Member Case Study: Chronic Muscle Soreness

author : AMSSM

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Tips on the treatment of chronic muscle soreness

Member Question

Any tips on chronic muscle soreness? I have the most ridiculous tight muscles in my legs that i just can't seem to shake. It's not like I'm working out that much anymore.

I did 'Insanity' (crazy aerobic thing similar to p90x) for about 5 months straight. No problem. I just don't understand what is going on with my body now. I did a triathlon 4 or 5 weeks ago and ever since then my muscles are fried. I have basically taken off the entire 4-5 weeks from any workout at all. I just can't seem to shake it. The only thing that I did lately was wrestling on Sunday. My glutes shouldn't be super wrecked to the touch from that, but they are. My IT band and quads got pretty fried from the triathlon, they feel a little better now. However, they are not fully recovered.

I eat a lot. I take vitamins about every other day. Why am I not recovering well?

Answer by Vijay Jotwani, MD
Member AMSSM

Muscle soreness lasting weeks after participating in an athletic event is likely due to an underlying muscle injury that occurred during the event.  This injury may have included some myoglobinuria or rhambdomyolysis, conditions where muscle cells break open and release protein into the blood. 

Athletes are at higher risk of this type of muscle injury when increasing their exercise intensity, when they are dehydrated, if they have recently had a viral illness, or when exercising in high heat.  You may have noticed some dark urine in the days following the triathlon if this took place.  Typically this muscle soreness gets better in 1 to 2 weeks, so it is possible that you had some significant wear on your gluteus muscles from the combination of 'Insanity' and the triathlon.  Sometimes supplements (such as ephedra, tryptophan, and others stimulants) or medicines (such as the cholesterol medicines called statins, diuretics, or antipsychotics) can be associated with muscle soreness that persists.  

The fact that you are starting to get better is reassuring that your symptoms should gradually resolve.  A cornerstone for treatment is hydration so make sure you are getting plenty of water.  In addition, anti-inflammatory medicine such as ibuprofen can be useful for this soreness.  Given how long your symptoms have lasted, I would recommend seeing a physical therapist for stretching, manual therapy, and perhaps modalities such as ultrasound to help you feel better sooner.  Also, I would suggest that you continue to limit your exercise to activities you can do comfortably until you feel better. 

If your muscle soreness continues, you should consult your sports medicine physician.  A physical examination and possibly blood work with a urinalysis can help determine the cause of your muscle pain.  In cases of persistent muscle soreness, your doctor may order a muscle biopsy to check for rare inherited mitochondrial disorders that could be leading to your pain.
I hope that you feel better soon.

Vijay Jotwani, MD
IU Center for Sports Medicine

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date: December 22, 2011