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Sore muscles after lifting: Coping With Sore Muscles After Physical Activity


No Pain, No Gain? 5 Myths About Muscle Soreness

You just crushed a really hard workout. You upped the load of your training, or you stepped out of your routine and tried a new activity. You feel great — until you wake up the next morning, barely able to move.

Enter delayed onset muscle soreness, better known as DOMS. It’s an acronym that athletes and fitness buffs wear with pride.

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As its name suggests, “DOMS is muscle soreness that becomes evident six-to-eight hours following activity, peaking around 24 to 48 hours post-training,” says Jon Mike, CSCS, NSCA-CPT and PhD candidate in Exercise Science at the University of New Mexico. While the symptoms will often start to diminish at about 72 hours, “the precise time course and extent of DOMS is highly variable,” Mike says.

“Eccentric muscle contraction is more likely to be the culprit because it places a higher load on your muscles.

You’re most likely to experience DOMS when you introduce a new training stimulus, like a new activity, increased intensity or volume. Or you may experience it if you’re new to physical activity in general. “Your body is making adaptations to better prepare your muscles to do that activity again,” says Lauren Haythe, certified Kinesis Myofascial Integration Practitioner and yoga teacher. That’s why on Day 1 at the gym, after doing squats or lunges with 10-15 pound weights, you can be brutally sore the next day. “But, as you continue on, you can build up from there, and you won’t be so sore,” she says.

While all kinds of muscular contraction can cause soreness, eccentric contraction — where the muscle lengthens as it contracts — most often leads to DOMS, according to Mike. This includes movements such as running downhill, lowering weights or lowering down into a squat or push-up position. “There is also some evidence that upper body movement creates more soreness than lower body exercises,” says Mike.

Muscle discomfort is the most common characteristic of DOMS, but there are other symptoms. According to the American College of Sports Medicine (ACSM), these may include reduced range of motion and joint stiffness, local swelling and tenderness, and diminished muscle strength. These symptoms appear gradually following exercise (not to be confused with acute pain that may arise during physical activity).

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Muscle Soreness: Myths vs. Facts

No pain, no gain. Lactic acid build-up. An indicator of muscle growth. These are all phrases that we tend to associate with DOMS. While you may think you know everything you need to know about the condition that has you waddling like a duck, you may find what’s actually happening in your body surprising.

Photo by Jonathan Borba from Pexels

Myth #1: DOMS is caused by the build-up of lactic acid in your muscles.

The verdict: Not true. During exercise, your body needs energy, and it breaks down molecules to get that. As a result of this metabolic process, your cells naturally become more acidic which makes your muscles feel like they’re burning. But lactate doesn’t cause this. Lactate is actually a by-product of the metabolic process and serves as a buffer and slows down the rate at which the cells become acidic. “People produce lactate all the time, even at rest. It clears your system 30-minutes to one-hour after working out,” says Mike.

A study in Clinics in Sports Medicine found that DOMS is the result of microtrauma in the muscles and surrounding connective tissues, which causes inflammation. The reason that eccentric muscle contraction (think lowering a dumbbell back down in a biceps curl) is more likely to be the culprit is because it places a higher load on your muscles compared to concentric contraction. “It’s the active lengthening of muscle fibers under load. It’s like you’re pulling on a rope, and there’s so much force that the rope starts to tear and pull apart,” says Mike.

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Myth #2: It’s not a good workout unless you’re sore the next day.

“It doesn’t mean that you’re not getting as good of a workout because you’re not crippled the next day.”

We often wear our DOMS as a badge of honor and believe that if we’re not sore, we’re not doing enough during out workouts. But that’s just not true.

“It doesn’t mean that you’re not getting as good of a workout because you’re not crippled the next day,” says Monica Vazquez, NASM certified personal trainer. “You should feel [soreness] 24 hours to three days after the activity. If, after three days, you try to do the same exercise and you cannot because you go immediately to muscle failure, you’ve done too much,” she says.

According to Mike, studies show that soreness itself (using a scale from 0 to 10 to assess the level of soreness) is a poor indicator of muscle adaptation and growth. There are many factors that influence how DOMS presents itself in individuals. “There is great variability, even between people with similar genetics and even among highly-trained lifters [and athletes],” he says. So while comparing notes (and commiserating) is all part of the process, soreness and DOMS isn’t the best gauge of how effective your workout was or who’s in better shape. 

RELATED: 5 Signs It’s Time to Take a Rest Day

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Myth #3: The more fit you are, the less susceptible you are to DOMS.

It’s true that you will start to feel less sore as your body adapts to your workouts and learns to distribute the workload across your muscle fibers more effectively. That’s why you should regularly change up your exercise routine.

However, there is also a genetic component to how sensitive we are to pain and soreness. “People can be no-responders, low-responders or high-responders to soreness,” says Mike. If you’re a high-responder, you will experience DOMS more acutely than someone who is a no- or low-responder when given the same training load. While you can’t change your genes, it is important to know where you fall on the spectrum to understand how your body may respond to changes in your workouts.

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Myth #4: Muscle damage is a bad thing.

Yes, trauma to your muscle fibers appears to cause DOMS, but it’s not a definitive measure of muscle damage. In fact, a certain degree of soreness seems to be necessary. “When muscles repair themselves, they get larger and stronger than before so that [muscle soreness] doesn’t happen again,” says Vazquez. While these mechanisms are not completely understood, Mike notes that some muscle trauma is needed to stimulate protein production and muscle growth.

“Research has found that static stretching prior to working out does not safeguard you against injury…”

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Myth #5: Pre- and post-workout stretching is a good way to prevent and treat DOMS.

Unfortunately, no. A review of studies for the Cochrane Database of Systematic Reviews on the effects of stretching before or after exercise on the development of delayed-onset muscle soreness found that pre- and post-workout stretching did not reduce the effects of DOMS in healthy adults. In fact, research has found that static stretching prior to working out does not safeguard you against injury. In actuality, it may decrease your power and strength.

While you may not be able to avoid soreness altogether, ACSM suggests advancing slowly with a new workout. This gives your muscles time to adapt and recover. Vazquez recommends always including a proper warm-up (including dynamic stretching), and cool-down period as part of your routine.

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Stop Waddling: How to Recover from DOMS

There are a number of ways to alleviate those can’t-make-it-up-the-stairs symptoms. A sports massage is one good way to reduce the effects. “A massage will move the fluid and blood around in your body which can help heal the microtrauma in your muscles better,” says Haythe. A study in the Journal of Exercise Rehabilitation found a massage to be beneficial on both gait and feelings of post-workout soreness.

Other common ways to treat DOMS include foam rolling, contrast showers (alternating between hot and cold water), Epsom salt baths, increased protein intake (to increase protein synthesis), omega-3 supplementation (to reduce inflammation) and sleep. New research in the Clinical Journal of Sports Medicine suggests that supplementing with saffron may also help to alleviate DOMS. Regardless of your preferred Rx, Haythe recommends looking at your diet to make sure your taking in nutrients to help your body heal. “Find a diet that can really help you feel the best that you can feel,” she says.

