of different sports or workout activities, you may need to keep a diary to track your workouts and the occurrence of the pain.

While resting from this kind of acute pain, you can use an anti-inflammatory medication temporarily to treat your symptoms. However, do not use anti-inflammatory medications (often called NSAIDS) on a regular basis to mask your symptoms and continue the pain-causing activity.

After taking two weeks off from the specific activity that caused the problem, try it again without taking any anti-inflammatory. If soreness returns and persists, and it's an activity you don't want to stop, seek expert advice from a doctor, coach or athletic trainer on how you might avoid further pain or even injury. An expert may suggest you try modifying your technique. The expert you consult should be able to offer guidance on exactly how to do so.

If, after trying all of the above, the specific pain persists, you may need to turn to a different activity.

If you have been taking anti-inflammatories on a regular basis to alleviate exercise-induced pain, you definitely need to seek expert advice. There may be long-term consequences to continuing any activity that's causing you ongoing pain and injury. In addition, taking an anti-inflammatory on an ongoing basis can lead to other very serious health issues. These can include stomach bleeding (which can be fatal yet show no warning signs) and liver failure. If you must take an anti-inflammatory, cycle on to the drug for the weekend or the day you are doing the activity, then off again for the remainder of the week.

A good alternative to anti-inflammatories is Tylenol ( acetaminophen). Some people don't realize that Tylenol is good for joint and muscle pain — possibly as effective as anti-inflammatories. And it's probably safer for most individuals, if taken as directed.

If exercise triggers arthritis pain for you, a glucosamine supplement is worth trying. There isn't clear scientific evidence to support its effects, but anecdotal evidence suggests that glucosamine does help, and as yet there are no known side effects. To test its effectiveness for yourself, try it for two months, then stop for a few weeks and see if your exercise-induced arthritis symptoms return.

Eric Heiden, M.D., a five-time Olympic gold medalist speed skater, is now an orthopedic surgeon in Utah. He co-wrote "Faster, Better, Stronger: Your Fitness Bible" (HarperCollins) with exercise performance physician Max Testa, M.D., and DeAnne Musolf. Visit

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