Muscle Soreness Pt. 3: Management

by Melanie Brohm, B.Sc., RMT

Welcome back to our 3-part series on Muscle Soreness! If you've read the first and second parts, you will have learned a lot of information about muscle soreness and ways to prevent or minimize it during your workouts. In this final part of our blog series, learn how to manage the symptoms of a hard workout!

MANAGEMENT:

Don’t Stop Exercising

Reduce the intensity of the exercise if you feel sore or tender. A short 30-minute walk, gentle stretches, mobility work will actively promote blood flow to the muscles and help with recovery. In general – if you don’t move, you lose. It is also important to gradually build your fitness – strength, cardio, flexibility or endurance. Stick to a consistent schedule that slowly builds intensity, volume and includes times of rest and recovery.

Get Quality Sleep

Deep sleep – also known as non-REM - is most effective at rebuilding muscle tissue with the production of Human Growth Hormone (HGH) (The effect of acute sleep extension vs active recovery on post exercise recovery kinetics in rugby union players - PubMed (nih.gov), The relationship and importance of sleep and Muscle Recovery. (sportslabnyc.com))

Ice Bath or Cold Shower

While the research is mixed on the benefits of Ice Baths or Cold-Water Submersion Therapy for specific muscle recovery, but the overall potential benefits are numerous. They can ease sore and aching muscles by making the body feel good through reducing the effects of heat and humidity and reduce inflammation. Ice baths help deregulate the nervous system which can help with sleep quality. I was a volunteer massage therapist with a research study involving the Winnipeg Blue Bombers for 4 years (2015-2019) comparing the effects of massage, ice bath or dynamic stretching as a tool for muscle recovery. There was no concrete evidence that one was superior to the other.

Ice baths are generally 10-15®C with a slow submersion of the body lasting between 5-10 minutes done immediately after the intense activity. High caliber athletes use ice baths as a recovery method when another intense activity is scheduled within the next 24-48 hours.

Warm Bath or Shower

IF you don’t like cool, try some heat. Be cautious with the temperature if you have low blood pressure with full body submersions. The heat will sedate the nervous system and have a calming effect on the body by releasing endorphins. It will mildly increase circulation to the sore muscles bringing oxygen and nutrients needed for healing. Test the temperature (37-40C warm, 40-46C hot) of the bath before entering to prevent burns and stir the water to avoid any hot spots. Soak in the tub for 10-15 minutes or until the water becomes tepid (27-37C).

Essential Oil and Epsom Salts

Some people like the addition of Essential Oils or Epsom Salts to their warm bath or shower. Always do a spot check for allergies 24 hours before use to prevent hives or rash. Also, avoid if there are any open wounds or skin infections as they can become more irritated. Essential oils have their own individual risks, benefits and application dosages. Do your research before use. Also what one might find relaxing or sedating, another person might find irritating. Scent is closely related to memory. You can find these in many forms from the oils to steamer blocks you keep on the floor of the bathtub while you shower. Epsom salts have a reputation for relieving itching from poison ivy, skin irritation and inflammation, sore muscles, stiff joints and stress. The general application is anywhere from 1-3 cups into a 3⁄4 full tub. The variety is due to the size of tubs that are available. Those who are familiar with the effects of an Epsom salts bath can increase the amount used. Epsom salts can be unscented or mixed with different scents.

Massage – Now you get the hear my biased opinion...

Yes, massage can be used as a management tool for muscle soreness. (Effect of sports massage on performance and recovery: a systematic review and meta-analysis - PMC (nih.gov)) We have the education and training to treat a number of musculoskeletal issues. The hardest part will be finding a Registered Massage Therapist(s) that fits your needs. Did you notice the plural?? No, you do not need to stick to one RMT (or other health care provider for that manner) to help achieve your goals of treatment. If you want a more spa experience, book with an RMT in one of the fantastic spa facilities in the city. It is a great way to combine some hydrotherapy (steam, sauna, hot bath, cold bath, etc) with your treatment. If you want more of a clinical experience or focus on rehabilitation, book with an RMT that works in that setting. Every massage is therapeutic. The difference is in the marketing (relaxation, deep tissues...don’t even get me started on that word!) and unfortunately the public is misinformed on what certain terms mean. For example, “Certified” means you get a certificate – but was it a one hour course? Was there an exam? What was the quality of the education? For myself, I have extensive training in treating craniomandibular conditions – that is the jaw, commonly called TMJ issues. I am currently referring clients who don’t have TMJ problems to other great RMTs so I can use my skillset to the best of my ability. Do not see a referral to another RMT or health care practitioner as a rejection. We do this because we know another person can help you reach your goal better, faster and with less of a financial investment or because what is needed is out of our scope of practice or you’ve hit a plateau. The other key element in choosing a great RMT is communication. They should ask for feedback about pain, pressure, comfort and discomfort and modify the treatment as needed. Tenderness that is tolerable is acceptable. Clenching your teeth and holding your breath in pain is NOT therapeutic and places your body in a protective and sympathetic (fight, flight or freeze) response. The RMT is also responsible for maintaining a professional boundary. The RMT can be friendly and personable, but we are not your friend. We are your health care provider. As such, we should not be discussing personal matters, asking for advise or seeking connection from those we treat on the table. This is why we don’t treat friends and family.