RELATED: 13 Quick and Easy Protein Shake Recipes

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When It’s More Than Just Soreness

There may be times when you overdo it with your workout and feel bad. Really bad. But when should you be concerned?

“If your level of soreness does not go down significantly after 72 hours and into the 96 hours mark,” says Mike. ACSM advises that if the pain becomes debilitating, you experience heavy swelling in your limbs or your urine becomes dark in color, you should see your doctor.

If it’s an injury, you’re more likely to feel it immediately during your workout — something you should never ignore. Soreness, on the other hand, will appear gradually, often the next day. “An injury will likely limit your range of motion and last longer than three days,” says Haythe.

When all is said and done, you should avoid or revere DOMS. But it shouldn’t be your only gauge of your level of fitness or strength. “People think that the only part of their workout that matters is the hard part,” Vazquez says. “But, you can do more of the hard part if you don’t injure yourself.”

Long-term, Haythe says, “You’ll build more muscle, strength and endurance if you give your muscles a chance to take a deep breath and recover.”

Photo by Maksim Goncharenok from Pexels

Originally posted July 2014. Updated December 2016 and September 2021 

When to Listen to Your Body’s Pain – Cleveland Clinic

Athletes, fitness buffs and novices alike all know the saying, “No pain, no gain.” To some extent, this saying is true.

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Weight-bearing and cardiovascular activities stress the body. As a result of that stress, we enhance our strength and endurance. By pushing our physical boundaries, we optimize our athletic performance. But this process is almost always at the cost of feeling some level of pain.

And that leads to questions pondered at times by weekend warriors, bodybuilders and recreational athletes alike: “Should I push through the pain? And is there such a thing as ‘good pain’?”

Sports medicine physician Dominic King, DO, has an answer that helps cut through abundant and often-conflicting advice:  “A certain low level of soreness is acceptable, but you should not push through pain while exercising.”

There will be times when the pain is bad and persistent enough to warrant not just giving the exercise a rest but also paying a visit to your doctor.  

Getting sore

Good pain, believe it or not, does exist. When you have pain that is a feeling of soreness or achiness, it’s usually the result of mild inflammation or microtears in your muscles or tendons, Dr. King says. Extensive exercise can also cause a build-up of lactic acid in the muscles.

The muscle repairs these tears when you’re resting, and this helps muscles grow in size and strength. This microtrauma may sound harmful, but it is your body’s natural response when your muscles experience work.

This kind of acceptable pain might occur when you start a new exercise or go back to an exercise you haven’t done in a while. You feel some achiness that lasts for a few days. This kind of soreness diminishes after you rest.

Delayed Onset Muscle Soreness

Another common form of exercise-induced muscle soreness can develop when you perform an unfamiliar physical activity for an extended time without a gradual ramp-up. This is called delayed onset muscle soreness, or DOMS. It develops a couple of days after intense exercise. 

DOMS also can happen after exercise in which you are contracting your muscles at the same time you are lengthening them, says orthopedic surgeon Mark S. Schickendantz, MD. This can happen, for example, if you run downhill, resutling, again, in those microtears in muscles.

Unfortunately, no treatment yet has been shown to actually reduce the length of time that muscles remain sore and weak. Ibuprofen or alternating hot and cold packs may help to ease the pain temporarily, Dr. Schickendantz says.

The good news is that the soreness typically goes away in a few days on its own. Whether or not you should work through this type of pain is a tricky answer. If you’re only experiencing low-level soreness, Dr. King says, it’s probably okay to do a lighter workout. Some physical activity might even help to ease the achiness.

“There is, however, a very fine line between gaining results through building muscle and causing damage,” Dr. King says. If your DOMS is a bit more painful, it’s best to avoid strenuous exercise until you are no longer sore. 

What to do about persistent pain

But strong, sharp or persistent pain that develops while you are exercising is a different matter.

“Pain represents injury,” Dr. King says. “It occurs as a result of overuse or too much stress placed on a muscle or a tendon. It can be the result of repetitive use or a single episode of overloading a muscle or tendon. That’s muscle strain.”

Pain during physical activity is a signal that you are putting too much strain on a muscle or tendon and should stop, Dr. King says.

“People used to say you need to ‘suck it up,’ or just push through the pain. They’d say you need to keep going to get results. But pain is your body trying to tell you something, and you have to listen,” Dr. King says.

It’s also important to make sure the pain and tightness you’re experiencing is not associated with something more serious, Dr. Schickendantz says.

Symptoms of possible structural injury that merit consultation with a physician include:

  • Sudden, sharp pain.
  • Sharp pain that prevents you from moving a body part, decreases your range of motion, or prevents you from moving altogether.
  • Pain in an area that was previously injured or where you’ve had surgery.
  • Pain associated with deformity or massive swelling.
  • No pain relief after several days of rest, ice or over-the-counter anti-inflammatory medication.
  • Constant pain or pain that is worsening in severity.
  • Pain coupled with pressure and bruising.
  • Pain that is so intense that it causes nausea and/or vomiting.
  • Pain associated with fevers and chills.
  • Pain that keeps you up at night or wakes you from sleep
Give it a rest

The cornerstone of treating muscle soreness is rest, but it’s also important to move and maintain your range of motion as much as possible.

Applying ice and heat definitely can help, as can judicious use of anti-inflammatory medicines.

“However,” Dr. King says, “inflammation is your body’s way of healing injuries. So you may not want to halt that inflammation entirely. If you have to ice often or take medications frequently, this may indicate an unacceptable type of soreness that should be evaluated by a physician.”

If soreness or pain is significantly affecting your daily activities, causing noticeable weakness, persists for several weeks to a month or continues when you are resting or interrupts sleep, it is time to see a doctor, Dr. King says.

Start low and go slow

Stretching before and after exercise and staying well-hydrated can help you avoid muscle strain. But the absolute best way to avoid reaching the stage of unacceptable pain — as well as to prevent the onset of DOMS — is to start low and go slow, Dr. King says.

That means you start at a very low intensity and duration and slowly ramp up your time and effort to build endurance.

“If your daily job and daily activities do not involve flipping tires and grabbing large ropes, then that is probably not how you should start out with an exercise program,” Dr. King says. “Instead, give yourself plenty of time to reach your fitness goals.”

The start-low-and-go-slow approach goes for cardiovascular exercise and weight training, and every type of exercise in between. 

And be sure you’re always using the proper technique for any exercise, says Jamie Starkey, LAc. “Recurring pain connected with sports often is due to incorrect form or technique. If you can catch these errors early, you can retrain yourself so that you avoid re-injury or chronic recurrences.”

How to Prevent Muscle Soreness After Weight Lifting

  • Delayed-onset muscle soreness (DOMS) is common when new to strength training.
  • It should become less frequent as your body adapts if you’re training in a structured way.
  • Light cardio like walking can help ease the pain.
  • Read more Working It Out here.
  • Visit Insider’s homepage for more stories.

