Soreness or Injury? - The Box

Soreness or Injury?

Here are 10 tips to help you determine what your pain is signaling.
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Shoulder-Pain

All CrossFitters quickly grow accustomed to feeling some pain the day after a WOD. Whether it’s climbing out of bed or putting on a shirt, something will remind us that we’ve been pushed to our limits again. And we accept that, knowing full well that muscle soreness is an expected, natural and even beneficial response to a training session. However, because we feel this soreness as pain, how can we tell whether it’s just regular old delayed onset muscle soreness (DOMS) or an injury?

Well, here’s how. Evaluating the differences takes some awareness and experience, but doing so can help you prevent major injuries and downtime.

Onset of Pain

DOMS is caused by micro-tears in the muscle, which cause swelling and pressure on pain receptors. This pain can begin anywhere from two to 24 hours after a training session. However, normally DOMS kicks in about 12 hours after a WOD and peaks at about 36 hours. An injury, on the other hand, will likely be painful immediately after training.

Length of Pain

Normal muscle soreness should begin to abate within two to three days. Even in the case of major DOMS, which could take up to seven days to fully heal, the pain should change in intensity over that week. Pain from an injury will not abate in a few days. If pain following a workout does not go away, that may be your first clue that you should seek medical attention.

Type of Pain

What exactly are you feeling? DOMS will cause muscles to feel tight, tender to the touch and dully achy. When exercising, sore muscles will seem tired or burn. An injury is associated with pain that is more sharp and acute, often akin to a stabbing sensation.

Location of Pain

Can you pinpoint the pain with one finger? Does the pain involve a small area that hurts when palpated or pressed? Or is the pain located in a tendon, bone or joint? If you answered yes to any of the above, you may be dealing with an injury. DOMS normally involves a larger or broader area of musculature, such as the muscle belly of the quads, hamstrings, calves or pecs.

Symmetry

Pain from DOMS is typically symmetrical. That is, it will be present in both legs equally. Typically, injury pain is asymmetrical; it will be present in only one leg, shoulder, etc. The exception would be an athlete who uses just one limb in an activity, such as a one-arm throw.

When You Feel Pain

Injuries are normally painful throughout the day, even when you’re not moving. Muscle soreness will usually not cause pain when you are sedentary.

Pain Improves

Besides pain-alleviating medications, injury pain will improve with ice and rest. DOMS, on the other hand, will improve with stretching after movement.

Pain Worsens

Pain from normal muscle soreness will worsen after you have been immobile or sitting for a while. Pain from an injury will get worse with continued activity; the pain doesn’t seem to improve during the warm-up or WOD.

Swelling

While DOMS includes some swelling, it’s typically over a diffuse area and is not focused on a small area or particularly noticeable. If the swelling is obvious and in a localized area, there’s a good chance you have an injury.

Sounds

Did you hear anything? Athletes often (but not always) hear a sound during an injury. That’s not the case with the normal muscle breakdown associated with DOMS. Torn muscles pop (especially hamstrings), and snapping or cracking noises can occasionally be heard when incurring an injury.