Should You Work Out When You're Sore?

When it comes to working out, if you subscribe to the theory, "No pain, no gain"—even if you're really sore—you might be walking the line between major gains and possible injuries.

Soreness isn't always a cause for alarm, in fact, it's very common—especially after an intense workout. Still, there's a delicate balance between when to add more reps and when to recover or cross-train. Working out when you're sore won't necessarily lead to needing to take time off, as long as you identify the difference between muscular soreness and injury-related pain. It's also important to know how to help your body recover when bouts of soreness set in.

One thing is for sure: Soreness shouldn't be used as a benchmark of progress, but rather an important signal from your body.

One of the most common types of soreness that newbies and veterans alike experience when working out is known as delayed-onset muscle soreness (DOMS), which can appear a few days after a workout. This is different from acute soreness, which you would experience during a workout due to muscle fatigue, that goes away within an hour or once exercise has stopped.

Nick DiSarro, PT, DPT, OCS, CEAS, a board-certified clinical specialist in orthopaedic physiotherapy and director of operations at ResilientRX, based in Austin, admits that current research doesn't fully explain why DOMS occurs. He explains it's likely due to a combination of factors including inflammation and microscopic muscle tears. Gone are the days that it was thought that DOMS occurred because of lactic acid build-up, recent research suggests.

An important truth, however, is that soreness shouldn't be a gauge for whether your workout was a failure or a success. "Soreness does not automatically indicate an effective workout, nor does it mean you overdid it or did something wrong", says DiSarro. "It really all depends on how you feel and what's tolerable for you".

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Megan Steele, PT, DPT, a Los Angeles-based exercise physiologist, physiotherapist and an adjunct faculty member at Mount Saint Mary's University, adds that exercise-induced muscle damage most often occurs when we lengthen our muscles after a workout. Think calf tightness when going up and down stairs after a long run or quadriceps tenderness when sitting down in a chair in the days after doing squats.

"Soreness occurs with exercise due to minor muscle damage, also called exercise-induced muscle damage, and the associated inflammatory process that occurs due to the mechanical overload of the muscles. This pain is often more dull and achy in nature, and often spans the length of the muscle", says Steele. "These are normal signs of soreness".

If soreness is common, how can you differentiate between standard achiness and a bigger injury? Your soreness is likely not injury related if:

• There is a delayed onset of soreness. If soreness is experienced in the days following a workout, you can likely chalk it up to a bout of DOMS. "You can rest assured if you experience a delayed onset in the soreness", says DiSarro. "This discomfort can set in anywhere between 24–72 hours, [even] after not feeling any soreness for about 12–24 hours following your workout".
  
  
• Soreness dissipates after 72 hours. If you are in fact experiencing DOMS, you should notice your soreness decreases in the days after working out (and with acute soreness, it should dissipate within an hour of ending exercise). "The good news is that soreness has a relatively short time limitation", says Steele. "If something is lasting longer than a few days [...] it may be time to check with your doctor or a physiotherapist".
  
  
• Soreness is a dull ache. Don't be surprised if you're sore in areas you didn't target in your workout. Steele notes that you may notice your core or glutes are sore even if your workout focused on your legs—this is especially the case with stability exercises. If your soreness is accompanied by any sharp or shooting pain (either during or following exercise), Steele notes that this could be an indication that something more than just DOMS is going on.
  
  
• There is no visible swelling. While exercise can cause some inflammation, a 2017 study in the Journal of Applied Physiology suggests that muscle swelling and markers in the blood that appear from actual muscle damage don't appear until after DOMS would have subsided (appearing typically four days after exercise).
  
  
• You aren't experiencing pain at rest. Steele says that normal soreness after exercise is felt "when we ask our muscles to lengthen after a workout" (like quad soreness when sitting down or calf soreness when taking the stairs). "Some [abnormal] signs of soreness may be pain at rest, or when we're not using our muscles or asking them to contract", says Steele.

Because soreness is often a normal part of exercise, the key is to emphasise recovery. DiSarro explains that this is because soreness is "a sign that you are challenging your muscle tissue". Research has been inconclusive on the exact recovery programme to alleviate DOMS. DiSarro recommends that good nutrition, adequate hydration and sleep quality will help your muscles recover and continue to perform in the long term.

"Generally, if you are new to working out or getting back to it after a period of inactivity, you should allow for adequate recovery time between workouts", encourages DiSarro. "This may be in the form of working on mobility, stretching, walking, light cardio or strengthening a different body region as you recover from the previous workout".

A small study of eight participants found foam rolling to be beneficial in reducing DOMS (a common method that Steele recommends to her patients). Some evidence suggests that a massage can be an effective method to reduce DOMS, however, some other research says otherwise. In the same review that eliminates massage as a DOMS treatment, non-steroidal anti-inflammatories (such as Ibuprofen) were found to show some reduction of soreness, but should be used under supervision of a doctor.

The short answer: If you've been able to determine the pain is not from injury, and as long as soreness is not causing limitations, working out while sore is OK—it just may be a bit uncomfortable. That said, you might encounter consequences if you're experiencing limitations, which Steele says can include impaired neuromuscular function, joint range of motion, strength, power and motor control.

"It may be a good idea to skip a workout due to soreness if you are so limited in your range of motion that you cannot perform an exercise properly", says Steele. "This may lead to [over]compensation or stress on other structures that can lead to an injury".

Everyone's pain tolerance is different. And as such, everyone's extent and severity of DOMS varies. Taking adequate recovery time is key. DiSarro suggests mobility work, stretching, walking, light cardio or focusing on a different part of the body than the one that is experiencing soreness as a way to help your body recover. This is especially important if you're new to working out or returning to exercise after a break.

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Words by Ashley Lauretta