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Dear Rachel,

I’ve been getting into the habit of weight training most days a week for a few months now, but something I’m still struggling with is muscle soreness. What warm-ups and cool-downs do you recommend I do to prevent my muscles from being so sore I can’t walk?

— Strong but Sore

Dear Sore,

Welcome to the club!

Delayed-onset muscle soreness (DOMS) is common when new to weight lifting, but the good news is that it should decrease over time as your body adapts.

But keep in mind that DOMS isn’t necessarily the sign of a good workout, so it’s good not to chase that feeling when you step into the gym.

There are things you can do to aid recovery and help with your strength gains.

The causes of DOMS are unclear

If you’re feeling soreness or stiffness in the muscle belly (not in or around the joints, which can be cause for concern), usually peaking around 24 hours after a workout, it’s probably DOMS.

It should usually subside within 48 hours, personal trainer Luke Worthington told Insider, however I remember one bout that lasted four days when I first started strength training.

A post shared by Rachel Hosie (@rachel_hosie)


“We don’t know for certain what the causes of DOMS are,” Worthington said. “Most sports scientists agree that it’s a combination of multiple micro-tears in the muscle proteins, together with localized inflammation.”

It’s perfectly natural and normal though.

“DOMS tends to be exacerbated by sudden increases in either the volume or intensity of training, or new movements that stress muscles through different ranges or different angles,” Worthington said.

That’s why it’s more common for people who increase their training volume or change exercises to experience DOMS.

DOMS should become less frequent

As your body adapts to a new stimulus, DOMS should become less frequent. But this only happens if you’re training in a structured way which allows your muscles to become familiar with movements, Worthington said.

If you’re working out randomly and doing different things each time, DOMS can become a problem because the adaptation phase never occurs, meaning you have “newbie” DOMS every time.

“As well as being very inconvenient for every day life, this also means that we can’t follow one of the fundamental principles of training: progressive overload, which means we can’t really make any progress,” Worthington said.

If DOMS is a consistent and debilitating problem, he advises reassessing your training program, perhaps rotating exercises every 4-6 weeks, and including periods of both high and low intensity and volume.

Walk it off

While waiting for your body to adapt, there are ways you can mitigate DOMS.

Warming up and cooling down properly are important parts of your workout, but Worthington said there’s no evidence to suggest stretching prevents DOMS.

Light cardio can help though.

“Consider several minutes of light cardio using the same muscle groups you worked out to flush out any

lactic acid
from those muscles,” sports medicine specialist Dr. David Geier told Insider. “For example, maybe you do 5-10 minutes of light rowing after a back and biceps workout, or 10 minutes on an elliptical trainer after a leg workout.”

A post shared by Luke Worthington (@lukewtraining)


Low intensity exercise, like a walk, can increase blood flow, which helps transport nutrients to the muscles and moves metabolites, or waste products, away from them, Worthington said.

When we move more in vigorous exercise, our bodies produce more metabolites, which are a natural by-product of exercise, he said. To recover, we need to move more of these metabolites away and provide the muscles with more fuel.

Staying hydrated and refueling well will help, and Geier also recommends massaging out your muscles with a foam roller or percussive therapy device.

The best way to heal those sore muscles?

“Sleep is probably the single most effective recovery tool, and it’s free!” Worthington said.

Wishing you well,


As a senior health reporter at Insider and a self-described fitness fanatic with an Association for Nutrition-certified nutrition course under her belt, Rachel Hosie is immersed in the wellness scene and here to answer all your burning questions. Whether you’re struggling to find the motivation to go for a run, confused about light versus heavy weights, or unsure whether you should be worried about how much sugar is in a mango, Rachel is here to give you the no-nonsense answers and advice you need, with strictly no fad diets in sight.

Rachel has a wealth of experience covering fitness, nutrition, and wellness, and she has the hottest experts at her fingertips. She regularly speaks to some of the world’s most knowledgeable and renowned personal trainers, dietitians, and coaches, ensuring she’s always up to date with the latest science-backed facts you need to know to live your happiest and healthiest life.

Have a question? Ask Rachel at [email protected] or fill out this anonymous form. All questions will be published anonymously.

What Causes Sore Muscles? | Why Am I So Sore?

You wake up the morning after a workout and your quads hurt so badly you can barely swing your legs out of bed. Or, on the flip side, the day after an interval session that left you drenched, your muscles feel smooth, refreshed, and completely, well, normal.

What gives? It’s no surprise that you’ll feel sore if you really ramped up the intensity of a workout from what you’re used to, or if you did something completely new. But what about your regular routine? Why are you sore as anything after some workouts, but after others, you barely feel like you did anything? And is there a common thread behind why some leave you aching and others don’t?

As it turns out, postworkout muscle soreness depends on a lot of factors, according to Brad Schoenfeld, Ph.D., C.S.C.S., assistant professor of exercise science and director of the Human Performance Lab at CUNY Lehman College. Here are some reasons why you might feel like you’ve been run over by a truck after some workouts, but not others—and, perhaps more importantly, what you can do to feel better fast.

What causes muscle soreness?

Aching muscles after a workout, otherwise known as delayed onset muscle soreness (DOMS), are due to micro-tears in your muscles that occur when you put stress on them, says Schoenfeld. Usually, you’ll begin to feel sore 24 to 48 hours after a workout—that’s how long it takes for your body to produce inflammation as a result of that injury, which is responsible for your muscle pain. (These micro-tears must then be repaired in order to make your muscles stronger in the long run.)

What exactly are the factors that go into why you might feel more sore after some workouts than others? We explain three major ones below.

1. How often you train

How sore you get depends on how often you train, according to Schoenfeld.

“In the early stages of training—or if you’re not used to doing something regularly—muscle soreness will be worse than if you do an activity regularly, because your muscles aren’t used to the activity,” he says. In other words, a lack of a certain activity in your routine leads to more muscle micro-tears when you finally do it. (But your muscles will get used to the activity over time and won’t tear as much anymore.)

Overtraining can have the same effect. “If you really overdid it, you could be sore for up to a week,” Schoenfeld says. Again, this is due to the fact that your muscles aren’t used to the duration or intensity of what you did, so they’re more likely to micro-tear as a result.

But because everyone is different, finding your training “sweet spot” might take some trial and error. To avoid super soreness when running, however, building your mileage slowly is your best bet—many runners follow the 10 percent rule, where you up your mileage by no more than 10 percent each week.

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2. The types of exercises you’re doing

The micro-tears in your muscles happen whether you do a long run or squat your max weight, but the level of soreness you experience because of these tears depends on the specific type of exercise you’re doing.

Eccentric movements cause more muscle damage and more inflammation as a result, which leads to more muscle soreness, according to Schoenfeld. What even are eccentric movements, you ask? According to a landmark paper published in the British Journal of Sport Medicine in 1995, “eccentric muscle activation is the controlled lengthening of the muscle under tension.” Plain and simple, it’s the “lowering down” part of exercises like leg lifts or bicep curls, for example. is also eccentric, Schoenfeld says, since your muscles are lengthening. This is why you’re more likely to be sore when you run—or hike—down a steep hill as opposed to when you go up one.

