Acute muscle soreness
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Overview
Acute muscle soreness (AMS) is a term used to describe muscle soreness felt during the muscle's use in an activity or shortly after its use (generally no longer than an hour). It is not connected to its longer counterpart, delayed onset muscle soreness, which can last up to 72 hours after muscle activity.
Pathophysiology
- It is generally known to be caused by tears in the muscle fibers or fascia. Soreness can occur after trying a new muscle activity or exercise, exercising during or after a prolonged period of being sedentary (little or no exercise or movement) or a large change in your current exercise routine.
- A new theory has emerged as to the cause of AMS which states that AMS is caused by ATP-derived hydrogen ions in the muscles. This deprivation lead to a pH and acidosis levels within the muscles. This decrease of levels within the muscles is what causes the soreness which is perceived by the patient.
- Though AMS is now believed to be caused by ATP-derived hydrogen ions they may not be solely responsible. For instance, if other substances can drop the pH and increase acidosis in the muscles, then theoretically they can also contribute to AMS.
Causes
Life Threatening Causes
Common Causes
Causes by Organ System
| Cardiovascular | Exercise induced rhabdomyolysis, lactic acidosis |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | Mononucleosis |
| Drug Side Effect | Influenza vaccine |
| Ear Nose Throat | Mononucleosis |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | Lactic acidosis |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| Musculoskeletal/Orthopedic | Decreased muscle oxygen, exercise induced rhabdomyolysis, mononucleosis, muscle tears, shin splints, muscle swelling |
| Neurologic | Fatigue |
| Nutritional/Metabolic | Exercise induced free radical production, lactic acidosis |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | Exercise induced rhabdomyolysis |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | Muscle tears, repetitive strain injury |
| Urologic | No underlying causes |
| Miscellaneous | Decreased muscle oxygen, exercise induced free radical production, exercise, fatigue, shin splints, strength training, stretch shortening exercise |
Causes in Alphabetical Order
- Exercise
- Influenza vaccine
- Lactic acidosis
- Mononucleosis
- Muscle tears
- Repetitive strain injury
- Shin splints
- Strength training
- Stretch shortening exercise
Natural History, Complications and Prognosis
AMS, in general, disappears quickly (hence the term acute). To speed the recovery period would be to stop the exercise or movement causing it. However, the soreness can last even after the muscle/s cease activity and can remain for up to an hour.
Treatment
- There are ways to quicken the recovery period and relieve the patient of the pain. This is achieved by the removal of all the ATP-derived hydrogen ions and so techniques to speed up the removal of these ions will shorten recovery time.
- Techniques include:
- Light aerobic exercise
- Stretching
- Massaging the affected area's or muscles.