Sore? Just an intense workout or perhaps an overuse injury? Do you know the difference? “What is D.O.M.S. and what exactly is lactic-acid ‘burn’? Can taking ibuprofen or non-steroidal, anti-inflammatory drugs (NSAIDs) really limit my muscle growth? … No pain, no gain, right?!”

Though usually not an issue for most of our overweight, American society, it’s important enough to take a moment to discuss exercise recovery, because that is actually when muscle growth and tissue repair take place after all. Most folks don’t need to worry about overtraining because they are barely incorporating any intense activity into their daily routine. But overtraining can be a problem, especially as we age into our 30s, 40s and beyond, where recovery times can triple! For the most part how long your recovery period should be between workouts is common sense: If a body part or certain muscle group is still sore, then don’t exercise it just yet because it is still undergoing repair. You can, however, certainly cross train with another exercise, or train a different muscle group. And, of course, there are times when we have an illness or have just competed in a race or perhaps just returned from a ski trip, for example, where we need to build in extra rest days. All of the above is also predicated on what kind of quality night of sleep we have been getting as well, as that is when most of our growth hormone is secreted and when most tissue repair actually takes place.

For the most part exercising is invigorating, stress-relieving and reviving—but not always, so listen to your body. The more you consistently train, the more recovery-awareness you will acquire. Too much of anything can have negative consequences and exercising too much can result in suppressed immune system, lower hormone levels and greater risk of chronic inflammatory injuries, ESPECIALLY if you are not getting that cornerstone, good night of sleep, which I cannot over-emphasize, more so than any recovery-smoothie, supplement or NSAID!

The Physiology of Muscle Soreness

There are three types of muscle-fatigue and muscle-soreness:

01  Accumulation of lactic acid within the muscles during intense exercise above your “lactate threshold.” This feels like a “burning” sensation (the good type of burn), and as soon as intensity is decreased below your lactate threshold heart rate, your body will quickly remove and recycle the lactic acid; within 30 minutes of finishing exercising all lactic acid is gone from your muscles.

02  Intense anaerobic exercise can cause acidosis within the muscles due to large amounts of ATP consumption. This acute fatigue can last in the muscles for several hours after very intense exercise and leaves you feeling lethargic for three to 12 hours post-exercise, such as an after an intense mountain-bike ride or a day of downhill skiing, for example.

03  Delayed onset muscle soreness (DOMS) sets into the muscles 24 to 36 hours after heavy anaerobic exercise, especially weight lifting with heavy eccentric contractions. This is caused by tiny tears and micro-trauma in the muscle fibers and the resulting inflammation. It’s exactly what those seeking to build muscle mass are after. This micro-tear, muscle-fiber damage—along with follow-on, inflammatory-response, prostaglandins and induced growth hormone secretion—is what is responsible for triggering follow-on muscle-hypertrophy (growth), when the body repairs the muscle fibers to be stronger than they previously were.


So if you feel pain after exercise, first you need to determine if it is the “good” type of pain, such as DOMS, which means you met your goal of stimulating growth and pushed your limits. (If you’re not sore to some degree, then you may not have pushed hard enough to build muscle.) The “bad” type of pain may be a symptom of an actual injury such as a strain or pull. Incidentally, all forms of intense, anaerobic exercise trigger follow-on growth hormone secretion. Longer duration, endurance-type, aerobic exercise generally does not trigger GH. Just moving about will help ease the pain of DOMS or workout fatigue in general, so AVOID the ibuprofen and other NSAIDs, if at all possible, as they will eliminate the very prostaglandins and mild inflammation that is inducing the growth and repair! Value this “good soreness!” 

If you do suspect you have overdone it and have a strain, sprain or pull, or otherwise debilitating soreness, then remember the RICE treatment formula for acute injury: Rest, Ice, Compression and Elevation for the first 48 hours. Afterwards it may help to cycle ice, heat, ice, heat, and, in the case of injury, ibuprofen and NSAIDs will help control inflammation and reduce pain. Massage, foam-rolling and trigger-point work can do wonders to loosen up tight spots and ease stiffness. 

If the pain is intense, by all means go to urgent care and see a doctor!