Muscle soreness can be expected after you exercise. Pain, on the other hand, could indicate an injury.

Knowing the difference can help you remain active or can be a warning that you need to see a doctor.

Soreness

Generally, muscle soreness peaks 24-72 hours after your activity. What you’re feeling is the result of small (but safe) damage to your muscle fibers, called delayed onset muscle soreness, or DOMS.

Your muscles might be tender to touch, or feel achy and tight. Moving your muscles gently and stretching can help alleviate the pain, even if the initial movement is slightly uncomfortable.

dr. eric warren
Dr. Eric Warren

“If the soreness you’re feeling isn’t injury-related, then you’re probably OK,” said Dr. Eric Warren of Novant Health Waxhaw Family & Sports Medicine.

The muscle soreness will gradually subside.

Several factors will determine how quickly you bounce back – your age, level of fitness, the intensity and length of the exercise, and other health factors. Young healthy athletes might only need a day or two, Warren said. Someone who’s older, or beginning an exercise program or just plain overdid it, could be sore for up to three days.

If you want to continue exercising while you’re sore, change the routine a bit. It’ll give your sore muscles a chance to recover and you can work a different muscle group.

Warren offered a caveat: Rhabdomyolysis, a rare, serious condition in which muscle cells break down and release a substance into the blood that can lead to kidney failure. 

“It is a burning, heavy feeling in your muscles for days at a time,” he said. “It doesn’t get better after exercise. It’s lingering. And often that area or joint won’t have full range of motion, either.”

Rhabdomyolysis can be caused by pushing your body beyond its physical limits. Dehydration is a trigger, which can place distance runners at risk. Weightlifters can be susceptible, too.

Pain

Pain usually occurs during or very soon after performing an activity. It often may feel sharp or stabbing. Pain can linger and not fully disappear even after resting.

Warren has a simple rule: “Bone pain and joint pain are something we don’t ignore. Shin, foot, knee, ankle, shoulder, etc., any joint or bone, you should probably have it looked at.”

Pain usually signifies an injury. Swelling is a red flag, too. If your pain is extreme, or if it doesn’t resolve in seven to 10 days, see a doctor.

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Young athletes should be wary of injuries to their growth plates.

A stress fracture (a small crack in a bone caused by overuse and repetitive activities) is a concern for young athletes, who also have growth plates that can be injured, Warren said.  Growth plates – the area of growing tissue near the end of long bones – determine the future length and shape of the mature bone.

Adults also must be wary of stress fractures and arthritis, which in many cases calls for the exercise routine to be modified.

Pushing through an injury

Warren said he asks four questions of anyone with muscular or skeletal pain who is considering “pushing” through it, no matter their age:

  • Do you have full range of motion?
  • Do you have the strength you normally do?
  • Is the joint stable?
  • Are you having normal sensation, especially past where you’re hurting?

If someone answers “yes” to all four questions, Warren advises “give it a try.” Otherwise, stop immediately.

Pay attention to the signals

Sometimes athletes make a plan, or commit to a program, and unfortunately don’t listen to their bodies, Warren said. He’s seen runners who, despite an injury, feel compelled to continue training for a marathon because they’ve paid the entrance fee or out-of-town travel expenses.

“Be mindful of swelling,” he said. “For example, if it is a recurrent knee issue, pay attention to it. It’s your body sending a message that something’s not right.

Declining performance likely means you’re overtraining, Warren said. It also can lead to potential overuse injury.

“Our bodies need downtime,” he said.

Also, always talk to your primary care provider before starting an exercise program. It’s important to discuss reachable goals, any existing medical conditions and medications you’re taking.

 

You don’t have to be a professional athlete to get world-class care for your sports-related needs. Download our guide on common sports-related injuries.