Each week, every coach gets a letter from a student asking to be excused from training due to injury. Most of the time these injuries have been diagnosed by a professional and the student is following a proper rehabilitation plan. Sometimes however, students refer to ‘soreness’ as an injury and a reason not to train.
It is important to be able to identify the difference between pain and soreness. Here are some tips:
Onset and Length of Pain
Delayed Onset Muscle Soreness (DOMS) – the body’s reaction to intense physical activity – will normally manifest about 12 hours after physical activity. An injury, on the other hand, will likely be painful immediately after training. Normal muscle soreness should begin to subside within two to three days. Pain from an injury will not decrease in a few days. If pain following physical activity does not go away, it may be a clue to seek further help.
Type of Pain
What exactly are you feeling? DOMS will cause muscles to feel tight, tender to the touch and achy. When exercising, sore muscles will seem tired or burn. An injury is associated with pain that is more sharp and acute.
Location of Pain
Can you pinpoint the pain with one finger? Does the pain involve a small area that hurts when palpated or pressed? Or is the pain located in a tendon, bone or joint? If you answered yes to any of the above, you may be dealing with an injury. DOMS normally involves a larger or broader area of musculature, such as the muscle belly.
Pain from DOMS is typically symmetrical. That is, it will be present in both sides of the body equally (i.e. both legs). Typically, injury pain is asymmetrical (i.e. it will be present in only one leg).
When You Feel Pain
Injuries are normally painful throughout the day, even when you’re not moving. Muscle soreness will usually not cause pain when you are sedentary.
Besides pain-alleviating medications, injury pain will improve with ice and rest. DOMS, on the other hand, will improve with stretching and movement. (Let’s read that again! Training can actually help DOMS?!)
Pain from normal muscle soreness will worsen after you have been immobile or sitting for a while. Pain from an injury will get worse with continued activity (i.e. the pain doesn’t seem to improve during the warm-up or training).
While DOMS includes some swelling, it’s typically over a diffuse area and is not focused on a small area or particularly noticeable. If the swelling is obvious and in a localised area, there’s a good chance you have an injury.
So next time you feel pain or feel sore, run through the simple checklist below to determine exactly what your body is experiencing!
1 Black et al 2008, Cleak et al 1992, Cheung et al 2003, Dutto and Braun 2004, MacIntyre et al 2001, Paschalis 2007.