HIKING WITHOUT PAIN
Tid Bits of Info
- DOMS is most pronounced 48 hours after the onset if no activity is performed the next day.
- DOMS is not a “build-up” of lactic acid.
- Specific exercises will prepare your body for an upcoming event and prevent DOMS.
- DOMS is a result of microdamage to the muscle cells and the swelling within the cells.
- Seek the advice and treatment from a Physical Therapist if you want to prevent/avoid the onset of DOMS or have to treat it if it occurs.
Sally looked forward all year to her family vacation in the mountains. Each year in late October, her family rented a cabin in the scenic Blue Ridge Mountains. They spent the days taking long hikes and exploring the numerous rigorous pathways. Normally, she prepared for the trip with mini weekend hikes prior to her departure but a heavy work schedule limited her to one hike that was less than three miles long.
When the mountain trip finally arrived, the whole family spent the first day exploring the beauty of the changing colors and falling leaves in the mountain. They took a five-mile hike and walked down several steep, rugged hills. Sally navigated the hike well. The family returned late afternoon and enjoyed a warm fire on a cool evening.
When she woke next morning, Sally was in pain. The front of her thighs and her calves ached, and she struggled to stand and walk. She even had to hold the railing as she descended the stairs. The intense pain in her thighs and calves caused Sally to walk with a limp.
Muscles have two primary jobs in the body: movement and controlling the quality of motion within the body. This helps to dynamically stabilize the body’s joints. Many people suffer from muscle soreness following exertion of some kind. When the muscles are stressed excessively and have to forcefully contract to move or stabilize the joints of the body, there is a possibility that they will suffer damage to some of the muscle fibers. When the muscles are damaged, there is swelling of the individual muscle cells and the accumulated, excess fluid in the cell causes and outer covering of the muscle cell to stretch.
The increased pressure within the cell causes pain when the muscle cell is massaged or used to move the body. This condition has been labeled Delayed Onset Muscle Soreness or DOMS. Certain types of motions are more taxing to the muscle than others, and when Sally was hiking down the hills her muscles were being “loaded” excessively in an eccentric contraction. The muscles in her thighs and calves were lengthening under a great deal of tension in order to “put on the brakes” and control her descent. This type of muscle action has been linked to DOMS at a greater rate than any other type of contraction.
Sally is like many people that are treated in the Physical Therapy setting on a daily basis. She went from no significant activity to an aggressive (relatively) activity level. Her body was not prepared for that type of exertion. She damaged the muscles in her legs and she could have prevented the injury from occurring by properly preparing herself for those hikes. She needed to “hike” prior to going on her vacation. She could have performed several different types of strength building exercises and activities that would have increased the amount of stress and strain that the muscles could have handled during the hike.
If you have plans to go on a trip that will include a lot of activity (this includes walking) that your body is not used to, you should seek the advice of a Physical Therapist to discover what you should do to prepare for your upcoming event. These healthcare professionals can help you with an exercise program that includes stretching, strengthening and endurance enhancing exercises. You can learn specific activities or “drills” that can be performed to be more specific with your conditioning program if that is needed to better prepare for the upcoming trip.
If you develop DOMS, you can treat it several ways but the simple best way is to go out and perform a very similar activity that caused the condition in the first place. You have to perform the activity at a much-reduced intensity level or you can cause more damage to the muscles. Massage of the injured muscle can help to reduce the pain that is present. The use of NSAIDs is usually not needed but some healthcare providers suggest using them. Physical Therapists can utilize modalities and specific manual techniques that are capable of increasing blood flow to the injured muscles and help to decrease the excess fluid in the cells.
DOMS can ruin an activity and certainly reduce the enjoyment that one can have during an active vacation if it develops. There is usually no permanent damage to the muscle cells, but the pain can be severe enough that certain activities have to be modified or avoided completely. Fortunately, most people can reduce their chances of developing DOMS if they prepare properly for an upcoming adventure.
Knowing the reasoning as to why muscles become sore after overexerting oneself is an important concept for physical therapists to educate patients on. Most patients do not understand the physiologic basis as to why their muscles are sore after activity, and I believe educating them about proper strength training and stretching to reduce DOMS can help prevent unnecessary use of NSAIDS, or the potential to start abusing opioids to mask one’s pain.