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By Chris L. Wells, PhD, PT, CCS, ATC
I had a wonderful time at the NKF U.S. Transplant Games this year in Madison, WI, watching everyone compete and celebrate. As the days passed, more and more athletes came to me with complaints of muscle soreness. Some athletes admitted that they did not prepare for their events and others completed a pretty sound training program. This soreness is not considered a muscle injury; that is referred to as a strain. It is important to remember we must create a certain level of muscle breakdown and soreness to rebuild stronger muscles. So why were the athletes experiencing this muscle soreness, and what should they do about it next time?
There are many factors that are believed to contribute to muscle soreness. It is believed that minute muscle tears occur during activities that exceed the individual's normal muscle function. This means that the muscles are generating more force than usual, moving beyond the normal range of motion or moving the body in an unfamiliar manner. Muscle tightness and imbalance in strength between opposing muscles can also contribute to this soreness.
These minute muscle tears cause several things to occur at the muscle level that leads to the soreness that is felt. First, there is a release of enzymes from the injured muscle cells and retention of fluid within the muscle. This leads to muscle spasm, acute inflammation and changes in how the muscle regulates calcium. Calcium plays a very important role in the muscle's ability to contract and generate a force. With muscle soreness there is a delay in the cells ability to reabsorb calcium which causes muscle stiffness, spasms, and soreness. Besides the minute injury to the muscle cells there is also injury and inflammation from the connective tissue that is around the muscle cells.
What can be done to assist in the recovery? Prevention is the key to minimizing symptoms. Participation in a well-rounded exercise program that includes flexibility, muscle strengthening and endurance, and aerobic exercises is important. Our body is adaptable so it is also important to incorporate activity specific exercises. For example, if I would like to play recreational badminton, it would be important for me to practice the various skills included in the game as well as playing at competition level.
Once the activity is complete it is important to continue moving. Right after the activity it is advised for you to continue to exercise at a very low intensity. This could be a slow walk or cycling for about 10 minutes. This will allow the blood flow to continue to be elevated in the exercising muscles, which will encourage the removal of waste products produced by the muscle as well as the delivery of oxygen and other nutrients for repair and recovery. Muscle stiffness will reappear for a few days if you do not continue to exercise. Resting on the sofa will not help; it would be better to get up and be active for at least 10 minutes, enough to increase your body temperature and circulation to the muscles until the soreness is gone.
In addition to these recovery exercises, gently stretch the overused muscles. It is recommended to place the muscle in a stretch, ensuring the position is not painful, and holding for at least 30 seconds; repeat each stretch two to three times.
Finally, after your activity, recovery exercise and stretching you may achieve some additional comfort from applying an ice pack for 10 to 20 minutes. Ice application is believed to reduce swelling and inflammation and increase blood flow to the tissue underneath the ice pack.
I encourage you all to follow a training regimen while preparing for any physical activity and for life in general. Eat well, get plenty of rest, exercise at least three days a week, find time to play and enjoy yourself.