What is Delayed Onset Muscle Soreness

The term delayed onset muscle soreness (DOMS) is used to describe the discomfort that is often felt 24-72 hours after exercising. While DOMS is often attributed to a buildup of lactic acid, there is little empirical support for this view.

Rather, it seems more likely that DOMS is a byproduct of microscopic tearing of muscle fibers caused by over-exertion. The extent of these micro-tears, and thus the amount of discomfort that they cause, largely depends on the type of exercise and the level of exertion.

Whatever the cause, the symptoms associate with DOMS can include muscle pain, inflammation, stiffness, and weakness.

Treatment of Delayed Onset Muscle Soreness

Perhaps the best course of action is to prevent DOMS before it happens. Warming up before exercise and cooling down afterwards, along with proper stretching, can help to reduce the incidence and severity of DOMS. It is important to keep in mind, however, that excessive stretching can cause DOMS.

While the R.I.C.E. regimen may alleviate the symptoms associated with DOMS, the often diffuse nature of this sort of muscle soreness makes it difficult to apply in many cases. Nonetheless, there is evidence to suggest that rest, ice, compression, and elevation all have the potential to speed recovery.

Active recovery, which involves light aerobic exercise to increase blood flow throughout the body, has been suggested as a means for minimizing the occurrence of DOMS in the first place, as well as for reducing symptoms once it occurs. While anti-inflammatories such as ibuprofen may be effective at reducing the discomfort and inflammation associated with DOMS, they do nothing to reduce weakness.

Finally, though massage has been suggested as an effective treatment for DOMS, the data here are mixed. Likewise, it has been suggested that nutritional supplements such as vitamin C and fish oil may help to alleviate the symptoms of DOMS, but there is little in the way of scientific support for this view.

What is Golfer’s Elbow?

Golfer’s elbow, formally known as medial epicondylitis, is similar to tennis elbow except that it affects the other side of the elbow. The primary symptom is pain at the inside of the elbow (i.e., the medial epicondyle) which can increase with the flexing of the wrist, and can also radiate down the forearm.

Golfer’s elbow is caused by overuse of the wrist flexors, which pull the hand down. This can result in small tears in the flexor tendon, which attaches to the medial epicondyle. The end result is inflammation and pain. As the tendon heals, scar tissue can form.

Golfer’s elbow is also known as Little League elbow.

Treatment of Golfer’s Elbow

The first step in treating Golfer’s Elbow is to discontinue activities that cause the pain. Following the R.I.C.E. treatment regimen is known to be helpful in reducing pain and swelling. Anti-inflammatory medications might also be helpful. In chronic cases, a cortisone injection might relieve the pain/discomfort.

Physical therapists may be able to use ultrasound to help heal the damage. They should also be able to prescribe strength and flexibility exercises. In some cases, a wrist brace or splint might be required. If non-surgical forms of treatment do not solve the problem, surgery might be recommended. Seek the advice of a trained medical professional.

What are Heel Spurs?

Heel spurs are bone growths on the bottom of the heel where muscles and other soft tissue attach to the heel bone. Early signs of heel pain are typically due to plantar fasciitis. Heel spurs can develop when this pain is ignored and the chronic inflammation increases the stress on the fascia (i.e., the tough, fibrous band of tissue that connects the heel bone to the base of the toes). The end result is bone growth on the bottom of the heel.

Treatment of Heel Spurs

Conservative treatment includes taping of the foot, anti-inflammatory medications, and possibly cortisone injection. An exercise regimen, night splints, and physical therapy can be used in an attempt to reduce inflammation. Custom orthotics can be used to reduce the stress and strain on the plantar fascia, effectively reducing symptoms. If these conservative treatments fail, surgery may be indicated. In such cases, you should seek the opinion of a trained medical professional.

Please see golfer’s elbow for a description of, symptoms associated with, and treatment options for Little League elbow.

What is Plantar Fasciitis?