Concentric movements, on the other hand, do less damage to your muscles and therefore leave you feeling less sore, Schoenfeld says. Concentric movements are when a muscle shortens. For instance, the “up” motion of a bicep curl. Running uphill is also a concentric movement, since the muscles you’re using shorten as you climb.

[Run faster, stronger, and longer with this 360-degree training program.]

3. Your hormone levels

The hormone estrogen helps protect your muscles, according to Schoenfeld, so women—who have higher levels of estrogen—tend to experience less muscle soreness than men do.

And research confirms this. One study in the journal Sports Medicine found that estrogen has “been shown to play a significant role in stimulating muscle repair and regenerative processes.”

So if you’re a guy, you can expect to be a bit more sore from the same (or similar) workouts as your female counterparts, because while men do have some estrogen, they don’t have as much as women do.

What should you do if you’re sore after a workout?

The key to remedying sore muscles is active recovery, according to Schoenfeld. “Don’t plop down on couch and not move,” he says. Just sitting around has negative effect on soreness because you’re not getting any blood flowing to your muscles to help them recover.

Active recovery—like cycling, swimming, yoga, or even walking—helps repair tissue and alleviate soreness. A postworkout massage or foam rolling to relieve sore muscles help, too, according to Schoenfeld.

But if you are ridiculously sore, Schoenfeld cautions you to not work out until your muscles feel a bit better, since you could risk an injury (a larger tear). That doesn’t mean you have to wait until they’re completely better, though—if you’ve improved to the level where you are just mildly or moderately sore, there’s no harm in working those muscles, he says. Just make sure not to overdo it—if you are really sore, doing a shorter or less intense workout might be best in the meantime while your muscles recover.

Danielle Zickl
Health and Fitness Editor
Danielle specializes in interpreting and reporting the latest health research and also writes and edits in-depth service pieces about fitness, training, and nutrition.

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Should You Work Out When You Are Sore?

Is it safe to be working out while sore? The answer to this question depends on the severity of muscle soreness, which can range from slight tenderness to debilitating pain.  Delayed onset muscle soreness (DOMS) happens 1 -2 days after exercise.  The most likely cause of DOMS is microscopic muscle tears or a breakdown in muscle tissue that occurs during a workout.  Introducing new activities or suddenly increasing the intensity can cause DOMS to occur.

During periods of severe muscle soreness, a person has impaired coordination, less shock absorption, and a shortened range of motion.  If you exercise while very sore you are likely to alter your body mechanics putting more stress on ligaments and tendons and therefore increasing your risk of injury.

Should You Work out When You are Sore?

Overreaching is the state of training intensely without rest. This leads to overtraining and a decline in athletic performance.  It takes several weeks to months for this condition to occur, but watch for any of the following signs or symptoms, and take a few days to a few weeks off if these are present:

  • Increased resting heart rate
  • Depression or mood disturbances
  • Increased incidence of colds and flu
  • Overuse injuries
  • Muscle and joint soreness
  • Fatigue
  • Insomnia
  • Decreased appetite
  • Plateau or worsening of performance not improved with rest or reduced training

In either case, you’re better off resting to allow your body to recover and seeking a medical professional if necessary.

If you’re only slightly sore, exercise can bring relief, although only temporarily.  Take it easy by doing light resistance exercise (such as core stabilization exercises) or by doing low intensity cardio (such as walking).  Better yet, exercise muscles other than the ones that are sore. 

Functional training programs should be designed to allow muscle recovery, which usually takes 48-72 hours, depending on the type of training done and the intensity of that training.  People who lift weights every day will split their routines so they can work different muscle groups on different days.  Large muscle groups such as the quadriceps and hamstrings should be given the greater amount of time to recover (72 hours) while smaller muscles, especially the postural muscles of the core, are built for endurance and therefore can be exercised more frequently, such as every 48 hours.  Remember that muscles don’t grow during a workout, only during rest periods following exercise. If you don’t allow your body to recover, you won’t see the benefits of your workouts.

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How To Prevent Sore Muscles After Exercise

Can you prevent sore muscles after exercise? 

After a grueling workout, you’re tired and ready for a shower. You may even feel a little achy, but you know the real pain won’t start until tomorrow. 

That’s because delayed onset muscle soreness, or DOMS, doesn’t typically begin until about 24 hours after exercise. When it peaks after two days, you may wish you’d never worked out in the first place, even though the pain means you’re growing stronger. But why does it take so long to hit you and how can you prevent soreness next time? 

Joel Hardwick, an exercise physiologist at Piedmont Atlanta Fitness Center, explains that your body needs time to break down and rebuild muscle. 

“Your body wants to make sure that you really are going to be better for this,” he says. 

How your body rebuilds muscle

The rebuilding process can’t start right away, Hardwick says, because there’s a lot of “housekeeping” to be done first. If you try a difficult workout you aren’t used to, you’ll end up with some low-grade muscle damage – think microtears in the tissue. Your body will flood the area with enzymes to help clear the damage, which will then trigger swelling and inflammation. 

Once the immune system response kicks in, pain will worsen. Soreness peaks about two to three days after you exercise, but after that, your body can rebuild muscle and you’ll be stronger for it.

How to avoid DOMS

Still, Hardwick says, you can improve your fitness without experiencing DOMS. The key is easing into new exercises and routines, which will help prevent damage to your muscles. 

“Progress slowly and be cautious,” he says. 

Stretching can also help you avoid sore muscles, but be mindful about which stretches you choose. A pre-workout regimen should include only dynamic stretches, which take a joint through an entire range of motion and increase blood flow. 

Static stretches, in which you hold a pose without movement, can raise your risk for injury if performed before exercise. Reserve these stretches for when your main routine is over. 

Who’s at risk for DOMS?

Even physically fit people aren’t immune to muscle soreness. For example, Hardwick says, a runner who suddenly decides to take up rock-climbing will use muscles that aren’t typically worked. Even though the runner might already be in good shape, they’ll probably feel some soreness after scaling rocks. 

DOMS can strike almost anywhere, but you’ll typically experience it after activities that lengthen a muscle, Hardwick says. Think about a bicep curl: Your arm lifts the weight, but it must also control that weight as it’s lowered back down. It’s the lowering that extends the muscle and leads to DOMS. 

Even so, there’s usually nothing to worry about. Muscles soreness is annoying, but it’s not really harmful to you, Hardwick says. 

“It’s a normal part of life,” he adds. 

Easing the pain from DOMS

DOMS can make you feel stiff, sore or achy, but it shouldn’t cause sharp or intense pain. If you have a significant level of pain, see your doctor to rule out an injury. 

If you get sore, don’t rush to buy over-the-counter supplements, because they probably won’t help. You can, however, try a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen for pain relief. 

More exercise can also relieve soreness, albeit only temporarily. It’s perfectly safe to exercise through the pain, Hardwick says, though it’s probably best to avoid the same movements that caused DOMS last time. 

“If you have this muscle soreness, don’t do the same thing you did before,” Hardwick says. “Wait a couple of days before you go back to doing it.” 

