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How to heal sore muscles faster: 5 Ways to Ease Post-Workout Muscles


How to recover from a workout faster and stronger

Going to the gym and not progressing on your lifts or improving your times can get frustrating. If you’re the type that grinds away and works out hard, day in and day out, you won’t progress if you take rest and recovery lightly.

What’s the best way to speed up recovery of sore muscles?

Surprisingly, there are no definitive ways to speed up recovery of sore muscles that are supported by research. There are, however, a handful of treatments, which may help alleviate the feeling of soreness:

1) Rest or active recovery – Getting plenty of sleep and resting your body may be the most effective treatment. In addition, active recovery, which is light exercise during the recovery phase can stimulate blood flow to the muscles to help reduce muscle pain. Active recovery can include swimming, or a light jog.

2) Hydration – Drinking plenty of water can help flush out toxins from your body and prevent dehydration, which can make muscle soreness even more painful. While there is no consensus on how much water you should drink, somewhere around 1/2 your body weight in ounces of water per day is a good starting point.

3) Pre-workout & post-workout nutrition – Consuming a 2:1 ratio of carbs to protein either before, or after a workout, or both, may help reduce the severity of muscle soreness.

4) Topical creams – creams like Ben Gay and IcyHot provide the perception of pain relief, but have no effects on the underlying muscle.

5) NSAIDS – nonsteroidal anti-inflammatory drugs like Advil and Alleve can help relieve the discomfort of muscle soreness. It’s not advisable to use NSAIDS on a consistent basis, but rather for an acute bout of soreness.

Other treatments include ice, cold baths, Epsom salt baths, massage and gentle stretching, but the effectiveness of these methods for speeding up recovery is questionable.

How much time is appropriate for recovering from weight training? How about long distance running?

A: The amount of recovery you need from exercise depends on a variety of factors including (1) your fitness level, (2) the volume & intensity of exercise, (3) familiarity of the exercise. For example, if you are in great shape and complete 2 sets of bench press with light weight, your chest probably won’t be sore at all the next day and you could workout again without any issues. If you add more volume (sets & reps) and intensity (weight) such as four chest exercises for 12 sets with heavier weight and use unfamiliar movements, then it’s possible your chest may be very sore not only the next day, but for several days. Finally, it also depends on the metabolic intensity of the workouts. If you do heavy squats and deadlifts on Monday, it’s probably a good idea to hold off on completing the same exercises for a few days because of how much they tax your central nervous system.

The same variables apply to running where fitness level is particularly important. For example, some elite marathoners run 100+ miles per week and need almost no rest between runs. On the other hand, a weekend warrior may attempt to run 20 miles in a week, or change up the stimulus with hill running, which could create intense soreness and require longer recovery times. 

What types of factors inhibit recovery?

The 3 biggest factors that inhibit recovery include:

1) Lack of sleep – if you are chronically sleep deprived, the muscle soreness will likely be more painful and may take more time to heal.

2) Lack of proper nutrition – If you are not adequately hydrated, or deficient in potassium, or are not eating enough protein, pain from muscle soreness may be more intense.

3) Overtraining – If you continue working out intensely without sufficient rest, muscle soreness may get worse.

The best way to avoid very sore muscles and improve recovery is to use a progressive exercise program where workouts become harder at a measured pace over time.

Are there any specific foods that help assist recovery?

There are a handful of foods that may help assist recovery:

1) Foods high in potassium – potassium is a mineral that is crucial to heart function and muscle contraction. Those who have low potassium levels may experience muscle soreness and cramping. Foods with high potassium levels include bananas, oranges, melons, raisins, and potatoes.

2) High-protein foods – protein is the building block of muscle, so foods that are high in protein may help repair sore muscles. High protein foods include meat, eggs, and dairy.

3) Pineapple – this tropical fruit is high in the enzyme bromelain, which is a natural anti-inflammatory that can help treat strains, sprains, and bruises.

4) Cherries – some studies show that cherries may be as effective as anti-inflammatory medications. Cherries contain anthocyanins, which are antioxidants which reduce inflammation.

5) Fish oil – high in Omega 3 fatty acids, fish oil may help reduce inflammation in joints and muscles.

What do you do when you’re overtrained and fatigued for several days in a row?

Overtraining occurs when you perform more training—both in and out of the gym—than your body can recover from. For a newbie, overtraining can happen quickly, whereas for an experienced athlete, it may take weeks of unusually difficult exercise to set in.

There are a number of overtraining to watch out for including elevated heart rate, decreased strength, lack of motivation, and chronic soreness in your joints.

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12 Proven Ways To Speed Up Muscle Recovery

You know that feeling you get the day after a great workout? Where your body aches, you have trouble walking, and you’re cursing your spin class instructor? That’s your body telling you it has been broken down and needs time to recover. The muscle recovery phase after a workout is when your body rebuilds and re-energizes your muscles. But sometimes your body doesn’t heal quite as fast as you’d like it to.

Here are 12 proven ways to speed up muscle recovery after a tough exercise session.

1. Get 8 Hours of Shut-Eye.

Don’t underestimate the importance of a good night’s sleep. If you’re one of those people who think you “only need 5 hours,” you’re not giving your body enough time to recover and could be making yourself more prone to injuries in the future. Getting ample sleep is one of the best ways to speed up muscle recovery. So aim for 7-8 hours per night.

2. Hydrate.

Drinking water after a tough workout can help rid your body of toxins and prevent dehydration. This is important because dehydrated muscles can quickly become painful muscles. Drink a couple liters of water or more on days when you exercise.

3. Drink a Protein Shake.

Research shows that drinking a protein shake before or after a workout may help reduce the severity of muscle soreness and speed up muscle recovery. A 2:1 ratio of carbs to protein is ideal.

4. Apply Muscle Creams.

Having trouble sitting because of yesterday’s workout? Topical creams like IcyHot are effective for soothing muscle pain and helping you recover from a tough exercise session.

5. Grab Some Aspirin.

Anti-inflammatory drugs like ibuprofen and naproxen can help relieve the discomfort from sore muscles, which can speed up your recovery time. Don’t use NSAIDS on a consistent basis without getting the okay from your doctor. Rather, use them sparingly when bouts of soreness kick in.

6. Ice, Ice Baby.

Here’s one of the easiest ways to recover from a tough workout: apply an icepack to sore muscles for 20 minutes to help them recover faster.

7. Stretch Every Day. 

Stretching is one of the best things you can do to aid muscle recovery and help you prevent future injuries. Stretching is particularly useful on your off days. If you’re strapped for time, aim for full body stretches and light exercises like squats, lunges, and planks.

8. Roll Out Sore Muscles.

Foam rollers are cheap and effective tools for breaking up knots and sore spots in your muscles. Research shows that foam rolling breaks up scar tissue and knotting in your fascia, which is important because these knots are often the root cause of sore muscles and joints. So spend a few minutes in the morning and evening rolling out sore spots.

9. Get a Massage.

Getting a massage helps break up scar tissue and ease muscle pain. If you don’t want to dish out the money for a regular massage, trade massages with your spouse or significant other. You can thank us later.

10. Eat a High-Protein Meal.

Research shows that eating protein before bed helps with post-exercise muscle recovery. And chugging a protein shake or eating a high-protein breakfast when you wake up can help reduce food cravings throughout the day. Stick with healthy foods like lean meats, eggs, yogurt, and oatmeal.  

11. Drink Chocolate Milk.

Here’s a reason to get excited: drinking chocolate milk after a workout is one of the best ways to speed up muscle recovery. A research study proved that chocolate milk is “an effective recovery aid between two exhausting exercise bouts.” Make your own healthy version of chocolate milk by combining milk, raw cocoa powder and a bit of honey or stevia.

12. Drink Cherry Juice.

Drinking cherry juice and cherry supplements post-workout may help reduce the swelling and help your body recover from a tough workout faster.

5 top tips to beat DOMS after a workout

4. Sleep

Sleep is a really powerful tool for preventing DOMS and for muscle building, and is also key for a wellness lifestyle. Muscle-building chemicals such as Human Growth Hormone are naturally produced by your body in the deep stages of sleep. Aim for a minimum of 7 hours sleep to really help your body to recover from exercising.

If you find it difficult to reach the state of deep sleep required for a good recovery, then try practicing deep and slow breathing, and also turn off any electronics an hour before going to bed. Taking an salt bath as described above can also help to bring on a state of deep, high quality sleep.

Sleep is a truly regenerative process where your body is able to restore, rebuild and adapt. Developing a good sleep routine won’t only help with DOMS but will also help in gaining muscle and losing fat long term.

5. Active Recovery

Probably the last thing you feel like doing when you experience DOMS is moving your sore muscles. However, active recovery where you perform gentle, restorative movements can be one of the most effective tools you can use to dramatically decrease the amount of muscle soreness you experience. After all, sedentary lifestyles cause more hard than good – so get moving!

Light exercise that can help to stretch the sore muscles can also provide some pain relief by keeping your muscles moving. Even going for a walk, or taking the stairs instead of the lift, will help.

Active recovery can be painful to start, but after a few minutes, when the blood gets flowing and the muscles get warmed up, it will usually start to feel better. Slow, gentle stretching of the area will also relieve that tight feeling and help to reduce the pain.

One way to avoid DOMS from happening is having a cool down phase after each workout. Finish your training sessions with a 10-minute light cardio session, and then do some dynamic stretching like lunges, squats, or arm circles.

How To Heal Sore Muscles Fast

Recuperate faster.

Muscle soreness can be the result of a variety of factors, some positive and some negative. A strong workout usually leads to muscle fatigue. A long day at work or running errands can also cause muscles exhaustion. In order to properly mend, you need to learn the appropriate measures that promote healing. Our guide on how to heal sore muscles will provide you with numerous tips to help recuperate faster.

How To Heal Sore Muscles Fast

1. Stretch

Stretching is one of the best ways to break down muscle tissue. There are 4 main stretches but two that will be more beneficial in relieving sore muscles.

1. Static stretching is the most common form of stretching. Its mechanics involve stretching a muscle to its longest point of flexibility and holding for 30 seconds. This allows you stretch out the tender areas and improve blood circulation. The more blood flow the faster your body can repair.

2. Self-Myofascial stretching is the best technique for soreness. It involves the use of a foam roller or ball to help break down tender muscle spots. Soreness in muscles tends to be isolated and using a foam roller allows you to isolate a muscle group and work on those tender spots. The break down removes tension at a faster rate and increases blood flow.

Haven’t used a foam roller before? Our Foam Rolling Basics Lower Body and Upper Body guides will get you on the right path to quicker healing.

Stretching shouldn’t only be a pre and post workout regimen. Spending 5-10 minutes every morning and night to stretch helps prepare your muscles for the daily demand you plan to place on it. At night it helps alleviate the tension placed on them during the day.

2. Movement

A little movement can make all the difference also.

1. Without adding resistance to your muscles, consider doing some light body weight work to get the blood flowing. Finished a long day of leg workouts, do so prisoner squats to get the blood flowing. Triceps burned out? Try some wall push-ups to loosen up the triceps. Think low rep, low resistance.

