Muscle Pain
Muscle Pain
41 Ways to Relief
MAN: I don't understand (as he rubs his cramped calf, then his sore hamstrings, and then his strained shoulder). I exercise almost every Saturday. Softball, basketball, touch football. My muscles should be used to that stuff.
ALMOST EVERY MULE IN HIS BODY: Give us a break. You've never met an elevator you didn't like. The only thing we're used to is pain. We should have you arrested for muscle neglect.
Enter Ted Percy, ., associate professor of orthopedic surgery and head of the Sports Medicine Section at the University of Arizona College of Medicine, Arizona Health Sciences Center. "Overuse—that's the key word. Doing too much too soon."
WOMAN: I'm supposed to be in great shape. I walk 6 miles every single day. But my legs are killing me!
HER ANGRY LEG MUSCLES: You're killing us! You never take a day off. We should have you arrested for muscle abuse.
Enter Dr. Percy. "Overuse—that's the key word. Doing too much too often."
So there you have the most common reasons that you hut—the terrible trio of too much, too soon, and too often.
Now here are the treatment tips you need to know for those times when your muscles have sentences you to pain—whether it's a cramp, a strain, or general soreness.
Take it easy. "Every time you exercise, your muscles are injured," says Gabe Mirkin, ., sports medicine practitioner at the Sportsmedicine Institute in Silver Spring, Maryland. "It takes 48 hours for muscles to heal from exercise. Soreness means damage, and you should stop exercising when you feel sore."
Of course, you don't have to be running a race or playing a hard tennis match to injure your muscles. Working in the yard, walking around the zoo all day, or simply sitting in an unfamiliar or awkward position, or in the same position for a long time, can cause muscle problems.
How much rest you should give your muscles depends on the severity of the injury and the situation, says Allan Levy, ., director of the Department of Sports Medicine at Pascack Valley Hospital in New Jersey.
A cramp may require only minutes of rest, a severe strain may need days or weeks. But sometimes you might not have the luxury of resting the muscle as long as needed. "If you're out hiking, for example, and strain a muscle [which is the same as pulling a muscle], at least rest for a couple of hours, then carefully stretch the muscle" before trying to continue, Dr. Levy advises.
Overall, don't underestimate the value of rest.
Put yourself on ice. It's still the first line of defense against swelling and should be used immediately after injury, says Carol Folkerts, orthopedic coordinator of physical therapy at the University of Maryland Hospital in Baltimore. She recommends using an ice pack or wrapping ice in a towel or plastic bag and applying it for 20 minutes at a time throughout the day.
Keep the ice off the affected area for at least as long as you keep it on. "The ice constricts your blood vessels, and it's not good to constrict your blood vessels too long," Folkerts says. "You could kill the viable tissue in that area." People with heart disease, diabetes, and vascular diseases are especially vulnerable, and "they should use ice with caution and only with the consent of their doctors."
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Get wrapped up in yourself. Don't make a mummy out of that sore calf or strained ankle, but wrap it in an Ace bandage to keep the swelling down. Just be careful, Dr. Levy cautions, not to wrap too tightly, or you could cause swelling below the injured area. Compression may stop cramping, too, but Dr. Levy warms that it's a rather painful approach.
Put your feet up. That is the advice if you've injured your foot or lower leg. Specifically, raise the injured body part higher than your heart to prevent blood from pooling and causing swelling, says Bob Reese, head trainer for the New York Jets and president of the Professional Football Athletic Trainers Society.
Fire up. "After starting the ice, you may switch to heat for acute soreness or strain," Folkerts says. "Typically people like heat better; it's more relaxing. The heat will dilate the blood vessels and promote healing."
Just remember not to switch from ice to heat too soon, or the injured area may swell. "And you don't have to switch over to heat at all unless you want to," Folkerts says. "You can stay with ice."
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Use heat-penetrating rubs carefully. There isn't complete agreement here. "All the heat penetrating rubs are valuable," Dr. Levy says, "because they keep the temperature of the affected area up."
But athletic trainers, for the most part, are less enthusiastic about these popular over-the-counter analgesics. "They can irritate the skin," says Mike McCormick, director of sports medicine at DePaul University. "These rubs give a false sense of security—they warm, but it's surface warmth. They don't get the muscles warm."
Lay on some aspirin-based creams. Also sold over-the-counter, they're an alternative to the heat rubs. "They're greaseless and less likely to irritate your skin, and you won't feel the heat sensation as you would with a lot of other rubs," says McCormick. They work like aspirin, reducing pain and inflammation.
Bring on the A-I team. This is the anti-inflammatory team—"aspirin, ibuprofen—any of the over-the-counter nonsteroidal drugs," says Dr. Percy. "They'll help reduce pain."
S-t-r-e-t-c-h. For cramps and spasms, "gradually stretch the muscle out and you'll get the muscle to relax," says Dr. Levy.
"And stretching exercises can take care of your soreness as it exists now, as well as prevent soreness in the future," McCormick adds. Stretching is important because muscles injured during exercise shorten during the healing process, Dr. Mirkin explains. And unless the muscles are then lengthened, they will remain tight and more likely to be injured or torn. (For instructions on stretching exercises, see "Stretch to Strengthen" above.)