Once the area is healed, you should be able to repeat the routine with less or no soreness (as long as you’re working out with the same amount of weight). Your muscles are now prepared for that level of strain.

The important thing to remember, Hardwick says, is that you don’t need to put your muscles through that level of stress. Start a new exercise routine slowly, which will allow your body to adjust over time. Improvement doesn’t have to equal pain.

“You can still achieve your goals,” Hardwick says, “without going hardcore.” 

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How to Prevent Muscle Soreness After a Workout

Finishing that last rep and walking out of the gym is truly the best feeling. You’re buzzing with endorphins, feeling energized, and ready to take on the world! But, about 12 to 24 hours later, sore and stiff muscles begin to put a damper on your day.

If you’re like most people, getting sore is the worst part about exercise. It causes pain and discomfort that can distract you throughout the day. It might also make your next gym visit sound a bit too unpleasant to follow through with. Luckily, soreness from working out can be prevented. It just takes a little bit of knowledge and a few extra steps in your workout routine to keep your muscles feeling good and ready for your next gym session.

Keep reading to learn how to prevent sore muscles from exercise and how to help soothe already sore muscles:

First of all, what causes soreness?

Soreness is most common for anyone who has just started weight training, intensified their exercise routine, or performed a strenuous cardio activity. Exercise can cause microtrauma (micro-tears) to the muscle fibers, whiccauses them to become swollen and sore after about 12 – 24 hours post workout. More swelling can also occur from the increased blood flow muscles receive during physical activity.    

Remember that mild soreness from the exercise is completely normal and a natural outcome of physical activity. However, regular, intense pain after working out is not normal. This could be a sign of injury, so check with your doc if your soreness is frequent and painful.

Prevent Sore Muscles

Wanting to prevent sore muscles? Add these extra steps into your exercise routine to prevent or reduce the pain associated with sore muscles:

Hydrate. Make sure you’re properly hydrated before and during your workout. Muscle cells need water to recover, so always drink enough water throughout the day and keep yourself hydrated while exercising. Keep a water bottle with you at all times, even if you’re running or biking.

Warm-up. Never forget to warm-up before your workout! Warming up is essential to a great workout and muscle recovery because it improves blood circulation. One of the worst things you can do for your body is jumping straight into a workout without helping your body transition into exercise-mode. Check out some warm-up routines here.

Use proper form. Be sure that you’re using proper form while lifting weights, using equipment, and performing any other exercises. If you’re not sure how to use certain equipment or perform a certain exercise, don’t be afraid to ask a personal trainer at the gym. There are also a lot of helpful demonstration videos on YouTube you can watch to make sure you’re using proper form.

Ice bath. If you’re prone to muscle soreness and tenderness after a good workout, try taking an ice bath when you get home. Ice baths can help prevent inflammation before it starts.

Eat. Make sure you are getting the nutrients your body needs for muscle recovery. You need healthy proteins, carbs, and fats to help repair and maintain muscles. You can also try eating some healthy foods that naturally reduce inflammation, like tomatoes, olive oil, leafy greens, and cherries.

Treat Sore Muscles

Sometimes soreness can’t be entirely avoided after an intense workout. Here are some ways to help reduce that stiff, achy feeling if your muscles are already sore:

Keep moving. Use those muscles! Soreness actually increases when you don’t use the muscles that have been exercised. While you should avoid any vigorous activities that cause pain, sitting on the couch all day with little movement can actually increase the swelling and cause the soreness to last even longer. Try doing some light stretches to help your muscles recover faster.

Massage. Gently massage your sore spots. Massaging provides a feeling of instant relief and helps ease pain and tenderness. You can also try using a foam roller to massage any sore areas. Both techniques are known to enhance muscle recovery after physical activity.

Ice. Use an ice pack wrapped in a towel and apply to your sore spots. Be sure not to apply ice directly to your skin as this can cause irritation and damage to your skin tissue. Use an ice pack for short periods of time, several times a day. This should temporarily numb some of the pain and reduce swelling.

Don’t let sore muscles hold you back from exercising! With proper preparation and recovery techniques, you can significantly reduce or even prevent soreness from ruining your day.

How do you treat sore muscles after a workout? Let us know in the comments below!

Image created by Phduet – Freepik.com

90,000 How to recover from COVID-19 | Articles of the clinic Medservice

COVID-19 is a new disease that humanity faced just a few months ago. The virus mutates and grows stronger, the disease “gains momentum”, relatives, colleagues, friends get sick. In some, the disease is mild, with almost no symptoms. And someone is sick for a long time and hard. But in any case, the question arises of how to return to the usual way of life, physical activity.

Weakness, distracted attention, apathy or even panic – this is not a complete list of what you have to deal with.Sometimes the complications that the virus leaves behind can lead to more serious consequences.

By the end of October 2020, according to official data, more than 8,000 people had been ill in Udmurtia. For many of those officially COVID-negative, the fight against the new infection is not over yet. People don’t feel healthy. Let’s figure out why this is happening and how to regain the former quality of life.

Why weakness lasts for a long time after coronavirus and shortness of breath appears

Our life, whether we like it or not, is divided into “before” and “after”.The symptoms of coronavirus are known to everyone today, as well as the methods of examination and treatment. They talk and write a lot about this. Everyone knows that two or three weeks have to go through, and the virus disappears from the analyzes, which means that a long-awaited recovery should come.

But many patients are “stuck” at the same level of well-being that he had during the illness. All muscles hurt, fatigue persists, the head does not understand, physical exertion, even minor ones, is especially difficult.A person left for work from sick leave, and in the evening he comes home, falls exhausted and even eating becomes a problem. Or, it turns out that the habitual washing of dishes has turned into physical activity. It would seem that the treatment lasted almost a month, everything should be in order, but the state of health is bad, even very bad.

Such complaints are more and more often encountered at the doctor’s appointment at the Medservice clinic, Izhevsk. And now doctors know exactly what it is connected with. People who have had COVID-19 inevitably face deterioration in lung function after suffering pneumonia.This entails a violation of oxygen metabolism in the tissues of the body, which affects the internal organs and structures, in particular, the heart and the musculoskeletal system, the endocrine and nervous systems.

As a result:

  • weakness throughout the body increases, the patient quickly feels overwork;
  • even moderate physical activity is difficult
  • efficiency decreases;
  • shortness of breath appears;
  • it is difficult to breathe deeply.

Threat to the cardiovascular system

We all have already understood that coronavirus is a serious disease that harms not only the respiratory organs. The cardiovascular system is also seriously affected. One of the most formidable and common complications of COVID-19 is vasculitis, an inflammation of small vessels.

This disease is especially dangerous because it may not develop immediately, but some time after the onset of the disease. The virus infects the inner lining of the vessels – the endothelium.This inflammation is accompanied by an increase in blood viscosity and blockage of small vessels, formed by clots or blood clots. And the vessels permeate the whole body, which means that such inflammation can appear in any organ, and there will be violations.

