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Sore Subject -November 2003
14 Tips for preventing and treating muscle aches and pains
By Matt Fitzgerald
 
Trail runners generally think of energy as the limiting factor in training. We hope to not bonk with two or three miles left in our next long run, and want to feel energized for our next quality workout. Often overlooked in this focus on energy is that muscle soreness, particularly delayed-onset muscle soreness or DOMS, is also an important limiting factor in training. When muscles are sore, they are damaged, and when muscles are damaged, training is compromised.

A recent study at Ball State University supports this point. The hamstrings strength of a group of runners was tested just before a 10K race, immediately afterward and 48 hours afterward. It was found that the hamstring's strength remained significantly reduced two full days after the race. Although the source of the strength loss was not investigated in this particular study, it was almost certainly due to lingering muscle-tissue damage that is associated with post-exercise muscle soreness.

It is not possible to completely prevent DOMS any more than it is possible to maintain high energy levels throughout the training process. But there are several ways of reducing and treating DOMS and thereby minimizing its impact on training.

What causes post-exercise muscle soreness? In 1902, the first doctor to study DOMS hypothesized that it was associated with the microscopic tearing of muscle fibers during unaccustomed physical activity (that is, activity that is either more intense or more prolonged than normal). Subsequent study has confirmed that such "mechanical stress" is the primary cause of muscle pain after exercise. The mechanisms are complicated, however, and there remains more to be learned. Here's what we do know:
Eccentric muscle contractions cause the most muscle-fiber damage. In an eccentric contraction, the muscle lengthens as it contracts (for example during the lowering phase of a biceps curl) instead of shortening as in a concentric contraction or staying the same length as in an isometric contraction. The muscle is being pulled in two directions at once during an eccentric contraction, like a tug-o'-war, so it's easy to see the potential for tearing. Running involves a lot of such active lengthening of the muscles.

When a muscle fiber is strained too far, the surface membrane breaks open and some of its chemical contents spill out, damaging other muscle tissue, activating nerve fibers and initiating an inflammation response. The pain is probably associated with inflammation more than it is with the damage itself, which is why the soreness takes many hours to develop and often does not peak until two to three days after the tough workout or race. In addition to pain, other symptoms are loss of strength, stiffness and decreased range of motion. While DOMS does not constitute a serious injury in itself, overtaxing a damaged muscle by returning to intense running too quickly can lead to permanent damage.

High-intensity running is more likely to cause DOMS than prolonged running. This is because stride length increases at faster running speeds (more active lengthening) while contractions become more forceful at the same time. In other words, the pull becomes more forceful in both directions. However, prolonged running at lower intensities can also cause major soreness, because when muscle glycogen fuel stores run low, more and more muscle proteins are broken down and used to supply energy.

Surprisingly, there's little connection between the acute muscle soreness you feel during and immediately after runs and the soreness you wake up with the next morning. Acute soreness is associated with the buildup of metabolic wastes in fatigued muscles and dissipates within hours as these wastes are flushed away. Typically acute soreness affects different muscles than DOMS.

Preventing Muscle Soreness
Warm up thoroughly at the beginning of every workout. Beginning a workout with light activity warms and lubricates the muscles, making the fibers less prone to tearing during the more intense portion of the workout.

Run on soft surfaces as much as possible. The greater the impact forces your body is forced to repetitively absorb, the more damage your muscles and connective tissues will incur. The great African runners, many of whom grow up running on dirt, are known to avoid pavement like the plague, and it pays.
Know when to say when.

Don't overdo your long and high-intensity workouts. Develop a feel for how long your body can go in a workout without being hobbled the next day. Muscle damage and soreness manifest in direct proportion to how much you work your muscles beyond what they are accustomed to.

Increase training workload very gradually. The more slowly you add volume or intensity to your training, the smaller will be the gap between what your muscles are accustomed to and what you require them to do each week. The gradual overload method is not just the best way to minimize muscle soreness throughout the training process but is also the best way to achieve a maximum fitness peak: the slower you build, the longer you can keep building.

Cool down thoroughly after high-intensity workouts. Circulation is the primary means by which the muscles repair themselves after intense exercise. Finishing workouts with low-intensity activity keeps circulation levels up without further damaging muscle fibers and thereby kick-starts the recovery process.

Schedule recovery workouts between harder and longer training sessions. In other words, spread out your key workouts during the week. This will prevent muscle damage and soreness from accumulating. Consider doing at least one active recovery workout per week in a non-impact discipline such as bicycling or deep-water running. A growing number of elite American runners now performs one or more deep-water running (simulated running in the deep end of a pool aided by a floatation device) workouts every week for active recovery.

"My legs feel so good after running in the pool," says three-time U.S. Olympic Trials Marathon qualifier Tamara Lave (PR 2:37). "It's like getting a workout and a massage at the same time." Use a sports drink containing carbohydrates and protein during long runs. The addition of protein has been shown to increase the energy efficiency of a sports drink's carbohydrate content, resulting in greater muscle glycogen conservation and greater endurance. The longer you can delay glycogen depletion, the longer you can delay the rise of muscle protein breakdown for energy. In a study performed at the University of Texas, a sports drink that contained a balance of carbohydrates and protein increased endurance 24 percent more than a conventional sports drink that contained only carbohydrate.

