Getting fit feels great, but you’ll probably have some aches along the way. Don’t let the wear and tear derail your quest for a fitter body. Find out what’s causing you to hurt, how to treat minor injuries, which medications work best for pain relief and how to keep healthy in the future…
Working out is one of the healthiest moves for your body.
But it’s also one of the easiest ways to hurt yourself.
While minor aches are unavoidable with exercise, more serious pain can mean injury or that you’re pushing too hard.
“Playing while hurt is the reason so many former professional athletes have chronic musculoskeletal problems,” says Lynn Millar, Ph.D., P.T., professor of physical therapy at Andrews University in Berrien Springs, Mich.
How can you distinguish normal soreness from a more serious problem, and what should you do if you’re injured?
Good Pain: Minor Muscle Soreness
Hours after a tough workout, you may feel sore and stiff in the muscles you exercised.
That’s known as delayed-onset muscle soreness (DOMS), and it’s caused by taxing muscles you haven’t used much before or pushing conditioned muscles too far.
When they’re pushed beyond conditioning, some muscle fibers tear, explains Scott Hasson, Ed.D., University of Connecticut professor of physical therapy.
The body responds to the injury with inflammation, which causes dull, aching soreness 12-72 hours later.
These micro-injuries are actually key to developing stronger muscles. After the muscle fibers tear, they regenerate bigger than they were.
“To build larger, well-defined muscles, you have to tear some fibers – ideally during carefully planned workouts that cause minimal DOMS and no other injuries,” Hasson says.
DOMS most often occurs at the beginning of a new exercise program.
But if you develop a bad case – where you can barely walk – ease off intensity.
“Increase workouts slowly,” Hasson says.
Stop if you feel “any pain or muscle weakness during the workout,” Hasson says. “You’re overdoing it.”
Bad Pain: Injuries
Other kinds of exercise pain signal injury, which means you’re doing something wrong.
One of the most common overuse injuries is tendinitis, marked by painful inflammation of the fibrous tissue connecting muscle to bone. It’s also known as “tennis elbow.”
But tendinitis can strike not only the elbow, but any major joint, says Millar.
It’s a sign that the muscle attached to the affected tendon – in tennis elbow, the forearm muscle, for example – isn’t strong enough to handle the demand, so it becomes overworked, inflamed and painful.
Sprains cause similar pain and inflammation in ligaments, fibrous tissue that attaches bone to bone.
Then there’s bursitis, which also causes an ache and swelling of the bursae, small fluid-filled sacs around major joints.
Traumatic injuries are often caused by hyperextension, usually a quick move that the affected muscle isn’t conditioned to handle.
For example, while diving for a ball, you might strain – or “pull” – a groin muscle.
Fibrous muscle tissues are like fibers in cloth, Millar explains.
If you pull them too hard or quickly, some rip.
If many tear, you have a pulled muscle.
If they all go, it’s a “torn” muscle.
With tendinitis, and pulled and torn muscles, pain typically appears suddenly and feels sharp and severe, causing weakness, Hasson says.
It requires immediate treatment.
First Aid for Minor Injuries
For muscle strains and DOMS, apply a warm heating pad or hot, wet towel to relax the area, especially before (but not after) activity.
Holms also recommends liniments such as Bengay and Tiger Balm.
“They produce warmth that helps relieve pain and soreness,” he says.
But for tendinitis, a sprain or a pulled muscle, stop what you’re doing.
If it’s serious, see your doctor.
The most important home care is R.I.C.E.: rest, ice, compression and elevation.
R.I.C.E. treatment promotes healing and minimizes excessive swelling.
Some inflammation is good, because it brings more blood to the injured area and promotes tissue repair.
“But unchecked swelling causes unnecessary pain and restricts movement.” Millar says.
(If you have diabetes or any condition that reduces blood flow, don’t use R.I.C.E. Instead, see your doctor right away.)
Rest: Stop using that body part, even if it means postponing workouts for a while.
“Forget ‘no pain, no gain,’ ” says Robert Moore, Ph.D., professor of pharmacology at the McWhorter School of Pharmacy at Samford University in Birmingham, Ala.
“Pain is the body’s way of saying you need rest,” he says.
Ice: As soon as possible after the injury – during the first 24 hours – put a cold pack on the affected area for about 20 minutes, then remove it for 10 minutes before reapplying.
You can use a regular ice pack, a large bag of frozen peas, or make your own pack by placing a few ice cubes in a plastic bag and wrapping that in a clean cloth.