The brain, intestines, kidneys can suffer. One of the most vulnerable places is the myocardium or heart muscle. The heart requires good blood supply and nutrition to function properly. The resulting inflammation, myocarditis, causes:

  • weakness, decreased performance, increased fatigue;
  • rapid heartbeat, heart rhythm disturbance;
  • chest pain.

If you are worried about your condition after a viral infection, and it complicates your usual life, see your doctor. It is important to know that the earlier you start rehabilitation, the less the virus will have on the body.

Diagnostics and rehabilitation after coronavirus

The doctors of the Medservice clinic, Izhevsk, have sufficient qualifications and experience to help restore the impaired body functions. You need to seek help from a therapist, cardiologist or neurologist.Believe me, it is only at first glance that fatigue and poor health are exclusively personal feelings. They can be signs of serious complications that arise after the transferred viral diseases.

After coronavirus pneumonia, as after any other, X-ray control is necessary one, three and 12 months after the end of treatment. Our clinic employs a modern X-ray computed tomograph, which allows us to detect even the smallest changes in the lungs and bronchi.

With shortness of breath, persistent coughing, dyspnea and other similar complaints, control over the function of external respiration is necessary. To diagnose respiratory (respiratory) disorders and control the function of external respiration of our patients, we use a modern spirograph. The device allows you to carry out all the necessary studies and samples. Based on the examination, the doctor will draw up an individual rehabilitation (recovery) program for you.

The Medservice clinic has modern, high-tech equipment that will help doctors find out the cause of your discomfort and prescribe the necessary recovery (rehabilitation) course.For patients who have undergone coronavirus infection, our doctors have developed rehabilitation programs that take into account modern experience in the treatment of coronavirus infection.

Inquiries and appointments are made by calling 550-300 and 350-300.

You can ask questions by going to section FAQ.

Causes, diagnosis, exercise and treatment


  1. What injuries are typical for shoulder pain?
  2. Anatomy and function of the shoulder joint
  3. Prevention of shoulder pain
  4. Drug treatment
  5. When should you see a doctor?
  6. Shoulder pain: Diagnosis
    History, clinical presentation, imaging diagnostics, neurology, laboratory tests
  7. Shoulder pain:
    conservative treatment or surgery?
  8. Shoulder Pain: Exercise at Home
  9. Shoulder pain after injury, inflammation, wear and degenerative damage to joints

Shoulder pain appears for different, symptomatic reasons.A specialized examination of pain syndrome helps to determine the causes of pain and prescribe a method of treatment. © yodiyim / fotolia

The anatomical structure of the shoulder provides a huge range of rotation of the joint around three axes. In modern medicine, the shoulder is described as a spherical joint, but only two joints form it – a flat spherical, located between the head of the humerus and the scapula, as well as the acromioclavicular joints. Thus, the humerus is surrounded by a number of tendons and muscles that facilitate its movement.Shoulder pain starts in people for a variety of reasons. In addition to pathologies of muscles and tendons, shoulder pain can cause damage to the articular cartilage, periarticular bursa or joint capsule. As a rule, these structures are deformed due to intense training, trauma, or degenerative changes such as arthrosis (wear) of the joint. Doctors recommend treating shoulder pathologies with medication, orthoses, and physical therapy. In some situations, only surgery or shoulder arthroplasty helps.

What are the characteristics of shoulder pain?

The shoulder joint is one of the most mobile joints in the human body.
When we brush our hair, play a ball, scratch our back, or pick up an object, differentiated movement is generated by the regulated motor movement of the shoulder. The shoulder joint maintains a delicate balance of motor function of the shoulder and the transfer of energy from the shoulder to the hand.

Almost everyone has experienced shoulder pain at least once in their life.The reason for this is the sophisticated and special design of the shoulder.

Shoulder Anatomy

The shoulder joint is formed by the head of the humerus, the glenoid cavity of the scapula and the clavicle, which does not directly come into contact with the joint itself. The dynamic combination of muscles, tendons and ligaments stabilizes its position. Due to the large range of motion and complex activity of the joint, shoulder pain occurs due to various factors.

Shoulder pain can affect all tissues of the shoulder joint.In this case, posture, daily life, age, medical history, metabolism, and specific deficiencies in the anatomical components of the shoulder joint interact with each other. Quite often, only an experienced specialist can discover the main reason for the appearance of shoulder pain in a huge complex of disorders.

The shoulder joint is the combination of the shoulder blade with the humerus. The glenochumeral joint is located between the head of the humerus and the scapula and is responsible for the direction of movement in the shoulder.The head of the humerus is covered by the rotator cuff tendons, which are responsible for its position and mobility. The most important is the tendon attached to the upper part of the humerus, the supraspinatus muscle, which runs between the lateral end of the scapula and the head of the humerus. The joint between the clavicle (Clavicula) and the acromial process (Acromion) of the scapula (clavicular-acromial joint) is also responsible for the movement of the shoulder joint. © bilderzwerg / fotolia

Complex shoulder anatomy: Glenohumeral and acromioclavicular joint

Mobility in the shoulder is the interaction of several joints:

The glenohumeral joint – the joint between the shoulder and the glenoid cavity of the scapula – only partially supports the mobility of the shoulder joint.

Acromioclavicular joint

Also responsible for shoulder mobility. The acromioclavicular joint is a flexible connection between the outer edge of the clavicle (Latin Clavicula) and the upper edge of the scapula (Latin Skapula). Like every joint in the human body, the acromioclavicular joint can be affected by arthrosis or injured due to various factors.

What is the role of soft tissue in the structure of the shoulder?

Sliding surfaces (bursa, bursa) support the mobility and ability to slide many of the muscles, tendons and ligaments surrounding the shoulder junction.Therefore, they can also cause shoulder pain.

Periarticular / subacromial bursa (Lat. Bursa Subakromialis)

The synovial bursa in the shoulder (Lat. Bursa) is a plastic and elastic component that is filled with synovial fluid. These components are observed in the area of ​​displacement and mobility of muscles, tendons, bones and ligaments relative to each other. The bursa is filled with synovial fluid produced by the mucous membrane on the inside of the periarticular bursa. Painful inflammation of the bursa is one of the main causes of stabbing pain in the shoulder.

Tendons and Ligaments: Rotator Cuff

Unlike the hip joint, the shoulder joint is not fixed by fixing the articular head (Latin caput articulare) in the glenoid cavity. The head of the humerus is only adjacent to the articular process of the scapula (glenoid). The degree of loading and dimensional stability in the shoulder depends on the scapular-ligamentous complex (rotator cuff), which originates from the head of the humerus and is responsible for the stability and mobility of the joint.Tears and inflammations of the tendons – primarily the supraspinatus and biceps muscles – give rise to pain in the shoulder and are the reason for limiting its mobility.

Shoulder joint capsule

The shoulder joint, like any other, is surrounded by a strong connective tissue joint capsule, which is covered inside by a synovial membrane that produces hyaluronic acid, which is an important component of synovial fluid. If the synovial membrane becomes inflamed, the cartilage supply mechanism is impaired, as well as the structure of the shoulder joint, as a result of which the patient experiences shoulder pain.So, deformation of the articular cartilage can turn into painful arthrosis.

