When should I seek medical treatment?

The athlete should call the health professional if the injury causes sever pain, swelling, or numbness.

The athlete can’t tolerate any weight on the area.

The pain or dull ache of an old injury is accompanied by increased swelling or joint abnormality or instability.

High school athletes should see the team athletic trainer or team physician as soon as possible.

These health professionals will treat the injury and refer the athlete to the proper health professionals for further rehabilitation.

What is the difference between “good pain” and “bad pain”?

It is common among athletes that some discomfort is part of athletic activities and is necessary for the improvement of performance. For muscle strength to increase, the muscle must see some increase in stress over what it is used to seeing, and this stress is usually perceived as the “burn" in muscle during activity. This mild “burn” is what we call “good pain” and is the basis of the popular phrase, “no pain, no gain.” This pain should be short-lived and during the activity only.

If there is some discomfort after exercising, it should be short-lived and not carry on for hours or days. Fatigue after a good, strenuous workout is also a sign that the exercise is pushing the limits of the athlete’s physiology, but it too should not be destructive. The fatigue that lasts days means the individual’s physiology has been excessively challenged, and this means that the muscles and the energy stores are not being replenished after exercise. This more chronic fatigue after harmful exercise is called “over-training,” and it is a sign that the individual is doing too much exercise too rapidly. If after appropriate rest the fatigue continues, it may be a sign of other medical problems and the individual should consult a doctor.

What are the signs of “bad pain”?

The muscle, tendons, ligaments, cartilage and bones of the body are livening structures that react to the stress of exercise very slowly. If they see stress too fast, they cannot respond in time and begin to fail. The causes of the failure can be too much stress too fast, or it can be accumulated stress over time. When this occurs, each one of these tissues responds a little differently and begins to produce what we call “bad pain.”

For example, when muscles that have not been exercised for long periods of time see a lot of stress, they respond by getting “sore.” Muscle soreness typically occurs if the athlete does a new exercise to which you are not accustomed, or if you do a familiar exercise too hard. This soreness typically begins within a few hours but peaks around two days after exercise. This soreness is called “delayed onset muscle soreness,” and it actually reflects muscle damage. A little soreness or discomfort means that the muscle has been stressed, but if the muscle is exercised too much, the muscle can become very sore to move and touch, and may even swell. In severe cases, the muscle may be damaged to the point that the muscle starts to die.

In the individuals who are extremely out of shape, if multiple muscles are exercised too hard and too fast, then as the muscles die, they release proteins into the bloodstream, which can shut down the kidneys.

So it is generally recommended that individuals start an exercise program slowly and built up gradually.

In well-known sports medicine centers, usually experts recommend that, whatever amount of exercise athlete can do, cut it by one-third the first few times to prevent this problem with their muscles.

It is highly recommended for the high school athlete and high-level weekend warriors to maintain hydration, and follow up with slow start and report their aches and pains to the appropriate medical professionals within first 24 to 48 hours of their injuries.