2. Yoga is beneficial to our body in so many ways. The slow controlled movements and strong poses help blood flow through our body. The breathing techniques and meditation help clear our mind and body of toxins also.

3. Food

The food you eat can make all the difference in helping to heal your muscles at a faster rate.

1. Protein is essential for muscle recovery post workout. Ideally a protein smoothie within 45 minutes post-workout can help decrease the prolonged muscle soreness. If you’re not a fan of smoothies, eggs, lean chicken breasts, salmon, greek yogurt and tofu are some great options.

2. Carbs are also an essential part of muscle recovery. Carbs are our bodies key source of energy. With them, broken down muscle is replaced with newer healthy muscle. This also helps restore your energy levels for your next workout.

3. Certain foods have the ability to aid in healing muscle also. Foods high in antioxidants help remove free radicals in our body which cause damage. Blueberries, fresh ginger, cherries, pomegranates and cranberries all have properties that help offset post workout fatigue. When consumed as juices before a workout these all have the ability to reduce muscle soreness. They also have properties which allow them to act similar to drugs such as aspirin and ibuprofen.

4. Vitamin C rich foods also contain antioxidants and are a great option. Oranges, kale, bell peppers, kiwis, broccoli and papayas are all high in vitamin C.

4. Hydrate

Since our bodies are 60% water, hydration is always an important factor when considering any type of healing. Exercising removes water from your body and if you’re not properly hydrated, muscle soreness becomes more prevalent. Aim to drink 8-12 oz of water a day depending on your weight.

5. Hot vs. Cold Therapy

1. Hot therapy such as a nice hot bath, naturally relaxes and increases blood flow to muscles.

2. Cold therapy is best used for immediate relief. Ice packs help reduce swelling and sooth muscle soreness briefly.

6. Spa Treatment

You can pamper your muscles into rehabilitation in the comfort of your own home.

1. Soaking in your tub is always relaxing. Instead of a bubble bath try our DIY Ginger Bath Detox to relax your muscles and soother your entire body.

2. Creams have the ability to reach deep into our skin and provide a lasting soothing effect. Our DIY Natural Muscle Relaxer Cream uses lavender essential oil to relax joints and aid in muscle pain.

3. You may not workout your feet, but they can get sore and tired from all the walking. Our DIY Peppermint Sugar Foot Scrub uses brown sugar and olive oil to moisturizer and cleanse your feet. Peppermint oil is a natural muscle relaxer and the smell provides aromatherapy. 

7. Rest

Without proper rest your body won’t repair properly. Our bodies repair during while we sleep, so the more you incorporate the right food, drinks, movements and self treatment, the more your body will repair while you sleep.

Sources: Livestrong, Eatingwell

Before you get sore you have to workout hard to get there. Try these fun and challenging workouts that will make you run back to this guide for advice:

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Which one of these tips on how to heal sore muscles do you find most helpful? Any tips we left out? Leave us a note in the comment section below.

9 Ways to Get Rid of Muscle Soreness After a Hard Run

Running fast workouts and nailing long runs is a key part of the training process.

During the run we are feeling strong, pushing through that pain, and when we finish, we are greeted with one of the best feelings in the world; the runner’s high.

We go to bed that night with a smile on our faces, proud that we had a great run or race, and excited for what we can achieve in the future.

But then you get out of bed the next day.


Every step hurts,

We wonder if we can run if my legs are sore?

Surely, this cannot be good for my body to run again (if you even want to run again that is).

Will running with sore muscles help or make me feel worse?

In two previous posts I’ve discussed how the workout and recovery process works as well as the importance of keeping your recovery runs easy, but this post is going to outline what I call “the optimal recovery process”.

Unoriginal name, I know, but I’m not fan of making up strange words to impress.

I understand that not everyone will have the time necessary to perform this routine after every hard workout. You may only be able to fit this in after long runs or even as little as once per month.

While this is the ideal recovery plan, you’re free to pick and choose what you’re able to fit in after each workout. If it is sore calf muscles after a race that are bothering you, we have a separate post for preventing sore calves.

For example, the easiest elements, hydration and refueling, should be easy to get in after every run while the ice bath is a nice treat when you have the time.

On a side note, this is what separates professional runners from the rest of the pack; in addition to running, drills, and strength training each day, elite runners will often spend 1-4 hours per day on recovery!

Ready to get those sore muscles back to normal?

Let’s do it

How to Treat Sore Muscles After a Run


After a hard workout or a tough long run, you should begin by hydrating within the first 10-15 minutes after stopping.

Even if the temperature was cool, or downright cold, you still sweat a significant amount and you need to replace the fluid loss.

An electrolyte solution like Gatorade (or a spray that goes in any drink like EnduroPacks) works well and you should aim for 16-20oz of fluid.

When running in the summer, you can use our sweat loss calculator to determine the exact amount of fluid you need to replace.

For a more detailed look at hydration, see my article on how to hydrate after running.

What to eat after a run

After you’re hydrated, you can begin your stretching routine while also ingesting your post run snack or beverage.

This post run fuel could be something like chocolate milk, Endurox, yogurt and granola, banana and peanut butter bagel with orange juice. You want to aim for a 4 to 1 ratio of carbohydrates to protein.

I’ve also experimented with glucose tablets (made for diabetics) directly after running, especially when I travel. The tablet is pure glucose, which stimulates the insulin response in the body and ignites the recovery process.

It’s a quick and dirty trick if you’re crunched for time or have a sensitive stomach. For a more thorough look at post run nutrition, check out my article on post run recovery fuel.

Stretching is good after running only

The stretching and post run fueling should begin within 25-30 minutes of finishing your run.

The stretching should last 10-15 minutes, focusing on the major muscle groups (quads, hamstrings, calves, and hips) as well as anything that is nagging or felt sore on the run.

While the merits of stretching are a hotly debated topic in running circles, I believe stretching after a run is beneficial.

If you have a foam roller and are experiencing any small injuries, it would also be beneficial to roll out on the foam roller to alleviate any knots and tightness.

Ice bath is miserable now, but worth it later

After stretching, it’s time to hit the ice bath.

Fill your bath tub with cold water and add ice until the temperature reaches a balmy 55-60 degrees Fahrenheit.

If you don’t have a thermometer, the ice should still completely melt, but it should take about 3-5 minutes for a normal size ice cube to do so.

Next, grab a towel and your favorite magazine and submerse your entire lower body, up to your hips, in the water. Now, the trick to ice baths is surviving the first 3 minutes.

Bite the towel and dream about your biggest goals. This will help you get through the hardest part of the ordeal.

After 3 minutes or so, you’ll notice the temperature feels more temperate and you can actually relax a little. If you are a veteran ice bather, or just a sadistic human being, you can kick your legs a little to stir up the water.

This will help circulate the warm water surrounding your body and make things cold again.

Remain in the tub for 10-15 minutes.

Trust me, the more you ice bath, the more comfortable this process becomes.

After letting all the water drain from the tub, go ahead and take your shower. Your legs will feel cold for a few hours, but your muscles will thank you later.

Eat a well-balanced meal 1-2 hours after your run

After the ice bath, you’ll want to ensure that you get a well-balanced meal in your system.

So far, you’ve had Gatorade and some light snacks.

To completely refuel within your second optimal window, your muscles need something more substantial.

If you run in the morning, this could be breakfast – eggs with veggies and whole wheat toast, oatmeal with fruit and toast, I even think pancakes are a decent choice if you top with fruit and yogurt.

Lunch or dinner could be salad with a sandwich, pasta, or leftovers from the night before.

You just want to consume a high quality meal with a good balance of carbohydrates, proteins and fats. This will provide your body with the final nutrients it needs to top off the recovery process.

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Take a nap or get a massage – what a luxury

After your meal, put your feet up, take a nap, and follow it up with a massage.

I know this is where things can get “ridiculous”, as massages and naps are a fantasy and extreme luxury; however, I thought it should be included since this is the “optimal” recovery guide afterall.

Move without impact

The body repairs muscle damage by delivering nutrients to your muscles through the blood stream. As such, anything that can increase blood flow to your legs will help aid recovery – provided it’s not causing more damage.

That’s why you should include a short walk or some aqua jogging in your recovery plans (and not just when you’re injured). A short 15-30 min walk or aqua jogging session can make a huge difference in recovery.

Aqua jogging is even better in the summer when it gives an excuse to cool off in the pool.

If you’re interested in aqua jogging, then the absolute best way is to use one of my favorite programs, Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while you’re actually pool running.

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, it’s changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

That’s why we’ve partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product here and then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

Warm bath with epsom salts

About 60-90 minutes before bed, you should take a warm/hot bath in Epsom salts.

Combine 4 cups Epsom salt with 1 cup baking soda and relax in the hot water for 10-15 minutes. After the bath, dry off and roll out your muscles with The Stick and get in a good stretching session.

Not only with this help remove excess toxins from the muscles, the stretching before bed will ensure that you wake up feeling ready to go for your next run. Furthermore, the relaxing bath and the Epsom salts will help you sleep.

To sum up this routine in one easy to visualize chart:

  1. Hydrate as soon after your run as possible with Gatorade or electrolyte drink
  2. Stretch major muscle groups and anything that is sore or tight. Roll out any nagging injuries or problem areas.
  3. Eat a small meal that contains a 4 to 1 ratio of carbohydrates to protein
  4. Take an ice bath
  5. Eat a decent sized, healthy meal
  6. Nap, put your feet up, or get a massage
  7. Get moving
  8. Take an Epsom salt bath
  9. Roll out on the stick and stretch well
  10. Get plenty of sleep

As you can see, this routine is quite extensive. You won’t always have the time to get in all of these recovery protocols, but it does give you glimpse of the things you could do on those rare occasions. Do what you can, but at least now you have a plan.

If you are in marathon training, and looking for more advice, check out our marathon training schedule and accompanying 9 part video guide, and guess what, its totally free!

6 Ways to Relieve Sore Muscles


6 Ways to Relieve Sore Muscles

Make Your Muscles Feel Better With These Tips


When you’re living an active life full of hiking, biking, and other forms of exercise, occasional sore muscles are inevitable.


When you’re desperately seeking relief from sore muscles, try these six cures that really work! Before you know it, you’ll be back to your normal activities.


1. Drink water

Before you do anything else to work on your muscle soreness, drink plenty of water. Like the rest of your body, your muscles need water to repair themselves. Avoid dehydrating beverages like soda and coffee.


2. Don’t get stuck on the couch

It might sound counterintuitive, but total inactivity is the worst thing for muscle soreness. Keep moving to feel better faster. It doesn’t have to be anything crazy and probably not the same activity that stressed your muscles, but even a leisurely walk will get your blood flowing and your muscles healing.


3. Try foam rolling

Foam rolling is like giving yourself a deep tissue massage, right down to the pain you might feel. It’s effective for muscle soreness because it relieves tension and works out the knots in your muscles by applying pressure.


It can be painful, especially at first, but it will help your muscles recover faster.


