Acute muscle soreness (AMS) is the pain felt in muscles during and immediately, up to 24 hours, after strenuous physical exercise. The pain appears within a minute of contracting the muscle and it will disappear within two or three minutes or up to several hours after relaxing it.[1]
There are two causes of acute muscle soreness:[1]
- Accumulation of chemical end products of exercise in muscle cells such as lactic acid and H+
- Muscle fatigue (the muscle tires and cannot contract anymore)
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Transcription
Myofascial pain syndrome is a common chronic pain disorder that can affect various parts of the body. Myofascial pain syndrome is characterized by presence of hyperirritable spots located in skeletal muscle called trigger points. A trigger point can be felt as a band or a nodule of muscle with harder than normal consistency. Palpation of trigger points may elicit pain in a different area of the body. This is called referred pain. Referred pain makes diagnosis difficult as the pain mimics symptoms of more well-known common conditions. For example, trigger point related pain in the head and neck region may manifest as tension headache, temporomandibular joint pain, eye pain, or tinnitus. Symptoms of myofascial pain syndrome include regional, persistent pain, commonly associated with limited range of motion of the affected muscle. The pain is most frequently found in the head, neck, shoulders, extremities, and lower back. Trigger points are developed as a result of muscle injury. This can be acute trauma caused by sport injury, accident, or chronic muscle overuse brought by repetitive occupational activities, emotional stress or poor posture. A trigger point is composed of many contraction knots where individual muscle fibers contract and cannot relax. These fibers make the muscle shorter and constitute a taut band -- a group of tense muscle fibers extending from the trigger point to muscle attachment. The sustained contraction of muscle sarcomeres compresses local blood supply, resulting in energy shortage of the area. This metabolic crisis activates pain receptors, generating a regional pain pattern that follows a specific nerve passage. The pain patterns are therefore consistent and are well documented for various muscles. Treatment of myofascial pain syndrome aims to release trigger points and return the affected muscle to original length and strength. Common treatment options include: - Manual therapy, such as massage, involves application of certain amount of pressure to release trigger points. The outcome of manual therapy strongly depends on the skill level of the therapist. - The Spray and Stretch technique makes use of a vapor coolant to quickly decrease skin temperature while passively stretching the target muscle. A sudden drop in skin temperature provides a pain relief effect, allowing the muscle to fully stretch, and thus releasing the trigger points. - Trigger point injections with saline, local anesthetics or steroids are well accepted as effective treatments for myofascial trigger points. - Dry needling -- insertion of a needle without injecting any solution - is reported to be as effective as injections.
Cause
Muscle soreness can stem from strain on the sarcomere, the muscle's functional unit, due to the mechanism of activation of the unit by the nerves, which accumulates calcium that further degrades sarcomeres.[2] This degradation initiates the body inflammatory response, and has to be supported by surrounding connective tissues. The inflammatory cells and cytokines stimulate the pain receptors that cause the acute pain associated with AMS. Repair of the sarcomere and the surrounding connective tissue leads to delayed onset muscle soreness, which peaks between 24 and 72 hours after exercise.[citation needed]
AMS may also be caused by cramping following strenuous exercise, which has been theorized[by whom?] to be caused by two pathways:
Dehydration
The dehydration theory states that extracellular fluid (ECF) compartment becomes contracted due to the excessive sweating, causing the volume to decrease to the point until the muscles are contracted until the fluids can re-inhabit the vacuum.[3] Excessive sweating can also cause the electrolyte imbalance theory, which is sweating disturbs the body's balance of electrolyte, which results in exciting motor neurons and spontaneous discharge.[citation needed]
The feeling of soreness can also be attributed to the lack of contraction from the muscle, which can lead to overexertion of the muscle. The decrease in contraction has been theorized to have been caused by the high level of concentrations of proton created by glycolysis.[3] Excess in protons displaces calcium ions which is used within the fibers in activating the sarcomere, resulting in a reduced contractile force.[citation needed]
Electrolyte imbalance
When exercising, lactic acid becomes lactate and H+ through glycolysis. With more lactic acid consumed during the process, there will be a higher H+ concentration, thus lowering the blood’s pH level. This low pH level will affect the energy production process through the inhibition of phosphofructokinase. Phosphofructokinase is a key enzyme in the glycolytic process, which produces energy. A higher concentration of H+ will also cause the loss of contractile force through the misplacement of calcium in muscle fiber, which will disturb the formation of the actin-myosin cross-bridge.[4]
Treatments
There is conflicting research in terms of treatments of muscle soreness.[citation needed]
Stretching and muscle soreness
Stretching immediately before or after a workout does provide some help, but is not significant enough to be considered as a preventative measure.[5]
References
- ^ a b "Why am I sore after exercise? Should I workout with sore muscles?". www.cfaortho.com. Retrieved 2024-04-11.
- ^ Nelson, Nicole L.; Churilla, James R. (August 2016). "A narrative review of exercise-associated muscle cramps: Factors that contribute to neuromuscular fatigue and management implications: Exercise-Associated Muscle Cramps". Muscle & Nerve. 54 (2): 177–185. doi:10.1002/mus.25176. PMID 27159592. S2CID 206297548.
- ^ a b Layzer, Robert B. (November 1994). "The origin of muscle fasciculations and cramps". Muscle & Nerve. 17 (11): 1243–1249. doi:10.1002/mus.880171102. ISSN 0148-639X. PMID 7935546. S2CID 20514056.
- ^ Myers, Jonathan; Ashley, Euan (1997-03-01). "Dangerous Curves: A Perspective on Exercise, Lactate, and the Anaerobic Threshold". Chest. 111 (3): 787–795. doi:10.1378/chest.111.3.787. ISSN 0012-3692. PMID 9118720.
- ^ Herbert, Rob D; Gabriel, Michael (2002-08-31). "Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review". BMJ. 325 (7362): 468. doi:10.1136/bmj.325.7362.468. ISSN 0959-8138. PMC 119442. PMID 12202327.
This page was last edited on 6 May 2024, at 09:29