Simple delayed onset muscle soreness

by: Boris Prilutsky

It’s probably very difficult to find a person who, at least, a few times during her lifetime, wouldn’t experience delayed onset muscle soreness. Usually this happens when we perform some uncommon physical activity, such as working in the garden, moving to a new residence, starting a new work out routine and so on. Such post activity muscular soreness or pain is the result of a strain in muscles and tendons. In other words, the workload that you impose on your skeletal muscular apparatus is greater than its current capability.

Many times we hear that doctors use the expression: “sprain/strain or severe sprain/strain.” Overloads or strain leads to inflammatory conditions such as myositis, tendinitis, bursitis etc. Suffix “itis” stands for inflammation. Your delayed onset muscle pain/soreness is the result of inflammation within muscles, tendons ligaments etc.

As a physical condition, we characterize inflammation as swelling of muscles, tendons and other soft tissue, decreased blood supply to these soft tissues as well as obstruction in the metabolic waste products removal process.

If you strain your skeletal muscular apparatus only 2 to 3 times in the lifetime, I believe, this doesn’t endanger your health. However, if you overload yourself repeatedly, there could be significant side effects. Sometimes such side effects could escalate to very dangerous conditions such as compartment syndromes, stress fractures, acceleration of aging, including disproportional to age development of osteoarthritis, degenerative disc diseases, sleep disorders, tendons, muscles, ligaments tears, cardiovascular exhaustions and more.

As I stated before, you experience delayed muscular soreness or pain due to fairly high degree of inflammatory condition. Whether this will be acute or sub acute inflammation depends in a degree of strain, the condition of resting muscle tone, tension within fascia etc. In case of the occasional overload of skeleton muscular apparatus, human organism will overcome this condition with no significant complication. However, if this strains happen frequently, you’re developing chronic inflammatory conditions within skeleton muscular apparatus that is expressed in constant raised muscle resting tone or (reversible shortening of muscles), repeated multiple microscopic partial tears in muscles, fascia and other connective tissues, significant decrease of blood supply to the tendons, ligaments, and muscles, loss of elasticity in soft tissue and much more.

If in the morning when you wake up, you feel tension and aches all over the body and feel fatigue, it takes a while for you to get yourself out of this kind of state, and you often need a warm shower, coffee or other energy boosting drinks, etc. If you become psychologically and physiologically dependent upon maintaining your hard physical regime, in order to feel good, the next session of vigorous exercise for you will become almost like an addiction. If you start “loosening up” your tight muscles, and start feeling better as the exercise progressing, than due to repeated overtraining you developed fibromyositis, which is chronic inflammation, the condition that unless addressed, with time could lead to the decline of your health condition.

How can the described above condition debilitate your health?

In 1981, Professor Dembo, MD, Ph.D. (of the Leningrad Medical School), following extensive research, shed the light on how Post-Event Sports Massage rehabilitation can prevent hypertrophic heart syndrome. He tested 20 healthy male athletes ages 17-23 for the effects of Post-Event Sports Massage. Dr. Dembo recorded a decrease in peripheral vascular resistance and a decrease in left cardiac work following the administration oft Post-Even Sports Massage protocol. Among other machinery, Dr. Dembo used electroencephalograph (reflecting electrical activity in the brain) in this study. He also performed 24 hours hemodynamic studies. The athletes were observed over a 6-week period during their regular professional workout routine. Prior to the administration of massage treatments, the athletes have undergone sleep studies, where it was shown that they experienced abnormal peripheral vascular resistance and high levels of left cardiac work (particularly between 1am and 4am). Based on the database of the electroencephalograph it was evident that the quality of sleep was disturbed. During the next six weeks, following the same workout regimen, and having received Post-Event Sports Massage twice a week, there was a significant reduction in peripheral vascular resistance, left cardiac work, and an increase in deep sleep. In his conclusion, Professor Dembo stated that during the day was normal hemodynamic study readings included heart rate, blood pressure, and other cardiovascular parameters. During the nighttime the data indicated a worsening due to the overload of skeletal muscles expressed mostly at nighttime due to dysfunction and is a main reason leading to the abnormalities mentioned above.

