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Writer's pictureDr. Michael Tancini

Is it just Muscle Soreness, a Hot-Spot, or are you Injured?


You workout really hard or maybe you just finished a game (or competition), and now you hurt and you're really not feeling too great.

Are you just sore, have you developed a "hot spot", or are you injured?

This is something many athletes struggle differentiating between. You have been conditioning


throughout your athletic career that pain is just part of the game (no pain, no gain!). You feel pain and you simply just keep pushing. You don't want to miss training, you don't want to miss practice, and you definitely are not missing your next competition! But pain truly is not just "part of the game". [Is it something that you will experience, most likely everybody will experience pain at some point in training/competition/life]. It's a sign from our body telling us something needs to change. It's a message, and you need to know how to recognize and interpret the message your body is sending you. Interpret the message correctly, and you'll most likely continue on to higher levels of performance and feel great in the long run. Interpret the message incorrectly and you'll most likely end up battling "nagging injuries", feel like garbage, possibly develop chronic pain, lose the ability to participate in activities you love, and perform under your ability level.

 

Before we dive into how to differentiate between muscle soreness, a hot-spot, or injury; its important to understand pain is a very subjective experience. Pain is influenced by tissue health, stress levels, anxiety, fear, beliefs, sleep, emotions, coping strategy, and attention (mechanical and psychological). Every single person experiences pain differently based on those factors. It's complicated. Way more complicated than tissue is damaged = pain.

If you have any questions regarding your pain, please send us a message by clicking here .

 

To make sense of the messages our body is sending us, we are going to utilize a stoplight system.

Green = Everything is good to go!

Yellow = Hot spot. Does not need professional attention, move forward with caution.

Red = Intervention from a professional is needed for overcoming your problem.

Green Light: You're good to go!

Characteristics

  • Delayed onset MUSCLE soreness. (DOMS) This is soreness that follows training or a competition. You felt great during the activity, the soreness came on within 24-48 hours of the activity, and it normally goes away in a few days. There was no exact moment of pain or strain during the exercise, there is no bruising, and it generally feels better as you loosen up. It's most likely pin-point soreness over muscle tissue. Common places where you may feel sore are quads, hamstrings, adductors, glutes, calf, upper back, chest, biceps, triceps, forearms, abs...any muscle which was stressed hard.

Your plan of actions should Include...

  • DOMS is a normal part of training and competing. Stay active, you will feel better with movement. Prioritize recovery and modulate training volume+intensity to suit your status. Ask your coach to help you manipulate your training as needed.

What should not do...

  • Use OTC pain killers to help with DOMS. They will most likely diminish the strength/endurance gains you are trying to earn.

Yellow Light = Hot spot. Does not need professional attention, move forward with caution.

Characteristics

  • Soreness which is localized around tendons, joints, and bones.

  • This is soreness/pain which often presents after training.

  • There was no exact moment of pain or strain during the exercise, there is no bruising, and it generally feels better as you loosen up. However if you feel a little better after loosened up, it generally comes back worse when you're finished.

  • It commonly feels like a burning, shooting, tightness, aching, or "just funny feeling".

  • This issue HAS NOT been a chronic issue.

  • The first time you felt it was today or earlier this week.

  • It is not stopping you (or impeded performance) from doing anything, but you feel it (and is annoying) as you move throughout your day and in training.

  • It takes you a little longer to get warmed up.

  • You may joke with your friends, "I'm just getting old." even though you're really still pretty young.

  • Common places where this may be felt is at the front of the shoulder, inside/outside of elbow, front of the hip, the crease of your low back, your quad tendon / patellar tendon / patella, inside/outside of knee, lateral hip, inside of your shin, bottom of your foot (plantar fascia), inside of your ankle, achilles tendon.

Your plan of actions should Include...

  • Modify volume.

  • Modify loading in painful patterns.

  • Minimize volume in movements which exacerbate symptoms.

  • Prioritize recovery (sleep, stress, nutrition..etc).

  • Active Mobility.

  • Continue Training within tolerance of minimal exacerbation of symptoms.

  • Modify (decrease) tempo during painful loading patterns so they are no longer painful.

  • Monitor the progress of your "hot spot".

Duration of aggravation...

  • You should be back to baseline within about a 2 week period.

  • If not back to baseline or significantly improved from first instance of discomfort, get help from a physical therapist who knows the activities you do.

What should not do...

  • Continue training like nothing is any different.

  • Mask your symptoms with knee sleeves, tape, OTC pain killers, injections, topical pain relievers.

Red Light = Intervention from a professional is needed for overcoming your problem.

Characteristics

  • Soreness which is localized around tendons, joints, and bones.

  • In case of an acute muscle strain, this will be felt over muscles.

  • Soreness/pain which often presents before, during, and after training.

  • There may/may not have not been an exact moment of pain or strain during the exercise, there may/may no be swelling, may/may no is no bruising.

  • There may have been an exact moment of pain (mechanism of injury) or trauma.

  • There may be a feeling of unstableness, rapid swelling, unable to bear weight on the limb.

  • It commonly feels like a burning, shooting, numbness, tingling, aching, electricity, sharp.

  • They may be symptoms which travel down your leg or arm.

  • This issue might be a chronic issue (or there was a traumatic mechanism of injury).

  • It's limiting your ability to perform the task you love, its impeding your ability to live comfortably throughout the day (and night), and it is impeding performance in competition or training.

  • It takes you a little longer to get warmed up, and it still bothers you during the workout.

  • You have tried pain killers, knee sleeves, tape, and topicals to help it feel better. Still hurts.

  • Common places where this may be felt is at the front of the shoulder, inside/outside of elbow, front of the hip, the crease of your low back, your quad tendon / patellar tendon / patella, inside/outside of knee, lateral hip, inside of your shin, bottom of your foot (plantar fascia), inside of your ankle, achilles tendon. You may also feel this directly over a muscle in cases such as acute muscle strains.

Your plan of actions should Include...

  • Contact physical therapist for assistance on resolving your problem. The longer you wait to resolve your problem, the more aggravated it will get, the more you'll be limited in your life, and the longer it will take to resolve once receiving intervention.

  • Modify volume.

  • Modify loading in painful patterns.

  • Minimize volume in movements which exacerbate symptoms.

  • Prioritize recovery (sleep, stress, nutrition..etc).

  • Active Mobility.

  • Train movements which do not exacerbate symptoms.

What should not do...

  • Continue training like nothing is any different.

  • Mask your symptoms with knee sleeves, tape, OTC pain killers, injections, topical pain relievers.

 

If you are currently experiencing pain and are unsure of if you should be worried or how to best resolve it, please send us a message by clicking here . We will help determine what your best course of action should be, and provide guidance for overcoming your pain!


Whats the solution for long term injury free training? Bulletproof your body by fixing your foundational movement patterns and building strength within those movement patterns!

Build resilience, lift heavy weight, run fast, run long, and live your life without pain or worry.

Here at Ground to Overhead Physical Therapy, we provide athletes the solution to their problem of not being able to train (live life) the way they want to due to pain and/or disfunction!

We do this with in person appointments for athletes local to our clinic. Remotely, we help athlete through individualized training programs designed to resolve the athletes pain and achieve their goals. We coach the athletes through electronic communication, video analysis, and video calls; guiding them step by step along the process of eliminating their chronic-recurring pain.

Questions about the content within this post?

Interested in how you could eliminate your pain and improve your performance?

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I'll be happy to help!


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