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Give your muscles a massage. It would be nice to have a personal masseuse or masseur at your side at all times, and in a way, you do have one—yourself. Just rub gently, and as with exercise, stop if it hurts, Dr. Levy says. You also might want to warm the sore area before massaging it.
Add warm clothing. If you're exercising in cold weather and feel yourself getting stiff and a little sore, warm up by adding more clothes. You may be able to halt muscle problems right there.
"In cold weather we use running tights under players' uniforms to retain the heat," Reese says. "They like the compressive feeling it gives them, and the tights support the muscles a little bit."
Loosen your clothing. But if it's a leg cramp you feel approaching, you may want to shed tights or any other snug clothing to give your muscles a little more room.
Change positions. Whether you're bent over a keyboard typing or bent over a bicycle pedaling, your wrists and forearms are vulnerable to cramping and soreness, says Scott Donkin, ., a partner in the Rohrs Chiropractic Center in Lincoln, Nebraska.
But there's one important difference between the cyclist and the office worker—the cyclist always has the opportunity to select the bike that best fits him or her. Yet office workers, who have fingers and hands of all different sizes, typically use the same office equipment.
"The wrist and hands should be used in what is known as the neutral position," according to Dr. Donkin. "In this position, the wrist is bent neither forward, backward, inward, nor outward.
If you have long hands and fingers, you can reduce the strain by adjusting the keyboard to a more horizontal position (flat with the work surface) as long as it does not put your arms or shoulders in a strained position.
For those who have short hands and fingers, a higher incline on the keyboard, typewriter, or calculator will make the keys easier to reach.
Stand up. It's simple, and perhaps that is all it will take to stop a cramp in the leg or foot, Dr. Levy says.
Repeat the activity that made you sore the very next day. Say what? "Do the activity again the very next day," Reese says, "but with much less intensity. It will help work out some of the soreness."
Then continue to follow a hard-easy/hard-easy workout pattern. This is advisable because of the 48 hours needed for muscles to recover, says Dr. Mirkin. "All serious athletes train that way."
Branch out. This is perhaps an even better idea than the hard-easy routine, Dr. Mirkin says. If you're a walker suffering sore lower leg muscles, he suggests mixing in some swimming or bicycling (which works the upper legs) so you can continue exercising while healing.
Lose weight. If sore muscles and muscle strains have become a chronic problem, the extra weight you're asking them to move may be at least partially to blame.
Accept the truth. If running always makes you hurt, for example, then you may have to find another exercise. "Running is one of the most dangerous sports for injuries," Dr. Mirkin says.
Slow down instead of stopping suddenly. After hard exercise or physical work, the bloodstream is loaded with lactic acid, which collects in the bloodstream when there is a lack of oxygen, explains Dr. Mirkin. When the acid reaches high levels, it disrupts normal chemical reactions of the muscles and can make your muscles hurt.
"The most effective way to clear the bloodstream is to continue exercising at a slow, relaxed pace," Dr. Mirkin advises, adding that this may lessen immediate soreness but that it won't protect you from soreness the next day. That soreness, he says, is caused by torn muscle fiber.
Change your shoes. If you're wearing the wrong kind of shoes or wearing shoes that don't fit well, that could explain the foot, leg, and even back pains you're feeling while exercising, says McCormick.
Strengthen yourself. Weak muscles could be as much to blame for chronic strains as inflexibility. While men are more likely than women to be inflexible, "We tend to stress that women often need to gain strength. We stress to both men and women the need to develop strength and flexibility," McCormick says. (See "Stretch to Strengthen" on page 436 for suggested strengthening exercises.)
Be patient. The more serious the injury—a severely pulled hamstring, for example—the more of this virtue you will need to ensure a relapse-free recovery.
Drink up. Dehydration is often a big contributor to cramping, says McCormick. "We overstress the need to force liquids, especially before, during, and after physical activity. And for good reason."
PANEL OF ADVISERS
Scott Donkin, ., is a partner in the Rohrs Chiropractic Center in Lincoln, Nebraska. He is also an industrial consultant, providing tips on exercise to reduce stress for workstation users, and author of Sitting on the Job.
Carol Folkerts is orthopedic coordinator of physical therapy at the University of Maryland Hospital in Baltimore.
Allan Levy, ., is director of the Department of Sports Medicine at Pascack Valley Hospital in New Jersey. He also is team physician for the New York Giants football team and the New Jersey Nets basketball team.
Mike McCormick is director of sports medicine at DePaul University in Chicago, Illinois, and a certified athletic trainer.
Gabe Mirkin, ., is in private practice at the Sportsmedicine Institute in Silver Spring, Maryland. He is also associate clinical professor of pediatrics at the Georgetown University School of Medicine in Washington, . He is the author of several sports medicine books, including Dr. Gabe Mirkin's Fitness Clinic, and is a syndicated newspaper columnist and radio broadcaster.
Ted Percy, ., is an associate professor of orthopedic surgery and head of the Sports Medicine Section at the University of Arizona College of Medicine, Arizona Health Sciences Center in Tucson.
Bob Reese is head trainer for the New York Jets and president of the Professional Football Athletic Trainers Society.