What can you do in order to help yourself to improve and prevent over training complications?

You should significantly reduce your work out load for, at least, 5 weeks of rehabilitation. Your work out pulse rate shouldn’t increase for more than for 40 points. For example, if your average pulse is 70 beats per minute you should stop your workout session when pulse will reach 110 beats per minute. Instead of running you should walk. During these 5 weeks of rehabilitation, at least twice a week, you should receive massage therapy in office and in case if you cannot afford or do not have time you should purchase my self treatment medical massage educational videos where I propose step-by-step easy to learn techniques. Incorporate slow-motion floor exercise. In my medical massage educational videos, in addition to self massage, trigger point therapy, ice and self hot stone massage, I propose special exercise program that included posts isometric relaxation- stretching techniques. Don’t extend motion beyond the point when you experience pain sensation. For example, when you tilting/rotating your neck and after 35 degrees rotation you experiencing pain, stop and move to the opposite direction. Avoid excessive passive stretching.

Is delay muscle soreness, results of strain trauma only?

As you understand, vigorous exercises damage muscular tissue and other soft tissue with the development of aseptic (noninfectious) inflammation and interstitial edema. Body reacts to these developments by mobilizing neutrophils and directing them to the affected area. Neutrophils is a white blood cells. Neutrophils enter inflamed tissues and start their cleaning job (i.e., phagocytosis) removal of the waste products produced by the muscular injury and inflammation. Their increased concentration also attracts other types of phagocytic cells, macrophages. In the process of phagocytosis, catabolic enzymes are released from neutrophils, additionally damaging already injured muscular fibers. As you can see, due to overload, soft tissue is traumatized twice.

Shin splints must be addressed.

Abnormalities known as “Shin splints” are expressed in pain in front part of the lower leg. Shin splint starts as “delayed onset muscle soreness.” Many people experience this phenomenon few times in their life time and most doesn’t give this symptom any specific considerations. Yet for some patients this condition develops into a very serious pathology, requiring immediate emergency surgery and, sometimes, leading to death of muscles, irreversible damages to nerves, etc.

A formal medical term for “shin splints” is “medial tibial stress syndrome.” All the initial soreness is the result of overload/strain of tibial muscles that are responsible for dorsal foot and dorsal toes flexion.

Mostly “onset muscle soreness” in shin area is specific to runners, hikers, basketball players, etc. Repeated strain of tibial muscles results in myositis (muscle inflammation), which causing swelling. The edema, raised muscle tone, decrease of arterial blood supply is causing pain.

Frequently repeated re-injury of tibial group of muscles can result in stress fracture and/or compartment syndrome. All tibial muscles are attached to the tibial bone by connective tissues/fascia that surrounds muscles and helps to transmit muscle powers needed for movement.

Re-injury and/or chronic inflammation of the entire tibial structure at the time of forcible load on tibial muscles can cause cracks in tibial bone; in other words tibial stress fractures. In case if re-injury will cause significant edema, the internal arterial compartmental pressure could be great enough to stop blood supply to tibial muscles. In cases like this, if emergency surgical intervention will not occur, the tibial muscles will die.

I hope you understand that shin splints onset muscle soreness symptoms represent initiation of a very dangerous syndrome. If the development of this syndrome will not be prevented, it can cause serious irreversible damages. It is also important to be aware of the fact that the compartment pressure due to edema could be great enough to cause irreversible damage to nerves that innervate the tibial group of muscles.


I hope I illustrated how constant strain of skeleton muscular apparatus leads to significant side effects. This condition must be addressed. If at the time of reading my article you’ll have any questions please join my yahoo club and post your question. I will answer to the best of my knowledge.

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