Plantar fasciitis is a chronic foot injury that is common in athletes that perform repetitive flexion/dorsiflexion of the toes. The plantar fascia is the tough, fibrous band of tissue that connects the heel bone to the base of the toes. With each step, the plantar fascia is stretched, and the arch flattens to absorb the heels impact on the ground. Because the plantar fascia is not very flexible, repetitive stretching can result in small tears.

The classic sign of plantar fasciitis is heel pain during the first steps of the day. That plantar fascia shortens overnight resulting in pain when it is first stretched. Pain associated with recent weight gain or a sudden change in exercise pattern is also a sign of plantar fasciitis. While heel spurs can be a sign of plantar fasciitis, with about half of all patients with plantar fasciitis having spurs, they are typically not the cause.

Individuals with flat feet, high arches, and/or tight achilles tendons may be predisposed to plantar fasciitis. Rapid weight gain, a rapid increase in the intensity or duration of activity, shoes with improper/poor cushioning, and/or prolonged standing can increase the likelihood of plantar fasciitis.

Treatment of Plantar Fasciitis

Perhaps the most important treatment for plantar fasciitis is to avoid activities that irritate the condition, including walking barefoot on hard surfaces. The use of footwear with proper arch support is also important. Other treatments include weight loss and/or stretching of the achilles tendon and/or plantar fascia.

Taping the heel and arch may help to reduce pain, as can medial longitudinal arch supports. Massaging the fascia by rolling the foot over a 3-4 inch diameter tube can also be an effective treatment.

As directed by a physician, non-steroidal anti-inflammatory drugs (NSAIDS) can be used in conjunction with these other treatments for a period of 2-4 weeks. Strengthening exercises include crumpling a hand towel with the toes or pulling a weighted towel across the floor with your toes. Following exercise, place a cold pack or ice bag on the heel at the most tender spot. Remember, ice shouldn’t be applied for longer than 15-20 minutes without a break.

What is Tennis Elbow?

Tennis elbow, formally known as lateral epicondylitis, is similar to golfer’s elbow, except that it affects the other side of the elbow. The primary symptom is pain at the outside of the elbow (i.e., the lateral epicondyle). Tennis elbow ranks as the number one reason that people seek medical help for elbow pain.

The term tennis elbow is itself somewhat of a misnomer, as a wide variety of activities can cause this problem. The most common cause of tennis elbow is overuse of the wrist extensors, which pull the hand back, resulting in pain and inflammation of the tendons that attach to the outside of the elbow. The first sign of tennis elbow is pain on the outside of the elbow during or after intense use.

Treatment of Tennis Elbow

The first step in treating tennis elbow is to discontinue activities that cause the pain. The R.I.C.E. treatment regimen is known to be helpful in reducing both pain and swelling due to tennis elbow. Anti-inflammatory medications might also be helpful. In chronic cases, a cortisone injection might help to relieve the pain/discomfort.

Physical therapists may be able to use ultrasound to help heal the damage. They should also be able to prescribe strength and flexibility exercises. In some cases, a wrist brace or splint might be required. If non-surgical forms of treatment do not solve the problem, surgery might be recommended. In such cases, seek the advice of a medical specialist.

What is a Torn Rotator Cuff?

The term ‘rotator cuff‘ refers to the muscles that support and stabilize the arm, allowing it to move up and down as well as rotate. The rotator cuff is made up of four muscles — the supraspinatus, infraspinatus, subscapulairs, and teres minor. Injuries to these muscles can cause pain and reduce the range of motion. Symptoms of a torn rotator cuff include shoulder pain, decreased range of motion, weakness, and a deep ache.

Treatment of a Torn Rotator Cuff

A torn rotator cuff needs to be evaluated by a trained medical professional to determine if surgery is needed. If left untreated, large tears can lead to arthritis due to inflammation of the joint. A torn rotator cuff can often be repaired via arthroscopic surgery. Recovery then involves medication to reduce inflammation and physical therapy to improve strength and range of motion.