4. Stretch. Try some yoga

Stretching can also provide relief from sore muscles. These yoga poses for a better back are a great starting point. You can find an endless supply of quality yoga videos on YouTube. Try searching “yoga for athletes” for videos to help with your specific type of athletic muscle soreness.


5. Get a massage or massage your own muscles

Massage can provide much-needed relief from muscle soreness. The best scenario is to book a professional massage, but you can enlist the help of a friend or massage and knead your own muscles.


6. Take a warm soak

There’s nothing quite like a warm bath to relax muscles and mind. Toss some Epsom salts into the water. They’re known to help relieve muscle soreness. For a special treat, visit one of Colorado’s many hot springs.


Aches and pains you should never ignore

Muscle pain is common when you’re exerting your body, but certain aches and pains shouldn’t be ignored. For example, leg pain or swelling, especially in the calves, can indicate more serious conditions, like a blood clot. If you suspect your muscle pain could be something more serious, it’s always smart to see your doctor.

How to cope and recover from muscle soreness

Credit; Pixabay.

It’s common to experience sore muscles after performing strenuous physical activity, especially if you’re not used to it. For people who have just started working out, this sensation can be demotivating, on top of other nuisances such as lack of free time and feeling embarrassed due to lack of experience.

This is why it’s important to understand what causes muscle fatigue, what’s normal and what isn’t, and what you can do to recover from it in order to stay on track with your fitness goals.

What causes muscle soreness

There are two types of muscles soreness:

With AMS, the pain felt in muscles during and immediately, up to 24 hours, after strenuous physical exercise

As the name suggests, delayed onset muscle soreness refers to a gradually increasing sensation of discomfort that occurs 24 to 48 hours after training. This is completely normal, and it happens even to seasoned athletes and bodybuilders. If anything, muscle soreness is a good sign that your muscles are adapting to a novel fitness regimen. You can have both AMS and DOMS as a result of your workout.

DOMS is triggered when the body goes through physical activity that stresses the muscle tissue beyond a level of intensity that it is accustomed to.

Ultimately, the pain and aching associated with DOMS are due to the microscopic damage incurred by the muscle fibers.

DOMS is targeted, meaning it appears in the body parts that had been recently strained through intense exercise. Vigorous jogging, for instance, will cause soreness in the backside of the lower legs. Depending on the type of exercise, lifting weights might cause DOMS in the shoulders or upper arms. But this means that while you feel sore in a muscle group, you can work out other parts of your body. For instance, if your delts and triceps are still sore from the last round of exercising, you can train your legs or back.

DOMS is most likely to occur when muscles are performing an eccentric or lengthening contraction (i.e. running downhill, bicep curl, etc).

The good news is that subsequent trips to the gym are generally less painful and recovery is faster. In a study involving 14 men and women who went through two vigorous rounds of exercise 28 days apart, researchers at Brigham Young University found a significant increase in white blood cells and T-cells after the second bout of exercise. This suggests that muscles seem to remember the previous damage to their fibers and react similarly to how the immune system responds to antigens like bacteria or viruses.

Inflammation actually increased after the second round of physical training, which seems to indicate that inflammation itself does not contribute to muscle damage. Which brings us to the next point…

Should you take Aspirin or Ibuprofen after a workout?

Many take anti-inflammatory drugs like Ibuprofen and Aspirin thinking this will help them cope better with muscle soreness and recover faster. But, as we’ve seen earlier, that may be totally unnecessary. On the contrary, painkillers increase the risk of bleeding and damage to muscles, tendons or kidneys, and they can also delay muscle recovery from exercise.

When you exercise intensely, you run low on oxygen which causes lactic acid to accumulate in muscles, causing muscle burning. The only way to stop this is to slow down during intense exercising to allow lactic acid to be cleared. Contrary to popular belief, NSAIDs (nonsteroidal anti-inflammatory drugs) do not block muscle burning.

According to scientific literature, taking NSAIDs after injuries delays healing both in muscle tissue and bones. They may also increase the risk of low blood sodium levels and muscle damage from repetitive exercise.

Common types and brands of NSAIDs include ibuprofen (Motrin, Advil), indomethacin (Indocin), ketoprofen (Ketoprofen) and naproxen (Aleve, Anaprox, Naprelan, Naprosyn).

“Many people think inflammation is a bad thing,” Michael Deyhle, a researcher at Brigham Young University, said in a statement. “But our data suggest when inflammation is properly regulated it is a normal and healthy process the body uses to heal itself.”

Robert Hyldahl, assistant professor of exercise science at Brigham Young University, said : “Some people take anti-inflammatory drugs such as Ibuprofen and Aspirin after a workout, but our study shows it may not actually be effective. The inflammation may not be directly causing the pain, since we see that muscle soreness is reduced concurrent with increases in inflammation.”

Muscle fatigue is your friend

Credit: Pixabay.

The mild sensation of discomfort that you feel the next day after a strenuous workout actually works in your favor. It simply means that your muscles are adapting to more strain, growing stronger so they’re better equipped to take on a physical task next time, whether it’s long-distance running or lifting heavy weights in the gym.

Some people don’t have an athletic background but would still like to work out and get fit. For those just starting out, this novel sensation can oftentimes be intimidating.

It’s thus very important not let your initial enthusiasm wane when trying new things in your physical training. Feeling sore after an intense workout is completely normal, especially for beginners, and doesn’t necessarily mean you’re hurting yourself (which could happen if you have poor form in the gym) as some people worry.

So, bear in mind that it’s okay to be sore. Also, know that it gets easier the more you exercise regularly. As long as you don’t raise the intensity of your training too much the next time you perform physical training, there will be less muscle soreness and recovery will occur faster.

How to recover from muscle soreness

Credit: Pixabay.

DOMS is a normal and necessary process that accompanies physical activity more intense than the body is accustomed to. There is no way to avoid DOMS altogether, but there are several remedies that can help ease the aching.

The best thing you can do is get enough rest. This means sleeping at least eight hours during the night following your workout.

However, the most underrated remedy for DOMS is stretching and working on your flexibility.

By stretching, either immediately after a workout or the next day, you can help untighten your contracted muscles and ease soreness.

It’s also important to keep the muscles in motion with some light exercising, such as walking or a light jogging, even though you might feel sore.

A 2017 study found that foods rich in antioxidants may relieve muscle soreness. Watermelon, for instance, is rich in an amino acid called L-citrulline. Other foods that are a great source of antioxidants include pineapple, ginger, and cherries.

Applying heat to the site of muscle soreness is also a viable option, especially if the strain is more intense than you’re used to after a typical workout. According to researchers at Brigham Young University, increased muscle temperature promotes blood circulation, which shuttles more nutrients and oxygen to the damaged muscle fibers.

The increased blood flow also washes away certain chemical irritants that cause the pain. You can try applying a warm damp towel on the body parts you’ve trained following your workout or take a hot bath.

Moderate doses of caffeine may cut your post-workout pain down by almost 50%, so it might be a good idea to have a cup of coffee before heading for your workout.

If you do nothing special, the soreness will usually go away by itself in a few days. Some take longer to recover while others get back to their exercise routine very quickly.

Muscle fatigue from overtraining

It’s important to make a distinction between mild muscle soreness induced by physical training and pain incurred by overtraining or injury.

How can you tell the difference? If the soreness prevents you from performing everyday tasks (Does it hurt when you brush your teeth?), then you’re likely overtraining and should dial down the intensity of exercise.

Use muscle fatigue to your advantage

Credit: Pixabay.

Instead of being discouraged by the pain, it’s in your best interest to reframe muscle fatigue as a welcoming sensation that you associate with growth and progress in meeting your goals.

Once you start seeing the soreness as a sure sign that your muscles are engaged and growing stronger, you’ll actually feel more encouraged.

Most people stop going to the gym when they face muscle soreness. But, after reading this article, you should know how to flip the script and welcome the pain because, at the end of the day, that means growth.

90,000 Myofascial syndrome – causes, symptoms, treatment of myofascial syndrome in Moscow at the Spina Zdorov clinic

Myofascial syndrome. Fragment of the interview of Dr. Vlasenko to the channel “Neuromir-TV

There is an expression: “The spine is the key to health.” We will not deny this, but we should not blame the spine for all back pain either. After all, anatomically, the back also consists of ribs, shoulder blades, various ligaments and many muscles.And without the help of the spine, they can cause truly hellish torment, which can really be mistaken for the symptoms of a herniated disc or radicular syndrome.

Take muscle spasm, for example. It is believed that muscles make up about 45% of our body. Therefore, there is nothing surprising in the fact that muscle spasm can occur literally everywhere and at the same time cause severe pain. By the way, any woman who has given birth will confirm this. After all, pain and contractions during childbirth are nothing more than a spasm of the muscles of the uterus.The uterus is made up of muscles that are the strongest in a woman’s body. Another prime example of muscle pain is muscle tension headache. Here, as you can see, the name itself contains an indication of the cause of the pain – muscle tension.

I am giving these examples only for you, dear reader, to look at the question “Why does my back hurt?” from a new point of view. Although, in fact, there is nothing new in it, you just might not have known before that the culprits of back pain are most often not displaced vertebrae and discs, but muscle spasms.And to be absolutely precise – spasms of individual fibers in the muscles of the back, neck or lower back. This, by the way, is convincingly evidenced by both statistics and modern scientific research.

“But what about osteochondrosis and disc herniation?” – you ask. And nobody canceled them. Only now the role of osteochondrosis and hernias in the occurrence of pain is greatly exaggerated. There is convincing evidence of this. See for yourself:

In case of complaints of back pain, the patient undergoes an MRI scan and detects osteochondrosis or disc herniation.The patient is treated and the pain goes away. But, if you do a second MRI, it turns out that both the osteochondrosis and the herniated disc remained in the same place. So why did your back hurt? The explanation for this is quite simple – they were not the originators of the pain. And if we turn to statistics again, we find out that muscle spasms are the cause of back pain in 75–85% of cases. A hernia and osteochondrosis may be present, but never bother a person!

Muscle pain. What is myofascial syndrome?

Let’s start with the word “syndrome”.It is almost synonymous with the word disease. The only difference is that the symptoms of the disease have a common mechanism of development and a common origin. And the symptoms that make up the syndrome have only a general mechanism of development, and their origin is different. Easier to understand with an example. All symptoms of salmonellosis have a common origin – they are caused by Salmonella bacteria. Therefore, salmonellosis is a disease. But the symptoms of myofascial syndrome have different origins: impaired neuromuscular conduction, overload, fatigue, stress, metabolic disorders, a “sedentary” lifestyle, bad habits, injuries, etc.That is why myofascial syndrome is called “syndrome”.

Now – “myofascial”. This word consists of two words: “myo” – muscle and “fascia” – the muscular sheath, which covers every muscle in our body. Muscles and fascia are inseparable: they work together and get sick together. And they should also be treated together. Let’s agree right away: for simplicity, we will not say “muscles and fascia”, but simply – “muscles.” But, in fairness, let’s start with the fascia.

