Acute Strain vs. DOMS

Patients regularly ask me about the difference between a strain and delayed onset muscle soreness. (DOMS)

At times I have patients presenting to me with DOMS that they have mistaken for an acute strain. In today’s post I will explain the differences between acute strains and delayed onset muscle soreness.

Delayed Onset Muscle Soreness (DOMS)
DOMS is the stiffness and discomfort felt in a muscle typically 24-72 hours after strenuous exercise or change in physical routine, such as gardening or home renovation. The pain is caused by microtrauma to the muscle fibres after repetitive muscle lengthening under load, such as a negative repetition during a weight lifting exercise. Muscle lengthening or stretching will recreate the pain, however, there should be little to no pain while at rest. DOMS, although uncomfortable, usually resolves on its own within five days. Treatment is not necessary, however, if management is desired there is some evidence to suggest that increasing the blood flow to the area via light exercise, hot packs, massage or sauna may help speed up the recovery.

Acute Strain
Acutes strains are damage to muscle or tendons caused by a sudden lengthening of the tissue. The tissue may or may not be under load at the time of the injury. Pain and stiffness is usually felt instantly or shortly after the incident. Examples include pain in the hamstring while attempting a hurdle, or lower back pain while lifting a couch. The extent of tissue damage is greater than that resulting in DOMS, and depending on the degree of strain there may be some associated bruising. There may be pain at rest, however, any general use of the injured muscle will recreate the symptoms. The natural history (general recovery time) of an acute strain is typically 6-8 weeks. These injuries should be assessed by a musculoskeletal professional before treated. Rest, ice, compression and elevation are usually prescribed, however, mobilization may be required in order to establish functional scar tissue. Muscle rehabilitation or reconditioning may also be required. Consult your physician if you are considering the use of pain killers or non-steriodal anti-inflammatories.

So, next time you experience muscle pain or stiffness please consider the onset of the symptoms. Did the pain and stiffness start the next day and intensify the following day? If yes, then you are likely experiencing DOMS. Consider light exercise, massage, hot packs or sauna for relief. Did the pain start during or shortly after the activity? If yes, then you have likely strained something. Consult your chiropractor, physical therapist or physician for management.

Keep well until next time!

Dr. Andrew R. Bigness, B.Sc., D.C.
Genesis Health Centre
Cabana Court Chiropractic
Windsor, Ontario