The articular capsule has a special structure due to the fact that it is responsible for the process of mobility in the shoulder. In parallel with the glenoid lip, it is attached to the scapula, and in front of its attachment it is facilitated by the articular-humeral and coracohumeral ligaments. Sprains and deformities of the capsular ligamentous apparatus cause deep and prolonged pain in the shoulder.

In some inflammatory processes of the articular capsule of the shoulder joint (eg.Capsulitis / Frozen Shoulder Syndrome), die zu chronischen Schulterentzündungen führen können Patients experience chronic inflammation and pain in the shoulder.

Skapula functions

The position of the human body significantly affects the position of the bones of the shoulder joint: If we sit leaning forward a little, the scapula automatically rises to the top. The position of the shoulder joint adjacent to the scapula thus changes, resulting in impaired mobility of the scapula (scapular dyskinesia) and shoulder pain.

Articular cartilage and articular surfaces

The performance of the shoulder joint depends on the intactness of the cartilaginous surfaces covering the head of the humerus and the glenoid cavity, and providing movement of the bone fragments of the shoulder joint with a low coefficient of friction. In case of partial damage to the cartilaginous surface of the joint due to trauma, or due to wear and tear of the cartilage and arthrosis of the shoulder joint, patients develop severe pain in the shoulder and inflammation of the joints (activated arthrosis).

Shoulder Pain: Prevention

  • An active lifestyle
  • Avoid one-way traffic
  • Regular stretching of the dorsal and chest muscles
  • Active professional activity
  • Desks for working while standing

Shoulder pain can be prevented by staying in motion. If in everyday life you move a lot without harming the shoulder joint through one-way movements, sports and raising your arms above your head, you have every chance of avoiding shoulder pain.

With the help of special exercises, the shoulder joint becomes stronger and more mobile. The qualified specialists of the Gelenk Klinik in Freiburg recommend simple exercises for stretching the shoulder and chest muscles. If you are starting strength training, contact a trainer who will supervise the sequence of your movements.

People who constantly work in the office at the desk must constantly move, take breaks and stretch muscle exercises.Relax your shoulders and monitor your posture at all times: A strong, healthy back and good stretch in the front of your torso prevent shoulder pain. This way, you can avoid painful muscle spasms and narrowing in the shoulder joint (impingement syndrome).

Shoulder pain: How to help yourself on your own?

If you feel pain in your shoulder, you do not need to see a doctor right away. Less serious shoulder injuries can be healed on their own. In many cases, shoulder pain is treated with home remedies or over-the-counter medications.If you suspect structural damage to the tendons, bones and muscles after an accident, you should consult an orthopedic specialist.

If shoulder pain occurs due to increased training loads, you can do the following:

  • Keeping the joint at rest and relieving it of weight
  • Cooling compresses
  • Immobilizing the shoulder

What medications help to cure shoulder pain?

Medicines that are often used to treat pain without prescription include NSAIDs, non-steroidal anti-inflammatory drugs such as ibuprofen and diclofenac, which can be taken orally as tablets or applied to a painful shoulder area as a sports ointment.These drugs protect the joint from inflammation and prevent shoulder pain.

If you feel shoulder pain, you do not need to see a doctor right away. Only if the pain gets worse every day, and you cannot move your hand, an additional medical examination is necessary. © Gelenk-Klinik

Shoulder pain: When to see a doctor?

Shoulder pain is a fairly common occurrence in modern society. If you feel acute pain, you should not immediately contact an orthopedist.Typically, the pain lasts for about two weeks and then goes away on its own. Simple exercises and pain relievers speed up the process. However, if the pain intensifies and lasts a long time, it is recommended to look for a specialized clinic in which a thorough examination will be carried out.

Shoulder pain: When should you see a doctor?

  • Severe and stitching pain in the shoulder
  • Redness and overheating of the shoulder
  • Limited mobility or numbness in the arm and shoulder for several days
  • Sudden weakness and loss of energy in the shoulder joint
  • Shoulder pain that does not stop for several days
  • Chronic shoulder pain and traumatic injuries
  • Previous fall on the shoulder or arm, which causes severe pain and restricts mobility
  • Crunching and clicking in the shoulder
  • Clear change in the shape of the shoulder joint
  • Pain in the shoulder radiating to the neck or arm
  • Disorders of sensitivity in the shoulder: Numbness, tingling (“chills”), itching
  • Severe pain on the left side of the shoulder, sometimes chest pain and shortness of breath (suspected heart attack or angina pectoris)
  • Shoulder pain and temperature

Pain in the shoulder: Diagnosis and examination

How is the diagnosis carried out?

At the beginning, a conversation with the doctor is held during which the patient’s past illnesses are clarified.Using clinical tests and imaging diagnostics, the orthopedist identifies the cause of shoulder pain. Laboratory tests and neurological diagnostics help to exclude certain causes of shoulder pain, which is a condition for successful and targeted treatment.

Shoulder pain: History (information about the development of the disease)

At the beginning of the medical examination, an anamnesis is compiled, that is, all information about the background of your complaints is collected. During the conversation, the doctor will ask you questions about your injuries, the specifics of your work activity, as well as your lifestyle – for example, how often you play sports.To carry out a high-quality diagnosis, the clinic needs information about how much pain in your shoulder was manifested after accidents or injuries. In addition, shoulder pain may be explained by data on the state of metabolism in the body (diabetes, metabolism of fats and uric acid).

When compiling anamnesis, the doctor asks the following questions:

  • Have you had any previous injuries or pain in your shoulder?
  • How long does shoulder pain last?
  • Is the shoulder pain persistent or does it appear after certain movements in certain situations?
  • How does shoulder pain manifest? Deaf, deep, stabbing or burning?
  • Does shoulder pain appear at night when lying on your side?
  • What movements are limited by shoulder pain?

The hand strength and endurance test in various directions accurately determines the presence of injuries and injuries in the shoulder joint.© Gelenk-Klinik

Shoulder Clinical Examination: Test for Mobility, Soreness and Strength in the Shoulder Joint

The clinical examination begins with an external diagnosis of the shoulder joint: At the same time, the orthopedic surgeon looks to see if the shape of the shoulder has changed, whether both shoulders are parallel to each other, whether there is redness or swollen areas on it, as well as in which parts of the shoulder pain appears immediately after palpation.

In the second phase of the examination, the shoulder specialist examines the patient’s complaints using several clinical diagnostic methods that determine the functionality of the tendons, muscles and bone structures.So, to assess the mobility of the shoulder joint by the doctor, the patient performs special exercises by moving his arm in different directions. Thus, the degree of performance of each tendon and each muscle is established. The tendons of the supraspinatus and biceps brachii are tested. Flexibility test, such as internal and external rotation movements, ascertain the condition of the clavicular-acromial joint

Internal and external rotation movements, during which the arms are retracted behind the back, help to accurately determine the mobility of the acromioclavicular joint.If this joint is affected, this movement causes severe pain in the shoulder. © Gelenk-Klinik

Shoulder pain: Neurological and neurosurgical differential diagnosis

Pain and mobility problems in the shoulder are sometimes neurological in nature. In this case, the conductivity or integrity of the nerve pathways responsible for the functionality of the shoulder joint is lagging behind. To determine the degree of their conduction, electromyography (EMG) is performed – a neurological test to measure the conduction of nerve pathways.