Fascia is a muscular layer that sometimes shortens, similar to how things “shrink” when washed incorrectly.This happens for various reasons, for example, from a sedentary lifestyle or from injury. As a result of this shortening, the fascial sheath becomes tight, it compresses the muscle – and the muscle, under the influence of this tightness, has to reflexively contract itself. As soon as the muscle contraction reaches a certain force, the muscle automatically compresses the nerve endings, veins and arteries that pass through it. But the most important thing is that the pinched muscle can no longer contract normally. Consequently, the pinched muscle will become harder to work and weaken.

This pathological process is called muscle-fascial shortening . Under the onslaught of this pathology, the body will adapt to the growing pathological changes and keep an independent defense as long as there is enough strength. All this time, healthy muscles will take on the load, compensating for all the shortcomings. However, even healthy muscles will not be able to endlessly withstand the overload, so they will also begin to weaken and contract.Thus, the pathological process, spreading from one muscle to another, will gradually cover the entire muscles of the back and limbs. First, this will change the posture, then overload the spine, lead to the formation of intervertebral hernias and protrusions. And finally, having exhausted the possibility of compensation, the body will give signals “SOS” – the emergence of pain. This is what myofascial syndrome looks like.

We used to think that pain arises from the fact that a person lifted a weight, “lay down” his neck, or bent over sharply.But this is not the case. The listed circumstances only translate the disease into an open phase.

Common mistakes in the treatment of back pain

Many people, the first time they experience pain in the back or in another part of the body, make desperate attempts to “heal” with exercise. This happens under the influence of the prevailing opinion about the “pumping” of the muscle corset. This point of view is rather naive. It does not take into account the fact that a sore muscle requires treatment, not stress.After all, it would never occur to anyone to treat pain at the time of a sprained or broken leg by running – “limp but run.”

Treatment and rehabilitation should not be confused. The difference between the two is enormous. Treatment is about fighting the disease, and rehabilitation is about making up for lost time while a person was sick. Replacing the treatment process with rehabilitation is a very short-sighted step. After all, recovery exercises are not just physical education. They are called restorative precisely because they should be performed at the last – restorative stage of treatment, after the disease has subsided.But in no case in acute or subacute periods when the disease is at its peak! Otherwise, there is a great danger of tearing up the compensatory forces of the body, which are already at their limit.

Another common misconception is the “reduction” of the vertebrae. An inexperienced patient, who first encounters back pain, most often expects that everything will be “quickly put right” and the case will be over. How far from the truth he is! Indeed, by the time the pain appears, the balance between most of the muscles has already been disturbed.And if we compare the spine and muscles with the mast and ropes, it becomes clear that unevenly and asymmetrically stretched ropes can easily warp the mast.

Usually, when examining patients, the asymmetry of many muscles is clearly visible. For example, the left muscle groups pull over the right ones, the front muscles are tense more than the back ones, and the deep ones are more tense than the superficial ones. It is as a result of this that our “mast” is skewed. Therefore, if we restrict ourselves to “repositioning” the vertebrae without properly relaxing the muscles, then the stretched back muscles will “displace” the vertebrae again and again.Therefore, first of all, it is necessary to return the muscles to a normal state, releasing them from tension. And only then “set” the vertebrae and “pump” the muscle corset. But more often, after relaxation of the muscles, the vertebrae themselves “fall” into place, having received the long-awaited freedom.

Symptoms of myofascial syndrome

It happens that different diseases have similar symptoms, for example, pain. Speaking about myofascial syndrome, we do not forget that there are disc herniation, osteochondrosis and other diseases.After all, it often happens that a person has two or three diseases at the same time, and in different stages. For example, inactive disc herniation and exacerbation of myofascial syndrome. Therefore, it is important to distinguish between what exactly is bothering the patient at the moment. Therefore, in order to truly cure a disease, it must first of all be recognized amid the accumulation of active and inactive symptoms.

The symptoms of myofascial syndrome are:

  • trigger points;
  • zones of reflected pain;
  • Numerous autonomic disorders.

Now let’s take a look at each of them separately.

Trigger Points

Myofascial syndrome arises in the thickness of the musculature with microscopically small muscle spasms. Gradually, the spasm zone reaches a size significant for the microworld. The number of such areas increases, they thicken and become incredibly painful. They are called trigger points – from the English word “trigger”, which in this case denotes the mechanism that triggers myofascial pain syndrome.

Please note that trigger points are a specific symptom inherent only (!) In myofascial syndrome. Trigger points fundamentally distinguish myofascial syndrome from all other diseases: osteochondrosis, disc herniation, etc.

Treatment of trigger points in the Spina Zdorova clinic is carried out according to the American method of soft manual therapy described in the book by Travel and Simons Myofascial Pains and Dysfunctions.

If you accidentally find similar painful points in yourself in different parts of the body, then the likelihood of myofascial syndrome is very high. But two other symptoms will help to make sure of this.

Reflected Pain Zones

The reflected pain is like a sunbeam hitting a wall. Although the wall glows, any adult understands that this is just a reflection of the sun. Similarly, reflected pain is felt far from the place where its true source is hidden.Reflected pain can manifest itself in different ways: both independently and simultaneously with pain at the trigger point itself.

It is impossible to catch the sun “bunny” until you cover the mirror. Reflected pain cannot be eliminated if you do not know where its true source is. It is a great success that each trigger point corresponds to its own, strictly defined “pattern” of the pain zone – a pain pattern. This alignment allows the chiropractor to accurately identify the true sources of pain and effectively treat them.

Vegetative dysfunction

All processes that support the very life of the organism and its work are called vegetative. This includes breathing, eating and excreting, sleeping and waking, heating the body in cold weather and cooling in heat, and much more. Any violation of these processes is usually called autonomic dysfunction.

In simple cases of myofascial syndrome, autonomic dysfunction is subtle. It is manifested by swelling of the sore spot, discoloration of the skin or impaired sweating.But when myofascial syndrome is expressed strongly or for a long time, then autonomic dysfunction takes on very striking features. Morning stiffness, dizziness, nausea, sometimes vomiting, congestion in the ears, a lump in the throat and anxiety appear. General weakness, fatigue, irritability, depression, bad mood and tearfulness, insomnia at night and drowsiness during the day, distraction of attention and memory loss occur. Disturbances in the work of internal organs are frequent: abdominal pain, palpitations, lack of air.Headaches, a feeling of squeezing of the head, trunk or limbs.

However, all of these autonomic disorders, patients associate with anything, but not with muscles. Therefore, the chiropractor is the last to be consulted, thereby allowing the disease to spread its influence.

Pain areas of various muscles

Myofascial syndrome of scalene muscles

Myofascial syndrome levator scapula

Myofascial syndrome of the rhomboid muscle

Myofascial syndrome of the superior posterior serratus

Myofascial syndrome of the serratus anterior muscle

Myofascial syndrome of the pectoralis major muscle

Myofascial syndrome of the pectoralis minor

Myofascial syndrome of the biceps

Myofascial syndrome of the shoulder muscle

Myofascial syndrome of the coracohumeral muscle

Triceps myofascial syndrome

Myofascial syndrome of the deltoid muscle

Myofascial syndrome of the large round muscle

Myofascial syndrome of the small round muscle

Subscapularis myofascial syndrome

Myofascial syndrome of the trapezius muscle

Myofascial syndrome of the broadest muscle of the back

Myofascial syndrome of the multifidus chest muscle

Myofascial syndrome of the iliocostal muscle of the chest

Zones of reflected pain are marked in red, muscle trigger points are marked with a cross; the color drawings show the muscles themselves causing this pain.

Sign up for the diagnosis of Myofascial Syndrome

  • We will test the muscular system for latent and active trigger points in order to eliminate pain and restore muscle health, and prevent the development of pathologies.
  • Duration of diagnostics – 30 minutes. This is a full-fledged examination, and not a 2-minute “feeling” for show.
  • Diagnostics is carried out personally by Dr. AA Vlasenko, a doctor with 30 years of experience, an expert in the treatment of myofascial and radicular syndromes.

Causes of muscle pain. What are the causes of myofascial syndrome?

Lifting weights, hypothermia, negative emotions. What connects all these factors and muscle pain?

Acute muscle overload . As a rule, if back pain occurs due to heavy lifting, bending, awkward movement or injury, then it does not raise questions, its causes are so obvious. There is also chronic muscle overload , and it occurs due to scoliosis, poor posture or monotonous posture, for example, with a sedentary lifestyle.However, chronic muscle overload, due to its predominant pathological effect on the body, we will discuss separately.

Metabolic disorders . This is overweight, hormonal deficiency, anemia, low levels of hemoglobin, vitamins, calcium, sodium and iron. In addition, various toxins have a fatal effect on metabolic processes: from viral and microbial (remember muscle aches in the body with a cold), to toxic products of smoking, alcohol or drugs.In general, any intoxication seriously disrupts the nutrition of muscle cells, leads to overstrain and the development of myofascial syndrome.

Another cause of pain is hypothermia . It is the muscles that generate heat in the body. It is not for nothing that with active movements a person becomes hot, and when frozen, he shivers from the cold. Shivering is an extremely intense work of muscles to generate heat. Severe hypothermia can cause overload, leading to pathological stress and pain myofascial syndrome.

Emotional disorders. Let us emphasize this reason. Do you know why? Because most people do not know about the connection between emotions and muscles, and this connection is so essential that it cannot be neglected! And since we started talking about emotional stress, you need to understand that in a big city even the most conflict-free and healthy lifestyle is associated with oppression of the psyche. Artificial light, street noise, lack of sleep and other factors of the metropolis catastrophically overload the sympathetic system, which serves as a starter for muscle strain.Emotional overload is a significant and very significant reason that increases pathological muscle tension – take this into account when analyzing your pains.

And, finally, let’s name the most common and, perhaps, the main cause of myofascial syndrome. It is called muscle imbalance .

Muscle imbalance. Chronic muscle overload is the main danger

What is muscle imbalance? The balance between which muscles is disturbed with it? It is believed that muscle imbalance is a violation between the so-called opposing antagonist muscles, that is, flexion and extension, front and back, deep and superficial.But in fact, muscle imbalance is an imbalance between the phasic and tonic muscles.

According to their functions, the muscles of our body are divided into two groups. Some perform movement, and are called motor, dynamic, or phasic. Others hold a pose, counteracting the gravitational forces of the earth’s gravity and the pressure of the atmosphere on us. These muscles are called postural tonic, tonic, or postural. All muscle groups work during movement.For example, when walking, the motor muscles “go”, and the postural-tonic muscles keep the body upright. Therefore, the workload for both groups is distributed evenly and in a balanced manner. When a person is motionless, for example, sitting, then only the tonic muscles work for him, and the motor muscles are inactive.

The life of a modern person is deprived of movement. Today, since childhood, static and monotonous postures prevail. And if we add here postural disorders and scoliosis, which in themselves are static overload, then the scale of the problem becomes obvious.Static monotony forms a fatigue overstrain of tonic muscles, from this they shrink and “stiffen”, and motor ones, on the contrary, become decrepit from prolonged inactivity.