Compression Garments

Wearing compression garments hace become more popular with athleted and those in professions that involve prolonged standing. There are limited studies to support the research that wearing compression garments reduced the length of muscle soreness. (Effects of Compression Tights on Recovery Parameters after Exercise Induced Muscle Damage: A Randomized Controlled Crossover Study - PMC (nih.gov))

There are many different types of compression garments available, so it is important to select what suites your needs. For those who are generally healthy, there are a variety of styles for fashion, travel, sports. The key is looking for graduated compression. For those with chronic venous disorders (spider veins, varicose veins, lymphedema, lipedema), it is important to be measured and fitted properly. Most insurance companies will cover compression garments with a prescription. I currently wear Sigvaris 20-30mmHg compression thigh highs with intense activity and 15-20mmHg compression stockings with travel, work and lighter activity after getting my spider and varicose veins treated.

Foam Rolling, and Cupping

Foam rolling and cupping are self-care tools to reduce muscle pain and soreness and mechanically lengthen muscles.

Foam rollers are available in a variety of densities. The softer foam rollers can resemble a larger pool noodle while a dense foam roller can look intimidating with knobs or patterns on the surface. Typically, you position yourself on top of the foam roller, and litterally roll the muscle back and forth across the foam roller. The intensity can be varied by the amount of body weight you place on the roller. It does take some coordination to get into a smooth rhythm. Travel sized rollers are also available can be used like a rolling pin on the surface of the muscle you want to target. There is research to support the benefits of foam rolling to treat DOMS but the number of participants is low. (Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures - PubMed (nih.gov), Does the type of foam roller influence the recovery rate, thermal response and DOMS prevention? - PMC (nih.gov)) Cupping is increasing in popularity as a self-care tool. It is best to seek guidance from a health care professional before purchasing a set of cups on your own. These can include your acupuncturist, athletic therapist, chiropractor, massage therapist, physiotherapist and more – just confirm they have the proper training. They should demonstrate the proper use, explain the risks and benefits, contraindications, and how to clean the cups. I currently own 7 different styles of cups that I incorporate in massage treatments. For people who are interested in cupping as self care, we discuss what their goals are, and I loan them a set to get comfortable using before buying. There is a difference between static cupping – where you place a cup on a area and leave it for a certain amount of time and dynamic cupping – where there is either movement of the cup after it is placed on the tissues OR the muscles are moved through a range of motion after the cup is applied.

The research on the benefits of cupping is muddled. There are different styles of cupping in Eastern and Western medicine which makes consistency a challenge. Plus, most people report qualitative results – that is feelings. Research is based on quantitative results – numbers that can be measured and compared consistently.

Stretching and Yoga

This builds on our first muscle soreness management strategy of continuing to exercise. There are many different types of stretches available. All stretches are to be performed pain free. (The effects of different passive static stretching intensities on recovery from unaccustomed eccentric exercise - a randomized controlled trial - PubMed (nih.gov)) Static stretching is where you stretch a specific muscle until you feel a gentle pull, hold for up to 10 seconds and relax. Dynamic stretching involves moving your muscles through a range of motion with repetition. The movement is always controlled Yoga is the most common form of active stretching. It involves holding a position or pose for a determined amount of time. There is no outside assistance offering resistance – only the strength of your own body. Blocks and straps are used to facilitate balance and modify the position to be performed in a safe manner. There are many different styles and types of yoga available. Do your research to choose what works best for you.

This concludes our 3-part blog series on Muscle Soreness. Thank you so much to Mel Brohm for sharing your wealth of knowledge with us on a topic that effects us all!

*Melanie Brohm B.Sc., RMT of Brohm Therapeutic Massage is a highly-educated Registered Massage Therapist, and also a long-time Zumba/Yoga participant at Yvonne's Fitness. If you would like to learn more about what she does, or find out about her services, you can find her online here.