The Nike Farm Team recently began using one such drink. "All of our runners have said they notice a big difference when they use it, especially in recovery time," says coach Frank Gagliano. Run downhill strides. The most effective way to minimize DOMS is to cause it, in small amounts. This is because the muscle damage that is associated with DOMS, as long as it is not excessive, results in structural adaptations in the muscle that make it more resistant to future tearing. Research has shown that doing a small amount of intensive, eccentric work brings almost immediate benefits in this regard. Downhill running involves more eccentric work than level or uphill running. Try running four to six 100-yard strides at roughly one-mile race pace on a moderate downgrade twice a week during the base phase of training, before you get into high-intensity workouts. This will prepare your muscles to emerge from these workouts with less damage and soreness.

Treating Muscle Soreness

-Practice self-massage. At least three times a week, rub some massage oil into your legs and use your thumbs to knead the muscles from top to bottom (i.e. move away from the heart). Optionally, you can use a massage device such as The Stick (see sidebar). Massage increases circulation and is helpful in breaking up muscular adhesions.

-Ice your sore areas, or take an ice bath. Cold treatments are among the best ways of reducing inflammation without inhibiting tissue repair. Combining a cold treatment with compression of the sore muscle, for example with a neoprene sleeve, is even more effective. "I'm a big believer in using ice baths, especially after races," says Simon Gutierrez, runner-up at the 2003 USATF National Mountain Running Championship. "Besides taking time off, I think it's the best thing you can do to overcome muscle soreness."

-Stretch daily. "Stretching is a good way to increase circulation and accelerate tissue repair," says John Connors, M.D., a podiatrist who treats Lornah Kiplagat and other top African runners. "It also has the effect of immediately increasing mobility, which can be compromised by soreness." Always stretch a sore muscle gently, and if extremely sore, do not stretch it at all. In such a case light activity is a better alternative.

-Consume protein immediately after your workouts. The faster you get protein into your body, the faster your body can go to work repairing muscle damage. Always consume plenty of carbohydrates, to restore energy and fluids for rehydration following workouts. The most convenient way to get the nutrition your body needs for immediate post-run recovery is to simply continue drinking the same carbohydrate-protein sports drink you used during the workout.

-Maintain a diet high in antioxidants. There is some evidence that oxygen radicals play a role in the cellular damage that follows the rupture of muscle fibers during exercise. Antioxidant vitamins and enzymes are needed to limit this damage. Vitamins C and E are especially effective in defending against oxidative damage to muscle tissues. Good dietary sources of vitamin C are citrus fruits, melon and berries. Vegetable oils, nuts, dark green vegetables and whole grains are rich in vitamin E.

-Use an anti-inflammatory such as Ibuprofen, but only occasionally. Long-term chronic dependence on medications may result in damage to the liver and kidneys and reduce your body's ability to handle inflammation on its own. When soreness borders on the intolerable, first try using one of the newer sports creams such as Flex-Power (see sidebar) that have anti-inflammatory properties. But always bear in mind that no medication accelerates muscle tissue healing, and that training hard with lingering muscle damage-even if the pain is covered up-will only cause further damage.

Step up Your Snowshoeing
Trail runners want buffed quads, voluminous lung capacity and a tuned cardiovascular system. Snowshoeing can push these to new levels and give you a jump on next year's trail season. Here's how.

Gradually increase your distance and use a heart rate monitor and plan for at least one race. At first, you may be limited to walking to keep your heart-rate under 80 percent of maximum (220 minus your age equals a rough estimate of your maximum heart rate). The extra weight of snowshoes, boots and clothing requires more energy than running and you'll fatigue sooner. If possible, snowshoe twice a week with rest or running between sessions.

My favorite training session is a one-mile loop course with flats, steep uphills and a few downhill sections. Explore and find such a loop in your area; look for one that sees little traffic. In fresh powder, the snow packs down with each loop and offers less resistance. The first loop may take 20 minutes, the second 15, the third 13 and so on. The first loop in deep snow builds the quads because you're lifting extra weight and your quads much higher than when running.

By the third loop, the hardened trail has the condition of a snowshoe race-unless you're the leader and forced to break trail. Focus on the uphills on this loop. Don't roll your feet; instead, land flatfooted on the snowshoe cleats for maximum traction. Find power in pumping your arms, taking shorter strides than you think necessary. Your fourth loop is a reward-you get to pound the downhills. Land on the snowshoe tails, riding them down the hill. Your strides will be much longer compared to running. In the cushion of deep snow on steep slopes, take even longer strides, which may feel awkward at first. Mastering this technique is great fun.

On loop five, focus on the flats. Lift your feet as little as possible to save energy and speed up your cadence. Each stride should glide over the other snowshoe. Keep your heart rate in the 80- to 90-percent range. On loop six, I put it all together and try for my fastest time of the day with my heart rate hovering around 90 percent.

Your other snowshoe session for the week should emphasize endurance. Depending on the race length you're gunning for, do an uphill out and downhill back. Since most snowshoe races are relatively short (5K to 10K), work up to race distance in your training sessions. Keep your heart rate in a 70- to 80-percent zone and run whenever possible. Push hard while breaking trail on the uphill. Increase your speed while retracing your trail back to the starting point.

– Jim Freim, Ph.D.

This article appeared in Trail Runner magazine, issue #24 (NOVEMBER 2003). Order your back issue now!






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