It is this ratio, when the tonic muscles are overloaded with work, and the motor muscles are relaxed from idleness, is commonly called muscle imbalance.

Sooner or later, muscle imbalance leads to local muscle spasms. Beginning due to chronic muscle overload, spasms intensify under the influence of “second order” causes.Compounding the problem is that a person cannot feel muscle imbalance, unlike injury, heaviness or hypothermia. The invisibility of the initial stage of the disease allows it to take root deeply and spread its shoots everywhere.

Pain areas of various muscles

Myofascial syndrome of the iliocostal muscle

Myofascial syndrome of the iliopsoas muscle

Myofascial syndrome of multifidus muscle

Myofascial syndrome of the muscles of the perineum

Myofascial piriformis syndrome

Myofascial syndrome of the gluteus maximus muscle

Myofascial syndrome of the gluteus medius

Myofascial syndrome of abdominal muscles

Myofascial syndrome of soleus muscle

Zones of reflected pain are marked in red, muscle trigger points are marked with a cross; the color drawings show the muscles themselves causing this pain.

An effective treatment for muscle pain. Manual treatment of myofascial pain syndrome

How to restore the lost balance to the muscles? Although this task is difficult, it is quite real. Manual treatment and moderate physical activity will provide them with a full and high-quality recovery. And it doesn’t matter what you do: swimming, Pilates, exercise equipment or physiotherapy exercises, the main thing is that the sports load does not exceed your physical fitness and is performed at the appropriate time.

Note! Myofascial syndrome is the cause of 90% of back pain.

For any disease, there are basic, auxiliary and restorative methods of treatment. You can’t do without the main ones, the auxiliary ones enhance the action of the main ones, and the general strengthening ones contribute to the restoration of the body. Purely theoretically, the best result will be obtained by a simultaneous combination of all influences, but in practice this will result in either a very troublesome or unjustifiably expensive treatment.Therefore, the most rational choice is still the main method, supplemented, if possible, by auxiliary ones. And here the question arises, what is the main method of treating myofascial syndrome? To understand this, we will give a brief description of the most common methods.

Drug treatment. When a pain attack occurs, it can grow like an avalanche, activating more and more trigger points. Therefore, if now you do not have a better option, then be sure to take your medicine.The most commonly used analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. Remember, as an axiom – pain cannot be tolerated.

Some people ignore any pill because of the possible side effects. But no medicine in the world can compare with the “side effects” of pain. Because even minor, but constant pain is a stress factor. It severely depletes and suppresses the nervous system. It may seem unexpected, but the word “depression”, in Latin – “depressio”, means the most real depression.In other words, even mild but prolonged pain gradually suppresses the nervous system, forming somatoform depressive states, the inevitable consequence of which is the consolidation and fixation of the pain itself. A vicious circle is created: muscle tension – pain – muscle tension.

The disadvantages of drug treatment for myofascial syndrome are that it cannot be used for a long time. Therefore, with pronounced, widespread and prolonged muscle tension, the final effectiveness of medications is low, they simply do not have enough time and power to release the muscles from tension and overcome the disease.

Acupuncture. Not a bad way to relax your muscles, but finding a smart specialist is a rare piece of luck, there are very few of them. Therefore, most often the cost of acupuncture exceeds its effectiveness. Health is not something that one can frivolously experiment with using extravagant methods of treatment, especially when there are correct and affordable solutions. This is my opinion.

Physiotherapy for pain and remedial gymnastics for pain are adjunctive treatments. At the right moment, they fully justify the tasks assigned to them. However, if physical therapy is prescribed prematurely, then the likelihood of a new exacerbation of pain is very high. During treatment at the Spina Zdorova clinic, the doctor will recommend the necessary exercises for you. Pilates is the best option.

Manual treatment of myofascial pain syndromes deserves the highest marks. Human hands are the softest, most sensitive, skillful … in general, the most-most “instrument” in every sense.It is not for nothing that “handicraft” has always been considered a sign of good quality and high quality. Judge for yourself, how the pill can “straighten” the vertebra? But manual therapy can. Relieve muscle tension and pain, eliminate blocks of joints – but you never know what else can be done by human hands and manual therapy. Of course, there are diseases that are more effective to treat with devices, medications or a scalpel, but the treatment of myofascial pain syndromes is the undisputed leadership behind manual therapy.

At the Spina Zdorova clinic we use all methods of soft manual therapy:


relaxation / PIR

Provides preliminary muscle relaxation and guarantees complete safety of subsequent impacts.We start each session with PIR.

Eliminates blocks and restores mobility of the spine and joints. With gentle movements, gently straightens the neck, spine, joints of the arms and legs.

Provides a tremendous muscle relaxation effect and reliably relieves pain.

Very mild local action with variable amplitude for the correction of vertebrae and joints.

The doctor fixes the patient in special positions, thus eliminating pain and severe stress.


Myofascial release

Frees muscles and vertebrae from clamps, so that they painlessly “fall into place”.

The most effective method of manual therapy for combating myofascial syndrome is myofascial release , from the English word “release” – release, deliverance. This is a proven method that allows a very high quality and gentle release of muscle tension, healing a person.

The qualifications of the doctors at the Spina Zdorova clinic make it possible to freely use these and other methods for the treatment of myofascial syndrome. In addition, in each case, we combine them, taking into account the synergy effect.

What is synergy?

Synergy is not just a jumble of different influences, it is the correct sequence in the combination of methods. Synergy leads to additional quality of treatment. An example from life is our hands. How long does it take to button a button? Seconds ?! And if you do it with one hand, you may not be able to cope in a minute.That is, to act with two hands is not twice as fast as one, but many times faster. Is there a difference to listen to the same music performed by separate instruments or by the whole orchestra together? This is the effect of synergy – it makes it possible to do everything much more powerful, more efficiently and faster, but at the same time – more carefully. This also applies to treatment at the Spina Zdorova clinic.

Prevention of myofascial syndrome

To avoid relapses, you first need to get rid of the disease completely.And then, reduce your risk factors. Create comfortable conditions for yourself to sleep and work. Monitor your weight and proper nutrition. Maintain your physical activity. But the main thing is not to neglect your health and do not save on it. Don’t let things take their course. After you recover, try to do at least one supportive gentle manual therapy session every three to six months – this can significantly reduce your risk factors. Remember: your health, first of all, is necessary for you!

Benefits of treatment in the clinic “Spina is Healthy”

  • Guarantee of complete and qualified treatment.The word “full-fledged” is the key word in our work.
  • High qualifications and extensive practical experience – 30 years.
  • We consider each case individually and comprehensively – no formalism.
  • Synergy effect.
  • Guarantee of honest attitude and fair price.
  • Location a stone’s throw from the metro in the very center of Moscow.

Acute muscle-fascial lumbar pain – Clinic Harmony

Acute muscle-fascial lumbar pain as a result of neurological disorganization between the flexor and extensor muscles of the trunk

A.V. Stefanidi, A.A. Skoromets, I.M. Dukhovnikova

Irkutsk State Medical University (Irkutsk)
Saint Petersburg State Medical University (Saint Petersburg)


Musculo-fascial pain syndromes (MFPS) are one of the most common and, at the same time, insufficiently studied pathological conditions, which has enormous clinical, social and economic importance for society.World Health Organization experts announced 2000-2010. the beginning of the century with the Decade of bone and joint diseases (The Bone and Joint Decade, Geneva, 2000-2010). Within the framework of the Decade, the study of back pain was declared one of the priority areas of research.

To date, overdiagnosis of vertebrogenic pain due to osteochondrosis of the spine is noted in Russian practice [3, 4]. Along with this, the role of functional disorders of the musculoskeletal system in the origin of musculoskeletal pain syndromes is underestimated [4, 9].
Currently, the preference in the treatment of acute pain in the lower back is given to medication, and the most justified from the standpoint of evidence-based medicine is the appointment of non-steroidal anti-inflammatory drugs (NSAIDs). Unfortunately, the overwhelming majority of NSAIDs have an ulcerogenic effect, which makes it necessary in each individual case to decide on the appropriateness of their use and the method of administration into the body [5].

The effectiveness of manual therapy in patients with pain in the lumbosacral region is still a matter of debate.A number of studies have obtained convincing evidence of the effectiveness of manual therapy [2, 4, 6, 8]. The European guidelines recommend a short course of treatment using manual therapy techniques as the treatment of choice for chronic nonspecific lower back pain [12]. A UK study where general practitioners can refer their back pain patients to osteopaths for manual therapy has shown that manual therapy improves physical and psychological outcomes at little additional cost.It was concluded that the inclusion of osteopathic manual therapy in addition to conventional treatment for back pain tends to avoid significant additional costs for inpatient care, medications and physiotherapy, as well as accelerate patient recovery and eliminate or reduce the need for medication, intake which can have serious negative consequences [17].

Purpose of the study – to study the clinical manifestations of acute muscle-fascial pain syndrome of lumbar localization, scientific substantiation and assessment of the degree of effectiveness of pathogenetic manual therapy.

Material and methods

We examined 119 patients (41 women and 78 men) aged 17 to 65 years with lumbar MFBS, which arose less than a month ago, without symptoms of loss of function of the spinal roots.

The following research methods were used: clinical neurological, vertebro-neurological, visual and manual diagnostics of the static and dynamic components of the motor stereotype, movements that provoke and reduce pain were identified.If necessary, consultations of related specialists were carried out. All patients underwent an X-ray examination of the lumbar spine. In 75% of the examined patients, signs of spinal osteochondrosis were revealed.

To assess the severity of the pain syndrome, a visual analogue scale for assessing pain (VAS) was used, according to which the intensity of pain syndrome was assessed by patients on a 10-point scale (0 – no pain, 10 – unbearable pain). According to the severity of the pain syndrome, the patients of each group were divided into 3 subgroups (Table.2).

Table 2
Distribution of patients by the severity of pain syndrome

Severity of pain syndrome

(1-3 points according to VAS) 9

(4-7 points according to VAS) 64

(8-10 points according to VAS) 46


All patients complained of pain in the lower back. In 20% of patients, pain was also in the sacrum, in 16% – pain radiated to one or both lower extremities, in 11% – to the buttocks, in 10% – to the groin or iliac region.When clarifying the anamnesis, it was revealed that the main initiating factor was inadequate dynamic physical activity (79%): abrupt uncoordinated movements without preliminary preparation. In addition, emotional stress was a frequent initiating cause – 45% in combination with occupational overload. More than a quarter of patients (28%) received drug treatment (NSAIDs in oral and transdermal forms, muscle relaxants, etc.) before being included in the study, and four of them (3%) were inpatient treatment in a neurological department.

The clinical comparison group included 20 people (12 men and 8 women) with pain in the lumbar region, without symptoms of loss of function of the spinal roots, who received standard medication (NSAIDs, muscle relaxants, vitamins) and physiotherapeutic treatment. In terms of age, profession, main parameters of the disease, the impact of biomedical and socio-hygienic factors, the patients in the clinical comparison group did not significantly differ from the main one.