Don’t apply ice directly to skin – it might cause frostbite.
“Icing constricts local blood vessels, which minimizes swelling,” says Richard Holm, R.Ph., a pharmacist in North Pole, Alaska, and spokesman for the American Pharmaceutical Association.
Compression: This also reduces swelling – it’s like squeezing a sponge, Hasson says.
Wrap the injured area with an elastic bandage, but not so tightly it cuts off blood flow.
The area shouldn’t hurt or throb, and fingers and toes shouldn’t change color or feel tingly.
Remove the bandage for a few minutes at least every four hours and reapply.
Elevation: Raise the body part above the level of your heart.
For leg injuries, put your feet up.
For arm injuries, try a sling.
This restricts blood flow to the area, further shrinking swelling, Hasson says.
After R.I.C.E., Heat: When the swelling starts to subside – usually in 48-72 hours – try a heating pad or soaking in warm water.
Heat promotes blood circulation in the area, which speeds healing.
As soon as you can, resume light activity, such as walking or gentle stretches, Hasson advises.
“Rest, but don’t immobilize painful muscles or joints,” he says. “That limits blood flow through them. You want blood flow to bring oxygen and nutrients to repair damage.”
Over-the-Counter Pain Relief
Most non-serious exercise pain will respond to over-the-counter remedies.
But because tendinitis, sprains, pulled muscles and DOMS all involve inflammation, you need a pain reliever with anti-inflammatory action.
That means one of several nonsteroidal anti-inflammatory drugs (NSAIDs) – aspirin, ibuprofen (sold as Advil or Motrin), naproxen (Aleve) or ketoprofen (Orudis).
Medications such as acetaminophen (Tylenol), on the other hand, relieve pain but not inflammation.
Which one you take is up to you, Holm says. The standard dose of each provides about the same pain relief.
Price isn’t an indication of quality, Moore says.
More expensive name brands, cheaper store brands and generics all are effective.
All may also cause side effects, which can be exacerbated if you take them frequently.
Aspirin is notorious for causing stomach upsets, so take it with food or use a “buffered” variety that contains antacids.
It can also increase bleeding or bruising with long-term use. If you develop hives shortly after taking it, stop – you’re probably allergic.
Ibuprofen is somewhat less likely to cause stomach distress and doesn’t impair blood clotting as long as aspirin does.
But don’t use it if you have kidney disease or diabetes because it can damage organs.
And if you’re allergic to aspirin, you may have the same reaction to ibuprofen.
Naproxen and ketoprofen have side effects similar to ibuprofen and also may cause constipation, diarrhea and headaches.
If you take other medications regularly, pain relievers may cause adverse drug interactions. Consult a doctor or pharmacist before taking them.
If you use heating pads or ice packs while taking a pain reliever, be extra-careful not to leave them on too long – the medication can mask the discomfort of burning or freezing.
Prescription Pain Relief
If over-the-counter drugs don’t provide enough relief, a doctor can prescribe either larger doses or stronger NSAIDs.
But with their extra power comes a greater risk of side effects, particularly stomach problems and bleeding, Holm warns.
A few years ago, the Food and Drug Administration (FDA) approved a new class of NSAIDs. These COX-2 inhibitor – celecoxib (Celebrex) – provides the same pain relief and anti-inflammatory action as older prescription NSAIDs but with fewer gastrointestinal side effects.
As a result, they’re popular for chronic pain, notably arthritis.
But COX-2 inhibitors have been linked to kidney damage and even heart attacks. Such side effects showed up in elderly people taking the drugs as a long-term arthritis treatment. Ask your doctor if they’re right for you.
For severe sprains, tendinitis or bursitis, a doctor might inject the inflamed area with corticosteriods, which are a strong anti-inflammatory, or anesthetics, which provide quick – but temporary – relief.
“Steroids and anesthetics don’t cure the problem,” says Francis O’Connor, M.D., director of the sports medicine fellowship at the Uniformed Services University of the Health Sciences in Bethesda, Md. “They just mask the pain a while.”
Some physicians will inject corticosteroids many times. But repeated injections weaken tendons and ligaments, and can slow the healing process, O’Connor warns.
Alternative Pain Relief
Acupuncture: Among its benefits, this traditional Chinese treatment has been shown to be effective for athletic aches. In a 2001 University of Iowa study, 86% of participants reported improved or resolved tendinitis.