That dreaded feeling after a particularly hard workout or after a longer than usual bout of exercise. Even just going up and down extra flights of stairs can bring on DOMS. Sometimes you don't even realize that you've done something extra until it's too late.

​Delayed Onset Muscle Soreness (DOMS) typically begins 6-12 hours after exercise that is more strenuous or vigorous than usual. The discomfort will increase over the next 2-3 days and then begin a hopefully steady decline over the 2-4 days after the peak.

​While experiencing DOMS you can expect decreased strength and coordination of the affected muscles. Sometimes these muscles will also have difficulty relaxing making them feel stiff and unresponsive.

The exact reason why DOMS occurs is not fully understood, but one of the primary theories is that there is microscopic damage to muscle tissues that is caused by intense exercise. There is some thought that metabolic exhaustion can also further the development of DOMS, even without underlying muscular damage.

Increased inflammation and chemical markers have been found during DOMS. Inflammation has a tendency to make nerve endings more sensitive and lead to increased pain sensation.

The biggest issue with DOMS for the average person is that, well, it hurts. And if you are already feeling less than your best when you started I can understand why some people would not be keen to continue onward. If the FIRST round of exercise felt like that, imagine what the next one must feel like. It's a bit of a tough sell if you look at it like that. However, there is hope! DOMS does not have to be a part of every workout.

The ideas for reducing the occurrence and severity of DOMS are as follows:

1. Adequate recovery. Get lots of sleep. Plan your exercise schedule accordingly.   
              
2. Compression of the affected area has shown limited benefit.          
              
3. Nutrition. Are you eating well? You just asked for more out of your body, did you give it more to work with?            
              
4. Keep going! The incidence of DOMS is reduced if exercise is repeated in a reasonable fashion on a consistent basis.         

 
Even if you do everything right, you may still encounter DOMS in your training and in your life. So, with all of this in mind, how would one make a decision about whether what they're feeling can be worked through or around on any given day?

Here is a little decision making flowchart that I find useful.

You've established that your muscles are sore. Are you injured, or just experiencing DOMS?

Begin your warm-up. You have an exercise routine, you set aside this time for yourself, and you may as well see if you can do what you set out to do. Following the warm-up, do you have full pain-free range of motion? If yes, carry on with the exercise adventure. If no, move on to the next check.

Perform 1-2 warm-up sets of the chosen exercise, performing with minimal-to-no weight and over the range of motion that you feel comfortable. Do you now have full pain-free range of motion? If yes, continue on into the sets that you set out to do! Otherwise, now is the time to consider changing the goals of the workout for this particular day.

If you have any questions or comments about the blog post today, please feel free to get in touch through our office.
 

Cheers!
 
-Trent, PT
 

References

1. Accelerating Recovery from Exercise-Induced Muscles Injuries in Triathletes: Consideration for Olympic Distance Races. Hotfiel, T. et al. Sports. 2019.
   
   
2. Eccentric Muscle Contractions: Risks and Benefits. Hody, S, et al. Frontiers in Physiology. 2019.           
              

    3. https://www.physio-pedia.com/Delayed_onset_muscle_soreness_(DOMS). Retrieved February 2020. 

Something a little special this week instead of our regular blog posting.

​Did you know our clinic is the feature of this months issue of 'Business Voice Magazine'? Follow the link below to have a special look at our clinic! 

https://issuu.com/saskatoonchamber/docs/bv_2020-jan-feb-issuu-min/s/10143331

​

With Family Day and the February break coming up, I am looking forward to some much-needed rest. Personally, I feel like the past few months have gone by so quickly that I haven’t had time to sit back and reflect on all that has happened. In the past three months, I graduated from university, took a whirlwind trip around Australia and New Zealand, started a new job and continued to provide medical coverage for sports teams around Saskatoon. It's safe to say it has been busy. During these three months, what I most often neglected was rest, and it has shown.  We often hear about the importance of exercise and physical activity on our mental and physical well-being, but what we don’t learn is how equally important rest and relaxation can be. In this blog post I am going to talk about how you can gain improvements in the gym and everyday life by taking some time to rest.

