Not All Muscle Soreness is the Same

In my practice, I’m often asked the same question over and over again. “Laszlo, I’m very active. I always have aches and pains. How do I know when I need to see someone about my symptoms?” Good question. “When?” indeed.

Let’s break it down by addressing some basic principles. First, let’s identify two of the most common types of muscle soreness that typically do not need medical attention:

  1. Acute muscle soreness (immediate muscle soreness): Acute muscle soreness is felt during or immediately after exercise. Symptoms are typically described as a burning pain. The primary cause is from a build-up of chemical end products and toxins in muscle tissue. Other possible causes and contributors include tissue edema and muscle fatigue. This type of muscle soreness or tissue irritation resolves quickly, within minutes to an hour after exercise. It does not usually require medical attention.
  2. Delayed Onset Muscle Soreness (DOMS): DOMS usually appears in muscles hours to days after unaccustomed or strenuous exercise. It is felt most intensely approximately 24-72 hours after the exercise. Symptoms can include pain and stiffness. Despite popular theory, symptoms are not due to lactic acid build-up, and lactic acid levels return to normal within an hour. The cause is most likely microtrauma (small scale damage) to muscle fibers. Muscle tissues adapt rapidly to prevent further damage. Symptoms are usually not felt while affected muscles are at rest and should disappear within approximately 72 hours. This situation does not (usually) require medical attention.

In contrast, an actual injury to a muscle can feel like sharp, deep and stabbing pain that typically occurs during the exercise. Swelling and/or bruising in area(s) afterwards can be an indication that something more severe has happened. Symptoms due to a specific injury usually will not ease up or improve after a few days.

These symptoms indicate a need for medical attention. A professional (RMT/ Physiotherapist / Chiropractor / MD) will be able to assess lingering and persistent symptoms and prescribe treatment to aid healing and prevent further worsening of the condition.

While these are only general guidelines, being able to differentiate between muscle soreness and actual injury helps in understanding how to best support your recovery.



Laszlo Szederkenyi

Registered Massage Therapist 

Allan McGavin Sports Medicine Centre | Plaza of Nations B103 – 750 Pacific Blvd., Vancouver, BC, V6B 5E7 

T 604.642.6761 | F 604.642.6762

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