Sore muscles: We all experience them one way or another, whether we’re athletes or just enjoy the occasional trip to the gym. Jodi Kuri, a physical therapist with The Ohio State University Wexner Medical Center, weighs in on different methods to treat this inconvenience.
Healthy New Albany: What causes sore muscles, and what are the symptoms?
Jodi Kuri: DOMS (delayed onset muscle soreness) is experienced 24-72 hours after exercise. DOMS occurs when there is damage to the muscle tissue after doing an unfamiliar or more strenuous exercise. DOMS can cause muscle pain and decreased range of motion in muscles, and reduce the force production of that muscle during that time.
HNA: Can muscles be too sore? Is there ever a point at which you need to take a more drastic approach when treating?
JK: Typically, DOMS will last one or two days. If an individual has muscle soreness lasting more than that time frame, then it could be something more. There are two approaches clinicians use to treat muscle injuries: MEAT (Movement, Exercise, Analgesia, Treatment) and RICE (Rest, Ice, Compression, Elevation). RICE is a good method to reduce and calm painful symptoms of an injury. If pain persists, then a person could be experiencing more than a minor strain. A muscle strain is another term for a muscle tear, and these conditions can be painful. These circumstances would need further examination by your doctor. Following evaluation by a physician, an individual will be better served for the MEAT method over RICE.
HNA: What are the different types of heat and cold therapy? Do different methods work better for different situations?
JK: Cold therapy is usually the most appropriate modality for reducing swelling and pain in the acute stages of an injury. You can use frozen peas (they conform to the body the best) or ice packs from the store; fill Dixie cups with water and freeze for no more than eight minutes; or take an ice bath if you can tolerate it (most can’t, so don’t feel like a wimp). Heat therapy is best suited for chronic injuries. Heat therapy mainly consists of heating pads and over-the-counter heat wraps. These conditions typically do not involve swelling and have been present for more than a week.
HNA: What are the drawbacks of each?
JK: The drawback of cold and heat therapy techniques is minimal. However, when using either modality, it is important to limit prolonged contact on the skin. Your skin can be damaged by prolonged exposure to cold and heat at extreme temperatures. When looking at the other effects of cold therapy, research has uncovered healing insufficiencies associated with the use of cold modalities. Icing has been shown to delay healing times of the muscle due to the constriction of blood flow and delays in the inflammation process. At the same time, cold therapy application can disrupt normal adaptive responses to exercise. Even though many people use ice for acute injuries, it is not recommended to be used for prolonged periods after the early stages of injury.
HNA: What’s the science behind why heat/cold therapies reduce swelling, soothe sore muscles, etc.? Why does it work?
JK: If an individual has an injury or increased inflammation in a muscle, cold therapy techniques can reduce swelling and slow down the pain sensation being transmitted to the brain. Some studies demonstrate cold therapy benefits at the cellular level during the body’s inflammation process. Heat therapy will do the opposite and increase blood flow to an area. Inflammation is inevitable with an injury or muscle strength adaptations. With the use of heat treatments, an individual can promote the acceleration of this process by increasing blood flow to the area. For example, if a person experiences soft tissue tension in a sore muscle, heat therapy can promote tissue extensibility and support the latter stages of healing.
To be honest, the verdict is still out in the literature to which method is the most appropriate. For my practice, I go by the length of time it has been from injury, amount of swelling and personal preferences.
HNA: Is there ever a scenario when you can use both heat and cold therapies, back to back, or switch them up depending on your conditioning?
JK: A lot of endurance athletes will alternate ice baths with heating after long runs or bikes. However, the research does not support any benefits with this method of heat and cold therapies. Studies have tried to substantiate the use of a contrast bath, which is just a back and forth process of cold and warm water submersion. However, results only demonstrated a temperature change on the skin and nothing in the muscular tissue.
HNA: Can you ever overheat or otherwise damage muscles while trying heat and cold therapies?
JK: I am more concerned about the tissue on top of the muscle. You can damage your skin by having a therapy that’s either too cold or too hot on your skin for a long period of time. I usually don’t encourage icing or using heating pads for more than 15 minutes.
Hannah Bealer is an editor. Feedback welcome at gbishop@cityscenemediagroup.com.
About the Expert
Jodi Kuri has been practicing as a licensed physical therapist since 1999. She has been with The Ohio State University Wexner Medical Center since 2006 and currently manages the physical therapy department at the Philip Heit Center for Healthy New Albany. Kuri graduated from Ohio University with a bachelor’s degree in biological sciences and a master’s degree in physical therapy. She also holds her certification as a health and wellness coach. Kuri became a board-certified orthopedic specialist in 2009 and has spoken on the state and national level on topics such as post-op and non-op hip rehabilitation.
RELATED READS
