Tuesday 29 January 2019

Muscle Soreness, DOMS, and Recovery

A researcher that I closely follow on social media posted about a great study on muscle soreness.

To date, we have been unable to determine exactly why we experience post-exercise delayed onset muscle soreness (DOMS). The problems that we've had regarding DOMS are as follows:

1) If the soreness is from tissue damage, then why do DOMS even occur in individuals who are simply new to exercise and not exercising at an intense enough volume to have truly initiated significant muscle breakdown?

2) On that same note, individuals adapt quite quickly to the point of experiencing little to no DOMS after regular, intense activity, even when tissue breakdown must be present.


This new research suggests that DOMS might have less to do with an accurate indication of the extent of muscle damage, but rather a (adaptable) pain response intended to remind the body to rest. This is similar to one of our theories on the need to sleep; while not initiating much in terms of physical changes to the body itself, it might be our bodies' way of forcing us to rest and achieve recovery.

This mechanism would explain why we can adapt so quickly and stop feeling as sore following exercise. As the body learns that we're recovering without much difficulty, it will feel less of a need to initiate that exaggerated rest-signal.

As the researcher pointed out, however, complete absence of that soreness does not equate to an absence of muscle damage, and it's still important to take those earlier DOMS experiences to learn on how to properly moderate your work and rest together. At the same time, this is reassuring to active individuals who worry about requiring soreness as an indication of a workout being beneficial.

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Wednesday 23 January 2019

Hang Up The Orthotics

In over two years of practice as an Athletic Therapist, I have not recommended foot orthotics to any of my clients.

The fact isn't that I consider orthotics to necessarily be a detriment and that they don't have their place; rather, I see other alternatives to attempt first, for a client's recovery, before going with the orthopaedic support route.

Orthotics went through a phase of being heavily over-prescribed for a couple decades, with any sign of a flat or stiff arch condoning their recommendation.


It is true that structural changes in the foot, such as a flat arch, might contribute to a higher rate of overuse injury in the lower body. However, it's important to remember that your arch is maintained by both ligaments and muscles, and so it stands to reason that exercise and strengthening can help to improve that arch support on its own. In fact, some studies find that exercise has a greater benefit than artificial insoles.

As well, it's important to point out that, like with any crutch or support, having the support of an insole can actually decrease the strength and stability of your foot muscles due to lack of need.

What's more, if formal exercise doesn't work for you, minimalist shoes are also shown to have identical positive effects on the strength of those small foot muscles.

Again, this isn't to say that orthotics don't have their place. I will always attempt and monitor the effects of exercise on its own first, and so far all of my clients have had no need for anything further. But if an individual's foot structure, whole-body condition, and specific injury require the extra support, then it should absolutely be encouraged.

BUT (this is the last 'but') it's also important to highlight that expensive, custom orthotics are found probably be no more effective than off-the-shelf insoles, so for those looking into the arch support route, consider giving this a try before making the larger expense.

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Wednesday 16 January 2019

Treadmill Running and Overuse Injury

Myself, I was never a huge fan of treadmill running. Mostly because I like nature and am a sucker for a nice waterfront view. But I digress...

Treadmill running isn't going anywhere. It's a staple in our gyms and a handy tool for being able to measure and control for our physical activity.


However, there have been some claims that treadmill running may pose an increased risk for overuse injuries.

The idea is based on the fact that overuse injuries stem from repetitive stress to a particular tissue, and this stress is greater when the variance in the movement is decreased. By this, we're referring to the fact that treadmill running strides will typically always be the same length, at the same speed, and with the same impact force. In contrast, running outside will have a much greater variability in the types of strides being taken, with the body needing to learn to adjust and adapt to the subtlest change in terrain.


While this claim is cited by several sources, few of them use hard, researched evidence. We do, however, have evidence supporting the general principle of low variance resulting in increased tissue stress. As well, while treadmill running has been shown to lower the rate of stress fractures, specifically, the same study found it to be less beneficial to bone strengthening than outdoor running. This might translate to decreased overall beneficial training adaptations from treadmill running and, thus, and overall increased injury risk.

I feel I must apologize for the inconclusiveness here, but hopefully it's good food for thought. Don't let this change your training regiment if treadmill running is currently working for you, but if you suffer from running injuries, it may be worth trying a modification in surfaces. And of course, if you're training specifically for running a race, the best training for you will be found outside.

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