The purpose of training or physical activity is to overload the body in order to gain improvements in strength, endurance, muscle mass, etc. Most people think that exercise is when we build muscle and become stronger, but actually it is the complete opposite. When strength training (ex. Lifting weights, body weight exercises, banded exercise) we break down muscle, creating micro tears in the tissues. It isn’t until we rest that the body can repair, rebuild and strengthen those muscles – this is known as adaptation. If we don’t allow our body to rest and recover, we can actually do more harm to our body than good – in the exercise world this is known as under recovery.  What this means is that if we don’t give ourselves enough rest, our bodies will continue to break down, preventing adaptation and impacting our performance. Continually overloading the body without rest may lead to a decrease in training quality and the possibility for injury.

What are some signs of over-training?

• Decrease in performance
• Persistent fatigue – Constantly drained, lack of energy or motivation.
• Persistent mild muscle soreness
• Loss of appetite
• Poor sleep

What are some forms of recovery?

• Sleep – We should be aiming for at least 8 hours of sleep every night.
• Rest Day – Avoid further loading for physical and psychological recovery. Example: Binge watching your favourite Netflix series on a Sunday afternoon.
• Active Recovery – Low intensity exercise such as walking, cycling, swimming or yoga.  
• Proper Nutrition – What we eat plays an important role in how we train and recover. Be sure to talk to a Dietitian on how you can ensure you are getting proper nutrition to optimize your performance.

This idea of a proper work to rest ratio isn’t just for physical activity but can be applied to all aspects of life. Take school for example – as a student you often spend your entire day in class, frantically trying to take in as much information as you can. Once class is over, it is on to a late night at the library, cramming for those four midterms in one week, running only on energy drinks. Studying and going to class would be like training or working out. Staying up late and poor nutrition would interfere with your ability to rest. This cycle continues week after week and is what my classmates and I would call “surviving, not thriving”. In the end you continually stress and break down your body until it can’t function properly (ex. worsening test scores, persistent fatigue, sickness, etc.).

​This February break I challenge you to not only get active, but take time to rest and recover. For myself I plan to sleep in, spend time outside exploring our amazing city, and end up on the couch watching my favourite show on Netflix. Rest and recovery can take many forms, but if we don’t make it a priority, we may never reach our full potential.

~ Alex, Physiotherapist

Last night I had the honour of attending a presentation in a small town that neighbours my hometown. The presentation was called “Lighting the Way for Community (Re)Connection” and it was great! The presenter shared information and stories that made everyone laugh (alot), cry (a little) and reflect on what it means to be a part of a community and how to make our communities great. For a small central SK community, it was very well attended and very worthwhile.

Connecting the community and building relationships was the focus of the presentation. It was quite powerful and spoke to most people on more than just one level. For me, it spoke to me as a mother and wife, as a friend, as a community member AND as a physiotherapist within the community. The speaker touched on many important and simple ways to connect and create great relationships, whether it be with your children, your community, your employees or your clients.

As a physical therapist it is important to have a connection with the people we are treating. Whether you work in a small town or a large city, a feeling of “community” and “connection” is important in building and maintaining a therapeutic relationship.

Our number one goal, as a physical therapist, is to help you achieve your goals. And whether you are seeing a physical therapist for the first time, or you’ve seen them over the years for a number of different injuries there should be a strong therapeutic relationship and connection in order for you to have the best success in achieving those goals.

The speaker discussed the following strategies for making stronger connections and relationships (albeit in more depth and with more flare). But as simple as they may seem, each is significant in building relationships and connections.

1. Showing genuine interest in the things one cares about.
2. Making eye contact.
3. Engaging with people on their level.
4. Providing education and learning opportunities at the right time.
5. Staying present.

Again, some may seem obvious, however, it doesn’t hurt to stop and reflect on each one in each specific relationship. As a physiotherapist, the way in which we show up EVERY DAY and make simple changes in our individual interactions can build better connections and relationships.

So in reflecting on the presentation and my takeaways as a clinician, I hope for you as a client coming in for treatment, you are able to find that connection with your physiotherapist - because that connection is the road to achieving goals!!.

~ Jacquie, Physiotherapist