Questions about gym injuries

Volume 1, Number 52 | The Weekly Newspaper of Chelsea | September 14 - 20, 2007
Healthy

By Greg Rothman, M.S. P.T.

You talked about DOMS in your Aug. 24 column, saying that it lasts from 24 to 48 hours. I started lifting weights a few years ago, and I get really major soreness that lasts for four or five days sometimes, and no one has been able to tell me why. Could this be a sign of something more serious?

DOMS (delayed onset muscle soreness) is common among people who do strength-training. It is thought to be a byproduct of microscopic tears in muscle fibers and sometimes resulting swelling, and is considered normal (non-pathological). Typically, DOMS is most prevalent and most intense when starting a new workout program or when a program is changed and new exercises are performed. Generally, it lasts from 24 to 48 hours but can last longer. Any pain that lasts for more than one week should be examined by a medical professional.

To prevent or minimize the discomfort of DOMS, make sure that you are doing the following:

• Properly warming up prior to exercise and cooling down afterward
• Stretching the muscles that you have worked during and/or following exercise
• Drinking enough water (at least 0.55 ounces for every pound of body weight)
• Taking a multi-vitamin and mineral supplement every morning

If DOMS symptoms continue, there are some things that you can do to help alleviate them and allow the muscles to heal more quickly:

• Do light, low-impact cardio exercise, which shuttles blood to the area and may speed the healing process
• Some research has shown that Vitamin C decreases the duration and intensity of DOMS, so make sure you are getting at least the RDA every day.
• Observe the RICE protocol: (R)est the affected area; use (I)ce for 15 minutes several times a day; (C)ompress the affected area with an elastic bandage; (E)levate the affected limb.
• Gently stretch the involved muscles
• Get a massage that focuses on long strokes to the effected muscles.

Following those recommendations will, in most cases, eliminate or diminish the discomfort associated with DOMS. However, if you still are getting severe symptoms that last as long as a week, you should consult your physician.

In your article, you wrote about shooting pains that go down the back of the leg, or sciatica. For the last few months, I’ve been getting similar pains that go down the front of my thigh and sometimes into my shin. Sometimes the pains last just seconds, and sometimes it’s hard to walk for a couple hours. Is this another kind of sciatica?

Pains that “shoot” down the leg are symptoms of nerves being compressed. Sciatica is the name given to the most common such problem, because the sciatic nerve is the largest nerve that travels down the leg. That nerve exits the spine between the fourth and fifth vertebrae, which is the most common site of disc problems, like bulges and herniations.

Other nerves also exit the spine at different levels and can become compressed, either between the vertebrae or within the muscles through which the nerves pass. The femoral nerve is a large nerve with many branches that runs down the front of the leg and may be the cause of your symptoms. The femoral nerve gets compressed with much less frequency than the sciatic nerve, but this is a not an altogether uncommon problem.

These types of pains can be the symptoms of problems that require medical intervention. I would recommend that you consult a medical professional to determine the cause of your symptoms. You may expect that a physician will want to do an MRI to determine where the nerve is being compressed so that the proper treatment options can be considered.

Very often, nerve compressions of this type can be treated with oral corticosteroids to reduce the inflammation and exercise to release the entrapped nerve once the acute symptoms are gone.

Less frequently, surgical intervention is recommended to release an entrapped nerve from between compressed vertebrae. I always recommend that all other options be tried, and second opinions gathered, prior to undergoing surgery, which should always be considered a last resort, to be undertaken only when no other option relieves the symptoms—and the symptoms are intolerable.

Given the transient nature of your symptoms, it seems likely that non-surgical options will have an effect; so, don’t worry too much, but do consult your doctor.

I hope that my series on the prevention and treatment of injuries was helpful. Following the recommendations set forth in the first of the three columns will go a long way toward helping you prevent some of the more common injuries that people sustain in and out of the gym. An ounce of prevention, as it has been said, is worth a pound of cure. So, take your time when starting a new exercise program, warm up and stretch properly, and pay attention to good form. Doing those simple things will, in almost every case, prevent you from getting injured in the first place.

Next week, I’ll write about the back-to-school season and how to get yourself prepared and fit before the season of overindulgence (Thanksgiving and the winter holidays) sets in. It’s hard to believe, but they are just around the corner.

Greg Rothman, M.S. P.T., is the owner of emPower Fitness Studios (emPowerFitnessNYC.com). He received his masters degree in physical therapy from Columbia University and has 15 years’ experience in the rehabilitation and fitness fields, most recently as the personal training manager and top-level trainer for Equinox Fitness Clubs in New York City. SEND YOUR QUESTIONS about nutrition, fitness and sports injuries/rehabilitation to Greg at emPowerFitness@aol.com.