Muscular Pain

Muscular injuries can range from mild post exercise soreness (Delayed onset muscle soreness or DOMS) to higher grade muscle strain. The most commonly affected muscles are the high speed and load muscles of your legs such as your hamstrings, calves and quadriceps. Symptoms generally consist of pain in the muscle belly, weakness and lack of flexibility.

Initial management includes the “POLICE” protocol:
Protect
Optimal Loading
Ice
Compression
Elevation

Your Physiotherapist can guide you in the best management of an acute muscle injury including advice on relative rest, continuing to load other areas as well as how to achieve optimal loading of injured area, the use of ice initially (24-48 hours) then heat and avoidance of anti-inflammatory medication for the first 3-5 days as it can cause increased risk of recurrence by 3.5x (Warren 2005). Early hands on management can include a “flush” or indirect massage to the uninjured areas of the muscle/ surrounding area, ultrasound and techniques to provide compression to the injury. Delayed onset muscle soreness (DOMS) is a common outcome of any high load or unaccustomed training and can last 3-5 days. Soft tissue massage, heat and gentle exercise have all been found to be mild-moderately effective in relieving the discomfort. Anti-inflammatories are not recommended until ~3 days post injury in case what you thought was simple DOMS actually turns out to be a mild muscle strain!

One of the most important things to address post muscle injury is to establish why it occurred in the first place! This can be due to external factors such as fatigue and overload of the muscle that may occur due to a sudden change in the intensity or volume of training. Internal factors such as general conditioning and fitness, muscle imbalance, strength and neuromuscular control can also contribute to the occurrence of a muscle injury.

Once you are optimally managed through the acute stage of your muscle injury, your physiotherapist will address these potential contributing factors by discussing your training history and lead up to the injury, as well as performing a full functional assessment and musculoskeletal screening. Another important component of your recovery is exercise rehabilitation and strengthening. Early, optimal loading guided by your physiotherapist is known to significantly improve muscle healing. Return to sport and other exercise is generally guided by certain criteria such as achieving sufficient pain-free muscle strength and flexibility. This type of criterion-based rehabilitation is aimed at preventing any recurrence of the injury and ensuring an issue-free return to sport or training.

Back to top