AUTOR: Francisco Barrios Marco, Fisioterapeuta

Delayed onset muscle soreness

Delayed onset muscle soreness is the pain or discomfort which occurs after exerting a muscle or muscle group unused to exercise. We may also experience muscle soreness after an accident, where despite not having sustained an injury the muscle tissue has been aggravated sufficiently to cause discomfort.

Muscle is unable to respond with normality to strenuous effort, if treated within two to three days the soreness subsides.

We have mentioned muscle soreness after an accident, but more often than not it is associated with excessive physical exertion in when we are unaccustomed to exercise or we can just as easily suffer from it even if we are fit. Taking up a new sport, for example, could also provoke soreness; we could be fit and a good swimmer but not trained and thus physically prepared for running.

Treatment:

1. Surface or deep heat treatment. This includes applying hyperthermia in the form of Capacitive Diathermy, infrared, sauna, hot baths, radar therapy, and even sunbathing, other techniques could include; hot air, warm blankets and pads.

2. Gentle massage of the area to relax muscle tissue and encourage drainage.

3. Electro stimulation set on relax mode, for drainage or anti-fatigue. We could also combine a massage programme followed by a drainage programme. Select a programme that is comfortable rather than a more intense mode which could reactivate the painful sensation from soreness. If we note no discomfort when we increase the intensity, we can finish off with a vascularisationprogramme on a higher intensity.

CRAMPS

A muscle cramp is an involuntarily and forcibly contracted muscle that does not relax. The spasm shortens the muscle movement and produces a sharp pain. Muscle cramps may occur during physical activity or whilst we are asleep and affect a muscle group, for example the calf muscles, strangely in a bilateral manner.

Insufficient stretching before exercise, excessive physical exertion in someone unused to exercise and isometric exercises can lead to a muscle cramp. Low mineral levels can also cause muscle cramps.

Treatment:

1. A session of electro stimulation with fast TENS programmes to alleviate immediately the pain. We could go onto a slower session of TENS encouraging the release of endorphins which alleviate pain. Later on we explain how we can use electro stimulation to prevent injury by improving blood circulation in a particular area, and how time should be spent applying a relaxing massage programme after training sessions.

2. Whenever possible when cramp occurs we should stretch the muscle straightaway. We can concentrate stretching exercises on the muscle in order to avoid cramps in the future.

3. Surface or deep heat treatment with hyperthermia, infrared, hot baths and pads.

4. Vigorous massage of the affected muscle with a rubbing action.

CONTRACTURES

A contracture is a hardening of muscle or muscle group; the muscle hurts on extension or when pressed upon and if we ask the patient to voluntarily contract the muscle whilst we resist it, pain returns. An excess of toxic substances above all lactic acid are considered to be responsible, excessive muscular activity can also cause intense rubbing between the myofibrils and cause pain.

Pain usually appears after training or progressively and intensely while training. We should avoid massaging the area immediately, as on many occasions, a contracture is a protection mechanism and could prove to be small tear, in which case massaging by an inexperienced person could actually worsen the condition.

Treatment:

1. By selecting a vascularisation programme using a Tens device toxic substances accumulated in the muscle are swept away. The application of a decontracture programme afterwards helps alleviate pain. Once the extreme pain has begun to subside, we can gradually increase the intensity on a decontracture programme so that the pain is no longer uncomfortable. The vascularisation programme can be used as a preventory measure. Follow with an endorphic Tens programme to keep pain under control.

2. Cold should be applied to the area immediately, followed by hyperthermia, infrared and hydrotherapy.

3. A drainage massage aids the elimination of lactic acid and other residues that build up after exercise, follow this with a gentle massage.

4. Without doubt rest is recommended and once the pain has subsided, training and stretching.