Results of own research

Visual and manual diagnostics revealed visual criteria for shortening of the oblique abdominal muscles in all patients.In the majority (73%), shortening was observed on one side of the external oblique, and on the other side of the internal oblique muscles of the abdomen. The rest (27%) showed signs of bilateral shortening of the oblique muscles of the abdomen in combination with shortening of the iliopsoas muscles. With the shortening of the internal oblique muscle of the abdomen, visually and manually determined the convergence of the costal arch and the iliac crest on the side of the lesion, restriction of the lateroflexia of the lumbar-thoracic spine to the side opposite to the overactive muscle, and a violation of the mobility of the ilio-sacral joint.On palpation, pronounced soreness of the attachment points of the oblique abdominal muscle on the ribs and the entire iliac spine was found. All patients in this group had trigger points in the gluteus maximus muscle. With shortening of the external oblique muscle of the abdomen, it was typical for the costal arch to approach the pubic symphysis and displacement of the pubic bone cranially on the side of the lesion. It is also characterized by the presence of painful muscle seals in the area of ​​the proximal attachment of the rectus femoris muscle.The pain in the lower back increased with the extension of the trunk.

Rotation of the trunk also increased lumbar pain: with shortening of the external oblique muscle of the abdomen, the pain increased during rotation towards the affected muscle, with overactive internal oblique muscle, increased pain occurred during rotation in the direction opposite to the lesion. Flexion of the trunk in such patients did not occur symmetrically, but forward with the shoulder from the affected side. With bilateral shortening of the oblique muscles of the abdomen and shortening of the iliopsoas muscles, flexion of the patient’s trunk in the lumbar spine and flattening of the lumbar lordosis were observed.The pain increased with extension in the lumbar spine. Trigger points in the abdominal muscles of both flexors and extensors of the trunk were identified in all patients with acute lumbar MFBS.

Neurophysiological substantiation of pathogenetic manual therapy

It is known that all muscles are controlled by two feedback systems. Muscle length is controlled by the muscle spindle system through the myotatic reflex, while muscle strength is controlled by the Golgi tendon system (via the reverse myotatic reflex).For normal muscle contraction, relaxation of its antagonist is necessary. Simultaneous muscle contraction of agonists and antagonists, which is normally impossible, can occur under conditions of contradictory afferentation in the CNS from proprioceptors [1, 7, 10, 11, 14].

Let’s consider this situation with an example. In a person who is in a flexion position in the lumbar spine, the myotatic reflex is activated from the extensor muscles of the back. these muscles are stretched when bending over. While maintaining this position for a rather long time, the flexor muscles of the trunk (iliopsoas, rectus and oblique abdominal muscles) completely relax and the receptors of the muscle spindles of the trunk flexors are inactive, and the length of these shortened muscles becomes less than their length in the neutral position (Fig. …1.1, 1.2). With a sharp uncoordinated extension (for example, with the loss of a fulcrum), the flexor muscles of the trunk are stretched from an inactive shortened state (Fig. 1.2, 1.3) and thereby the myotatic reflex from these muscles is activated, which leads to an increase in the tone of the iliopsoas muscles and obliques abdominal muscles. However, in the meantime, the myotatic reflex from the extensor muscles of the back is still active, because all this time, these muscles remained in a stretched state. Thus, we get a situation in which contradictory information comes from the proprioceptors of the flexor and extensor muscles of the trunk in the central nervous system and the tone of both the extensors (norm) and flexors (pathology) of the trunk increases, the person is fixed in a state of flexion.When an attempt is made to carry out further extension, the myotatic reflex from the flexor muscles is even more activated and the situation is further aggravated.

Fig. 1. The ratio of the length of the extensor muscles (a) and flexors (c, b) of the trunk at different positions of the body: 1 – neutral position, 2 – position of maximum flexion of the trunk, 3 – straightening of the trunk.

In addition, any stress (and pain is also stress), through excitation of the sympathetic nervous system, can also cause contraction of intrafusal muscle fibers and activation of the myotatic reflex [18].

In this example, it makes sense to return the patient to the flexion position, i.e. to shorten the flexor muscles of the trunk in order to turn off the pathologically active myotatic reflex from these muscles and fix the person in this position for the time necessary to reconfigure the movement regulation system. The position of the pelvis and hip, which shortens the flexor muscles of the trunk, reduces the mismatch between extra- and intrafusal fibers, reduces the pathological activity of the myotatic reflex from the flexor muscles of the trunk, and relieves pain.This principle is the basis for the treatment of low back pain by the method of positional relaxation (strain-counter-strain) on the oblique muscles of the abdomen and iliopsoas muscles [13, 15, 16].

Evaluation of the effectiveness of pathogenetic manual therapy

All patients of the main group underwent 5 daily manual therapy sessions for the abdominal muscles and iliopsoas muscles using the method of positional relaxation in the form of monotherapy. The meaning of this technique is to find painful seals in the shortened muscle and bring the attachment points of this muscle closer until the pain disappears or significantly decreases.The patient remains in this position for 90 seconds, then slowly returns to the initial neutral position, being passive all the time. When shortening the internal oblique muscle of the abdomen, the therapeutic position was most often bending the leg towards the opposite shoulder joint, with shortening the external oblique muscle – bending the leg towards the shoulder joint on its side, with shortening the posterior fibers of the oblique muscles of the abdomen and transverse muscle – abduction of the lower limb. After each session, they were asked to rate the remaining pain in the lower back using a visual analogue scale.

Almost all patients noted significant improvement after the first session of manual therapy. After the first session, lower back pain decreased by an average of 45%. After three sessions, in a third of patients (35%), pain in the lower back completely disappeared and the range of motion in the lumbar spine was restored, in almost half of the patients (48%) the pains decreased significantly, and only in 17% of cases the treatment result was unsatisfactory (see Fig. fig. 2).

Fig.2. Evaluation of the effectiveness of treatment of patients with acute MFBS of the lumbar localization by the method of positional relaxation (in%).

When analyzing the effectiveness of treatment depending on the sex and age of patients, it was found that the best results were achieved in the age group under 30 years old (regardless of gender), which is probably associated with smaller structural changes in the vertebrae and intervertebral discs at a young age (Fig. 3). Analyzing the dependence of the effectiveness of treatment with this technique for acute low back pain on the intensity of the initial pain syndrome, we did not reveal a clear pattern.

Fig. 3. Evaluation of the effectiveness of treatment of patients with acute MFBS of the lumbar localization by the method of positional relaxation, depending on age.

In addition, there was a dependence of the degree of improvement on the duration of the pain syndrome. The best results were achieved in the group of patients who sought help in the first three days from the onset of the disease (pain after the first session decreased on average by more than half from 7.0 points to 3.1 points on the VAS) (Fig.4). The lower efficiency of treatment of patients with a disease duration of more than three days can be explained by the fact that in response to pathobiomechanical disorders caused by neurological disorganization between the flexors and extensors of the trunk, the body includes sanogenetic reactions, which later become the cause of pain themselves.

Fig. 4. Evaluation of the effectiveness of treatment of patients with acute MFBS of the lumbar localization, depending on the duration of the pain syndrome.

In the clinical comparison group, allopathic treatment was carried out for 14 days in a neurological department.After two weeks, the pain completely disappeared, and the range of motion was restored in 50% of patients. In another third of patients (35%), the pain syndrome decreased by more than half (Fig. 5). However, the positive dynamics of the patients’ condition began to increase mainly by the end of the first week of treatment, whereas when using gentle manual therapy techniques aimed at normalizing the tone of the flexor muscles of the trunk, the method of positional relaxation achieved the same effect in the first days of treatment.

Fig.5. Evaluation of the effectiveness of treatment of patients with acute MFBS of the lumbar localization in the conditions of the neurological department.


The syndromes, accompanied by muscle weakness with lesions of the efferent link of the movement regulation system, have been well studied. The role of functional reflex-afferent dysfunctions in the pathogenesis of muscle imbalance remains poorly understood. If compression of motor nerve fibers changes the state of only the muscles innervated by this nerve, then the change in afferentation from the proprioceptors of the muscle causes motor disturbances not only in this muscle, but also in its antagonist, since they are reciprocally connected [10].Musculo-fascial trigger points located in the abdomen of a muscle can irritate the receptors of the muscle spindle, which will cause hyperexcitability of this muscle and hypoexcitability of its antagonist. Muscular-fascial trigger points, localized at the site of muscle attachment, irritating the receptors of the Golgi tendon organ, activate the reverse myotatic reflex, which leads to hypoexcitability of these muscles and hyperexcitability of their antagonists.

The study showed that all patients with acute musculo-fascial pain syndrome of the lumbar localization have trigger points in the abdominal muscles of both flexors and extensors of the trunk.

It is important to understand that the cause of low back pain in this case is not in the place of pain, but in the antagonist muscles, the muscle spindles of which were shortened and then quickly lengthened, which did not allow the receptors of these muscle spindles and the gamma system to adapt to the new position of the muscles …
Neurological disorganization between the flexors and extensors of the trunk increases with certain movements and decreases with the opposite. The movement that lengthens the involved muscle further exacerbates the dysfunction of the neuromuscular system.Increased pain during extension of the trunk indicates that the muscles that flex the trunk – the rectus and oblique muscles of the abdomen, the iliopsoas muscles – are pathologically shortened and tense. Increased pain during torso rotation indicates the predominantly oblique abdominal muscles are interested.


