How Much Muscle Soreness After Exercise Can Be Excessive?
It’s perfectly normal to feel some muscle soreness after the first day of a new workout, but you may have heard horror stories of people ending up in the hospital after overdoing it with an overly intense workout. Chances are, your muscle soreness is normal, but here’s how to tell.
What does normal muscle pain feel like?
Delayed-onset muscle soreness (DOMS) typically appears the day after an intense workout. The more severe the pain, the longer it lasts, often peaking 48-72 hours after the workout. In a mild case, you’ll feel only slight pain for one to two days; in a more severe case, you might wince when walking down stairs for most of the week.
The sensation can range from a dull ache to a burning pain. You’ll feel the most discomfort when you contract the painful muscle, especially if you’ve been sitting still for a long time. You might wake up thinking, “Oh my God, everything hurts,” but once you get up and walk around, you’ll likely feel a little better.
If you return to the gym during this time—and you should!—you’ll find that you can do the same exercises, but muscle soreness may make it more difficult to do them with the same weight or the same number of reps as you did the first time.
As a bonus, short-term muscle soreness will protect you from recurring pain the next time. This is called the “delayed-onset muscle soreness effect,” and you can take advantage of it by attending your next workout, even if you don’t feel quite right. Delayed-onset muscle soreness only occurs after new or very intense workouts, so once your body gets used to a particular exercise, you won’t experience severe muscle soreness anytime soon.
What if it’s rhabdomyolysis?
There’s a type of extreme muscle pain that can lead to serious health complications called rhabdomyolysis, or “rhabdo” for short. In rhabdomyolysis, muscles become so damaged that the body, and especially the kidneys, are unable to process the metabolic waste products that enter the bloodstream.
However, this isn’t a very common occurrence. If you’ve just finished a workout and feel pain throughout your body, it’s much more likely that you have severe delayed-onset muscle soreness (DOMS). To give you an idea of how rare this is, this study found 29 cases over four years (2010-2014) at a New York City hospital. Since it’s just one hospital, there should have been more cases than 29 in the city over those years; however, this is still a tiny fraction of the population who exercise.
But rhabdomyolysis does happen. And since it’s more common in absolute beginners who overexert themselves than in experienced athletes (who presumably know when to stop), you may experience your first bout of severe muscle pain and not know whether it’s unusual or not.
Who gets rhabdomyolysis?
Exercise-induced rhabdomyolysis (which, again, is rare) is more common in people who:
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Dehydrated.
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Physical exercise in extreme heat.
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Perform exercises at extreme intensity or extreme volume (or both) in a single workout.
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They are new to the sport and put a lot of pressure on themselves.
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Take certain medications, including ibuprofen or other NSAIDs.
Beyond intense exercise, rhabdomyolysis can also occur as a complication following injuries that damage large amounts of muscle tissue, as well as due to certain medications or other medical conditions. According to the CDC , symptoms to watch out for can appear anytime within a few days after exercise and include:
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Severe muscle pain, weakness and swelling.
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Dark urine (tea or cola colored).
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Severe fatigue.
If these symptoms occur, seek medical attention immediately. This may mean going to the emergency room or urgent care center. There, a blood test will confirm rhabdomyolysis, and you will receive the necessary care to prevent kidney damage or other serious problems. The Centers for Disease Control and Prevention (CDC) recommends having creatine kinase or creatine phosphokinase tests done, preferably with repeated measurements over several hours or days.
What to do if it just hurts?
Besides making sure you don’t skip your next workout, we have a few tips for you . The bad news is that nothing will cure post-workout muscle soreness; you need to recover. And to recover, you need sleep, food, and time.
But while you wait, a few things can help you feel better. Movement helps, so go for a walk or do some light cardio. A massage can be enjoyable, so ask someone to give you one or try self-massage with a foam roller or lacrosse ball .
Stretching helps some, but be careful not to overstretch, as this can further damage the muscles. I like to take a hot bath or use a heating pad. (A ride in a car with heated seats is a real treat after a back and hamstring workout.) And, as always, seek medical attention for any worrisome symptoms. An online article won’t tell you whether you’re seriously injured or just a little sore, but a real doctor can.