  1. One of the main causes of acute muscle-fascial pain syndrome in the lower back is neurological disorganization between the flexors and extensors of the trunk, resulting from the receipt by the nervous system of conflicting information from the proprioceptors of these muscles, which leads to contraction of both flexors and extensors of the trunk.
  2. It is advisable to include manual relaxation of the flexor muscles of the trunk (rectus and oblique muscles of the abdomen, lumbosacral muscles) in the complex of treatment of patients with acute muscle-fascial pain in the lower back. This method of treatment is especially indicated for patients who have contraindications to taking non-steroidal anti-inflammatory drugs.
  3. This treatment is most effective in the acute period for musculo-fascial pain in the lower back, lasting less than 3 days.REFERENCES
  4. Granite R. Basics of regulation of movements / R. Granite. – M .: Mir, 1973 .– 367s.
  5. Esin R.G. Myogenic pain: central and peripheral mechanisms, therapy: author. dis. … doct. honey. sciences / R.G. Esin. – Kazan, 2006 .– 224p.
  6. Zharkov P.L. Lumbar pain / P.L. Zharkov, A.P. Zharkov, S.M. Bubnovsky. – M .: Yuniartprint, 2001 .– 144 p.
  7. Ivanichev G.A. Myofascial pain / G.A. Ivanichev. – Kazan, 2007 .– 392 p.
  8. Kamchatnov P.R. Modern approaches to the management of patients with back pain.R. Kamchatnov. – 2004. – vol. 6, No. 8. – http://www.consilium-medicum.com/media/consilium/04_08/557.shtml
  9. Treatment of lumbar spondylogenic neurological syndromes / Ed. A.A. Skoromets. – SPb .: Hippocrates, 2001 .– 160 p.
  10. McComas A.J. Skeletal muscles / A.J. McComas / Per. from English – Kiev, 2001 .– 407 p.
  11. Sitel A.B. Manual therapy of spondylogenic diseases: a textbook. – M .: M .: Medicine, 2008 .– 408 p.
  12. Ferguson L.W. Treatment of myofascial pain.Clinical guidelines / L.U. Ferguson, R. Gervin. – M .: MEDpress-inform, 2008 .– 544 p.
  13. Human physiology: In 3 volumes / Per. from English / Ed. R. Schmidt, G. Tevs. – M .: Mir, 1996 .– – T. 1. – 323 p.
  14. Enoka R.M. Fundamentals of kinesiology / R.M. Enoka / Transl from English. – Kiev, 2000 .– 400 p.
  15. Airaksinen O, Brox JI, Cedrashi C, Hildebrandt J, Klaber-Moffet J, Kovacs F, et al, on behalf of the COST B13 Working Group on Guidelines for Chronic Low Back Pain. European guidelines for the management of chronic nonspecific low back pain.Eur. Spine J. 2006; 15: P. 192-300.
  16. Chaitow L. Positional Release Techniques / L. Chaitow, E. Wilson, D. Morrissey. – Elsevier Health Sciences, 2001 .– 215 p.
  17. Garten H. Lehrbuch Applied Kinesiology. Muskelfunktion Dysfunktion Therapie / H. Garten. – URBAN & FISCHER, 2004 .– 617 p.
  18. Jones L.H. Strain and Counterstrain. – Indianapolis: American Academy of Osteopathy. – 1981 .– 140.
  19. Korr I.M. Proprioceptors and somatic dysfunction. // J. Am.Osteopath. Assoc. – 1975. – 74: 638-650.
  20. Licciardone J.C. Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials / J.C. Licciardone, A.K. Brimhall, L.N. King // BMC Musculoskelet. Disord. – 2005. – Vol. 6. – P. 43.
  21. Passatore M. Influence of sympathetic nervous system on sensorimotor function: whiplash associated disorders (WAD) as a model / M. Passatore, S. Roatta // European Journal of Applied Physiology.- 2006, Vol.98, No. 5. – P.423-449.


A.V. Stephanidi, A.A. Skoromets, I.M. Dukhovnikova

Irkutsk State Medical University (Irkutsk)

Saint Petersburg State Medical University (Saint Petersburg)

In this article, acute low back pain is examined from the perspective of neurological disorganization between the flexors and extensors of the trunk, which arose due to improper afferent stimulation.Under certain conditions, in which the proprioceptors of the muscles send conflicting information to the central nervous system, it is possible that both agonist and antagonist muscles contract simultaneously, which can lead to contraction of the flexor muscles of the trunk during extension in the lower back. An algorithm for the treatment of acute pain in the lower back by manual relaxation of the flexor muscles of the trunk (rectus and oblique abdominal muscles, lumbosacral muscles) is proposed. This algorithm was used to treat 119 patients (31 women and 88 men) with pain in the lumbosacral region (without symptoms of loss of function of the spinal roots), which first appeared less than a month ago.After three sessions, pain in the lower back completely disappeared in more than a third of patients (38%), in almost half of the studied (48%) pains decreased and only in 14% of cases the pain did not change.

Keywords: muscle-fascial pain, pain pathogenesis, treatment of low back pain, manual therapy

A.V. Stefanidy, A.A. Skoromets, I.M. Dukhovnikova

In the article acute low back pain is described from the position of neurological disorganization between flexors and extensors of the body, emerged in the result of wrong afferent stimulation. In definite conditions when muscle proprioceptors send to CNS contradictory information there is a possibility of simultaneous reduction of both muscles-agonists and muscles-antagonists which can bring to reduction of flexors of the body during extension in lumbar part. The authors suggest method of treatment of acute pain syndrome in lower part of the back by manual relaxation of flexors of the body (mm.rectus and obliquus abdominis, m. iliopsoas). With the suggested method 119 patients (31 females and 88 males) were treated for pain syndrome in lumbar-sacral part (without symptoms of failure of function of spinal roots, first occurred less than a month ago). After three sessions pain in lower part of the back completely vanished in more than a third of the patients (38%), practically in a half of the examined (48%) pains weakened and only in 14% of cases pain feelings did not change …

Key words: myofascial pain, pathogenesis low back pain, manual therapy

664047 g.Irkutsk
st. Trilissera, 54
Stephanidi Alexander Vladimirovich
Tel. 8 (3952) 293490
E-mail: [email protected]

90,000 How to deal with a sore throat at home

Have you ever woken up with a sore throat on a cold, cloudy morning? If so, then you probably know that when you feel unwell, you don’t want to leave the house at all, especially if it’s bad weather outside.

Don’t worry! We’ve compiled a few things that can help you ease your sore throat at home and get back on your feet quickly.

Take a hot bath

A warm shower can help you feel better. This is because steam can moisturize and soothe irritated throat lining. Therefore, before water procedures, turn on hot water for 5-10 minutes so that the bathroom is filled with steam. This will bring you relief and improve your general condition.

Drink more tea

Yes, indeed, tea is capable of much! Since ancient times, chamomile tea has been drunk to reduce inflammation and relax muscles 1 .Try adding a spoonful of honey or a wedge of lemon to the cup. This can relieve pain. Tea is especially effective if you are in bed all day. Drink a cup of tea in the evening before bed: chamomile will help you calmly and soundly fall asleep. But be careful, these components are rare, but allergies can still occur.

Make sure you eat well and drink plenty of fluids

When you have a sore throat, pain when swallowing can make it difficult to eat properly.Your body really needs nutrients to function properly and fight disease. If solid foods make your sore throat uncomfortable, try mashed foods. Chicken broth is also a classic “home remedy”. It helps to rebalance the balance of power and soothe sore throat. Protecting your body from dehydration is just as important, so drink plenty of fluids!


If you can stay at home, grab a blanket and make yourself comfortable on the couch.Perhaps it’s time to include a movie or TV series that you have wanted to watch for so long. You must rest, so enjoy it to the fullest!

If your throat does not stop hurting, try Strepsils® lozenges with various additional properties. For example, to soften a sore throat – Strepsils® with honey and lemon flavor or to eliminate sore throat and nasal congestion – Strepsils® with menthol and eucalyptus flavor. Strepsils® tablets help relieve pain quickly and effectively 2 .They contain two active ingredients (dichlorobenzyl alcohol and amylmetacresol) that fight infections that cause sore throat.

What about work?

Depending on the degree of inflammation in your throat, you may need to take sick leave for a while. If you decide to stay at home, use this time as directed and give your body a break. Go to bed early, try not to go outside again. If you cannot leave work for a couple of days, try not to overload yourself in order to allow the body to recover from the illness.

These simple tips will help you ease your sore throat from the comfort of your home!

If your sore throat gets worse, then you need to seek help from a doctor.

Myalgia: Symptoms, Treatment, Symptoms | doc.ua


Symptoms of the disease can have different manifestations due to the type of disease itself. Nowadays, they often distinguish:

• fibromyalgia – a type of soft tissue damage outside the joint, tendons, joints. The areas of the back, neck and shoulders are most susceptible to fibromyalgia, and tactile examinations of the muscles are the most painful.Usually accompanied by an abundance of non-specific and biased complaints from the patient. The key symptom of this disease is pain in both muscle and bone tissue. Painful sensations are also accompanied by feelings of overwork and weakness. Western scientists are inclined to assume that frequent and severe disorders of the central nervous system, stress contribute to the flow of this disease into chronic fatigue syndrome;

• myositis is the most acute form of the disease, treatment of patients with this form must be undertaken urgently.A person experiences acute pain even with minor movements: this form of the disease affects all motor muscles. In the most acute cases, loss of motor ability is possible;

• polymyositis – complex muscle inflammation, accompanied by the occurrence of severe pain, constantly increasing dystrophy and weakness. In this case, cardiac and respiratory disorders may occur.

Diagnosis of the disease is carried out with the participation of a rheumatologist and other specialists, examination of organ systems using ultrasound (US), electrocardiogram (ECG), tomography, and even using soft tissue biopsy.

In addition to the above subtypes of the disease, the patient usually suffers from edema of muscle tissue, headaches, dysfunction of cell membranes.


Determination of the method of rendering assistance to the patient is due to the factors contributing to myalgia. In case of a cold, which provoked the development of myalgia, the doctor may prescribe the patient to undergo a course of antipyretic drugs that can relieve muscle pain along with a decrease in body temperature. Similar methods are used for other causes of the onset of the disease.For example, when the disease is provoked by various stresses, experts recommend that the patient undergo a course of sedatives. If it is impossible to establish the main factor that aggravated the patient’s condition, a set of measures is taken to eliminate the symptoms that have actually arisen.

In most cases, non-steroidal anti-inflammatory and analgesic drugs are prescribed. It should be noted that taking analgesics is usually prescribed only if the patient has severe pain.The dosage form of such drugs is very diverse – from ointments to intravenous injections. Ointments are most effective when rubbed into swollen or painful muscles. First of all, this is due to the significant side effect of non-steroidal drugs and the undesirability of their long-term use.

No need to self-medicate, only a doctor must prescribe the necessary and effective drugs for a speedy recovery.

For certain types of disease, treatment does not take place only with the help of drug therapy.For example, if a person with myalgia takes medications, then their effect can be significantly enhanced with the help of massages, physiotherapy exercises, and various sanatorium events.

Massage in the treatment of Myalgia

The most effective way to relieve a patient’s suffering is massage. Provided the patient is provided with qualified assistance of an experienced massage therapist, his blood circulation is restored in the near future, swelling decreases and pain syndrome disappears.Experienced massage therapists usually intensify the procedures in an increasing way – inversely proportional to the decrease in pain in the patient. Usually, the course of massage treatment does not exceed eight sessions lasting up to 15 minutes each. This order of things will allow you to quickly get rid of painful sensations without interrupting work or other important matters.

Ventilators for Covid-19 patients – what are they and how do they work?

Photo author, Dyson

Western countries are buying massively ventilators: due to the Covid-19 epidemic, these machines are in short supply in Italy, Britain and the United States.In severe cases, such a device gives patients the best chance of survival.

Simplified, the ventilator takes over the process of providing the body with oxygen when the lungs stop working. This gives the body time to fight the disease.

According to the World Health Organization (WHO), about 80% of people who become ill with Covid-19, which is caused by the coronavirus, recover without medical attention.

But out of every six cases, one is severe, and in severe cases it becomes difficult for patients to breathe.

Photo author, Getty Images

Photo caption,

The ventilator should only be used under the supervision of qualified medical personnel

How ventilator works

To connect a patient to a ventilator, doctors insert an endotracheal tube into the airway.

When a disease affects the lungs, the immune system responds by dilating the vessels so that more antibodies can enter the bloodstream.

But because of this, fluid can accumulate in the lungs – it becomes harder to breathe, and the body begins to experience a lack of oxygen.

To counteract this, a compressor is used to bring oxygenated air or other medical gases into the lungs.

Another component of the ventilator is a humidifier, which heats and humidifies the air from the ventilator to body temperature.

Ventilated patients are given drugs that relax the diaphragm and other muscles to allow the ventilator to fully regulate breathing.

It should be noted that the device is not a means of treating and restoring damaged lungs, but only gives a respite to the lungs so that they can recover on their own.

Patients with milder symptoms may be prescribed non-invasive ventilation with different types of face masks.

Photo author, Intersurgical


Oxygen caps reduce the likelihood of virus transmission

Another method used in the treatment of patients with Covid-19 is the use of a cap, which is fixed on the patient’s neck. The cap prevents the virus from entering the environment with the patient’s breathing.

In intensive care units, as a rule, they try to connect patients with affected respiratory organs to ventilators as soon as possible in order to prevent a sharp drop in the level of oxygen in the body.

Dr. Shonpidon Laha of the Intensive Care Workers’ Association told the BBC that most Covid-19 patients will not need a ventilator and can be treated at home with oxygen therapy.

But sometimes a ventilator is “the only way to get oxygen into a patient,” says the physician, even though the use of ventilators can be risky. It is not always clear to doctors which ventilated patients will suffer from the long-term effects of the virus.

Another problem is related to the availability of qualified doctors and health workers in hospitals to service the devices – there are not always enough of them.

“The ventilator is a complex beast. It can injure the patient if it is not properly adjusted. The technical aspects are complex. Some people have experience with using different types of ventilators in other medical fields, but in order to use them correctly in intensive care settings, they need support, “he says.

Due to the rapid spread of Covid-19, many healthcare systems are unable to cope with the influx of patients who simultaneously require mechanical ventilation.Sometimes, hospitals that run out of machines have to opt for patients who are more likely to survive.

How are swallowing problems dealt with when recovering from a stroke in an elderly person?

Dysphagia is diagnosed when the centers responsible for the swallowing process malfunction. As a result, 60% of post-stroke patients show spasticity of the facial muscles, tongue, larynx, or esophagus. And the question arises not only of good nutrition, but also of preventing complications such as aspiration pneumonia, which occurs when liquid or food particles enter the respiratory tract.

As a result, instead of an active recovery from a stroke , an elderly person has new problems: due to malnutrition and dehydration of the body, the rehabilitation potential decreases, there is a risk of airway obstruction, aspiration, etc.

How is the diagnosis and methods of dealing with swallowing problems after a stroke carried out?

Dysphagia is diagnosed by several methods. Used video fluoroscopy, fiberoptic endoscopy, ultrasound, manometry, finger method.The main task of these methods is to determine at what phase of swallowing the patient has problems. Only by determining this, it is possible to solve the nutrition problem, take safety measures and work on the process of restoring the functions of all organs involved in the process.
In a situation where, after a stroke, the swallowing process is impaired, for the first time a decision may be made to place the probe.

This decision is made on the basis of certified screening tests that help determine whether this patient can be fed through a tube or not, as this may threaten aspiration.The probe and tracheotomy tube are placed temporarily. Not more than a month. Because the probe, no matter what kind of plastic it is “friendly” to the human body, as a result of constant contact can form bedsores in the nasopharynx, esophagus, cause damage to the mucous membrane. And constant irritation of the mucous membrane leads to the separation of secrets of the protective plan, which can interfere with the process of training with a speech therapist.

The probe is placed for safety reasons and allows you to solve the problem with power supply.If swallowing is restored, the probe is removed, and the person begins to swallow himself. Then the speech therapist, together with the nutritionist, determines exactly how to feed such a patient – use mixtures, specially chopped food, thickeners (since water is sometimes more difficult to swallow than, for example, mashed potatoes).

But if swallowing has not been restored within a month, a gastrostomy tube is placed – a gastrostomy tube. It has a larger diameter than the probe, which allows, unlike the probe, to freely feed the patient not only with special mixtures, but also with coarser food.It is important that there is an opportunity to clean it.

Sometimes a gastrostomy tube is superimposed to facilitate swallowing exercises. Since it is much more difficult to do this with a probe. Therefore, the gastrostomy tube can stand for the whole life, or as long as it takes to restore the swallowing process.

Methods for the treatment of dysphagia acquired as a result of stroke. Exercises to restore swallowing reflexes

Engage in the restoration of the swallowing process in post-stroke patients (conduct classes to strengthen the muscles of the tongue, larynx, etc.)and track the result) should only be specialists. As a rule, speech therapists work with this. They also, based on the results of tests and research, determine the recovery method.

Sip has several phases and to understand at which phase the problems were formed and which part of the process needs to be worked on, special studies and tests are carried out. According to the test results, for example, Ice therapy, ice therapy can be used. Ice relaxes, removes spasticity that forms in muscles after a stroke and interferes with swallowing normally.

The course of classes that strengthen the muscles of the speech apparatus can include both practicing simple actions – open and close your mouth, fold your lips or tongue with a tube, imitate a cough and gargle, pronounce different sounds with an effort, as well as more complex ones, which are selected by a speech therapist for a specific the patient’s situation and problems.

When to start dealing with swallowing problems? Or the result does not depend on the time of the beginning of the classes?

The recovery time after a stroke of swallowing reflexes depends on how quickly the work is started.It is best to start working with any violations right away. And the denser the sessions with rehabilitation specialists during the first six months, the more chances are to use all the possibilities of the rehabilitation potential.

The first months are especially effective, and for all problems and disorders acquired as a result of a stroke. Not only due to the fact that some connections that have not yet been lost can be kept in working order. It is important that pathological connections have not yet formed, which will interfere with recovery.

And it must be borne in mind that no specialist will do something diametrically opposite to what was already used in restoration before him. It will just plug in additional modules and techniques.

The more disorders are manifested, the more difficult and longer it takes an elderly person to recover from a stroke. Therefore, the denser the classes with a speech therapist for the first six months, the more chances of success, the wider the opportunities and the better the result.

Can swallowing reflexes in dysphagia be expected to recover from a stroke at home?

Taking into account the fulfillment of all the doctor’s recommendations and the intensity of the exercises, such recovery from a stroke is possible.Of course, good results can be obtained both on an outpatient basis, if the patient’s condition allows, and at home. The main thing is that the classes should go on continuously and be supervised by a speech therapist.

In the process of treating and recovering from a stroke at home, it is important to remember the patient’s safety. Monitor the correct position of the body when eating, follow the doctor’s recommendations about the nature and consistency of food in the patient’s diet, and sanitize the oral cavity after eating.

It is also necessary that the patient’s relatives actively participate in the process, encouraged, reminded, stimulating the consolidation of results during independent studies during recovery from a stroke.At home, this is much easier to do. Feeling the support of relatives, the patient is recovering faster and one can count on a complete recovery from a stroke of independent swallowing.

90,000 If your joints hurt, go to a rheumatologist. Everything else is an attempt to become disabled

There are a lot of articles and materials on the Internet on what to do when joints hurt, with a description of the symptoms. In fact, there are dozens, if not hundreds, of the causes of these problems. Trying to understand them by non-specialists is, firstly, unproductive, and secondly, dangerous.Joint problems are a common cause of disability.

Almost 20% of the world’s population suffers from joint diseases. This is the statistics of the World Health Organization. In Russia, various joint lesions are found in every fourth resident of the country. The situation is even more dramatic among the older age group. The prevalence of joint diseases in persons over 60 years of age reaches 97%. We can say that the prevalence of joint diseases is acquiring the character of an epidemic.It is possible that one of the reasons is the failure to receive timely medical care for those suffering from ailment. This happens for a number of reasons. Including because patients … do not reach the right doctor. As a rule, this skips the period of the so-called “therapeutic window” when treatment is most effective. And sometimes adequate medical assistance is not provided at all.

Who is a rheumatologist

A rheumatologist deals with the diagnosis, treatment, and development of individual preventive measures aimed at eliminating diseases of the joints and connective tissue.That is, neither the surgeon, nor the therapist, nor the traumatologist, who are most often contacted with complaints of joint problems. Unfortunately, not all polyclinics have a rheumatologist.

For quite objective reasons, surgeons and traumatologists refer patients to therapists, and in the presence of complaints of pain in the back or cervical spine – to neurologists. Unfortunately, it is very difficult for a therapist, even with serious experience and a high level of professional training, to diagnose diseases of a rheumatological nature.Joint pain can be a manifestation of a complex of systemic diseases and pathologies. The patient may complain about fever, skin rashes, problems with internal organs, weight loss, and so on. All these factors in a complex can only be a highly qualified narrow specialist.

Osteoarthritis is not a diagnosis

Therefore, most often, with complaints of joint pain, the patient is given a “universal” diagnosis – arthrosis or wear of cartilage. In fact, not always the clinical manifestations that the patient complains about are associated with arthrosis.They can be a manifestation of pathologies of ligaments, tendons, periarticular tissues, injuries or, for example, a meniscus rupture, when it comes to knee joints. Moreover, almost all persons over 35-36 years old have degenerative changes in the joints associated with wear and tear of cartilage. Arthrosis is not a diagnosis. It can accompany arthritis, it can be a manifestation of systemic diseases. And most importantly, not always the clinical manifestations that the patient complains about are associated with arthrosis.

“Old age” is treated

Nevertheless, a person can still undergo ineffective therapy for a very long time. He has “arthrosis”, everyone has it and it is “early” to go to a rheumatologist. Perhaps this is due to the fact that, as a rule, regional polyclinics do not have their own rheumatologist specialists, and in regional clinics their reception is limited by the availability of appropriate quotas or the employment of the relevant doctor. The patient is not simply referred to a rheumatologist. It is quite difficult to determine the necessity of referring to a rheumatologist himself.Although such cases occur in practice, when patients themselves “find” their way to a rheumatologist.

The process is delayed, the “therapeutic window” is closed. And at some point, a person, especially in old age, is informed that now it is allegedly “too late” to go to a rheumatologist, and in general “old age is not cured.” It is not true. Even if the period of the therapeutic window is missed, regardless of age, modern medicine has answers to many challenges. The modern level of medicine can improve the quality of life at any age.

Addiction to blockades is a myth

Note that the “therapeutic window”, for example, for arthritis lasts about three months. At this time, the inflammatory process is in the exudative, primary phase and the reversibility of the disease with basic therapy is very high. In some cases, after the first blockade, the pain syndrome is relieved and the pain in this joint never returns.

In addition to the absence of a rheumatologist in most district polyclinics, there is another reason why the patient is not referred to a rheumatologist.This is a distrust of drug blockages, which are widely used in rheumatology. Unfortunately, even many doctors have a very prejudiced attitude towards this method. Many are convinced that after the blockade is applied, the patient allegedly becomes addicted to the drugs and after their use nothing else will help. It is a myth.

Moreover, blockades, as an invasive method, are included in the Russian standards of medical care, which in turn are based on international and European standards.They are successfully used in Europe and Israel. According to our experience and the experience of our colleagues, the direct injection of drugs into the articular cavity or tissues adjacent to the joint in arthrosis, allows you to stop the pathological process and restore the patient’s ability to work.