Peripheral nerve block has various explanations. Often it appears as a result of impaired function in the cervical spine. Stenosis (narrowing of the spinal cord or nerve roots) or compression of the nerve puts pressure on the nerve endings. in this case, the transmission of excitation and the conduction of sensory information cannot be carried out in full. Pain in the shoulder, a feeling of numbness, weakness and itching are the result of these pathologies.

Imaging examination of the shoulder joint

If possible causes of shoulder pain can be identified during the interview with the doctor and clinical examination, then imaging will confirm the diagnosis.Images obtained during imaging of the shoulder joint do not always clarify the picture of the disease. Therefore, for the accuracy of the medical report, it is necessary to take into account the symptoms and results of testing the mobility in the shoulder. With diagnostic imaging, the shoulder specialist receives direct information about injuries, fractures, and structural abnormalities of the shoulder joint. The Gelenk Klinik Medical Center in Germany offers several methods of imaging diagnostics, which will be described in more detail below.

Ultrasound examination of the shoulder joint

Ultrasound of the shoulder joint is used to diagnose soft tissue disorders (muscles, ligaments, tendons) of the shoulder in motion. In addition, ultrasonography shows fluid accumulation in the tendons and bursa as well as intra-articular effusions in the shoulder.

Ultrasound examination (ultrasound) is intended to visualize the condition of the muscles, tendons and soft tissues of the shoulder joint in motion. © Gelenk-Klinik

X-ray examination

X-ray of the shoulder joint helps to obtain information about the position and condition of bone structures.Depending on the position of the humeral head, scapula, and acromion, x-rays can confirm or deny the presence of shoulder impingement syndrome. Essentially, impingement syndrome is a narrowing between the head of the humerus and the acromion. With the help of an X-ray of the shoulder under load, the working capacity of the tendons, as well as the acromioclavicular joint after injury, is established. Radiography does not provide a direct image of muscles and tendons. In addition, this diagnostic method allows the doctor to make an assumption about the condition and functionality of the soft tissues of the shoulder joint.The deposition of calcium salts in the tendons of the supraspinatus muscle with calcification of the forearm is visible on an X-ray immediately. In addition, radiographs show arthrosis of the shoulder joint, as well as changes in bone structures in the shoulder, for example, due to cystitis or bone spur.

X-ray of the healthy shoulder with sufficient space for the head of the humerus below the acromion of the clavicle (acromion). X-rays show the location of the bones in relation to each other. The normal position of the bones suggests that the functions of muscles and tendons are not impaired.© Gelenk-Klinik

Magnetic resonance imaging (MRI)

Magnetic resonance imaging shows the condition of the bones in more detail. First of all, MRI shows changes in bone structures, pathologies of cartilage tissue, accumulation of salts and fluid. The advantage of this diagnostic method is the ability to display soft tissues: The structure of muscles, tendons and ligaments MRI shows in detail. In addition, this method of obtaining tomographic images accurately shows degenerative changes, fluid accumulation, tears of the rotator cuff or tendon of the biceps brachii.Thus, the doctor will be able to accurately determine the method of treatment and cure the pain in the shoulder conservatively or refer the patient for surgery. Therefore, if a patient needs surgery for medical reasons, MRI is indispensable.

Computed tomography (CT)

Computed tomography is a high-tech diagnostic method that allows you to get an accurate image of bones. During CT, a specific area of ​​the patient’s body is scanned in layers, that is, with small doses of X-rays in three projections.In addition, a computed tomogram provides detailed information about changes in the state of the bones. In contrast to CT X-ray, changes in bone structure associated with fractures or implantation (shoulder joint endoprostheses, screws and fixation plates are visible in a higher spatial resolution.

Shoulder pain: Laboratory tests

Often shoulder pain has no clear cause. A bacterial infection of the bursa (bursitis) or shoulder joint (bacterial arthritis) can also cause shoulder pain.Quite often, changes in the shoulder joint occur due to autoimmune diseases (rheumatoid arthritis in the shoulder) or the accumulation of uric acid in the tissues (gout).

A laboratory test of blood or synovial fluid (joint fluid within the joint capsule) provides accurate results and helps the orthopedist determine how to treat shoulder pain. Laboratory tests also show the presence of infection after arthroplasty.

Conservative Treatment: How is Shoulder Pain Treated?

Conservative treatment:

The results of a detailed diagnosis of the shoulder joint help the specialists of our clinic in Freiburg to draw up a productive treatment plan.However, sometimes the patient himself can influence that the pain in the shoulder does not touch him. If you move enough and regularly perform auxiliary gymnastic exercises during sedentary work, then back pain and shoulder pain can bypass you. If the shoulder joint is overloaded, you need to rest and keep your shoulder at rest. If necessary, our orthopedists will provide you with special bandages.

Mobilizing the muscles and tendons surrounding the shoulder joint during a chiropractic session helps stabilize shoulder mobility.For diseases such as impingement syndrome and periarthritis of the shoulder (frozen shoulder syndrome / Duppel syndrome), manual therapy is a very important technique to help treat shoulder pain. © Gelenk-Klinik

Physiotherapy, self-study and biological regulatory therapy based on cellular technologies

If you are experiencing shoulder pain, physiotherapy will help you gradually get rid of it. In addition, it is worth noting that physical therapy is the most appropriate treatment for the shoulder joint like no other.Doctors explain this by the fact that the stabilization of the shoulder occurs with the help of muscle and tendon rings – the rotator cuff. Since shoulder pain is often caused by muscle imbalance, rest, exercise, and metabolic optimization can help you.

Biological regulatory therapy based on cellular technologies consists of several stages, which together contribute to the restoration of healthy tissues and stop the development of the inflammatory process.The image shows a method of biomechanical stimulation (BMS) of muscles using a special vibrating device. Injuries, inflammations, functional disorders of the tendons are treated much faster in this way. Shoulder pain is one of the most significant areas treated with biological regulatory therapy based on cellular technologies. © gelenkreha.de

Shoulder Pain: Physiotherapy and Biological Regulatory Therapy Based on Cellular Technologies

Mobility in the shoulder and the position of the head of the humerus under the acromion depend on the balance of the muscles and tendons surrounding the shoulder joint.Pain in the shoulder or abnormalities in the metabolic process of soft tissues require a visit to a physiotherapist. The objectives of physiotherapy are:

  • Treatment of muscle spasms
  • Correction of incorrect posture
  • Restoring muscle balance, e.g. between the pectoral muscles and the back muscles
  • Muscle balance of the rotator cuff
  • Improving metabolism to eliminate inflammation (frozen shoulder syndrome) or calcification of the forearm
  • Optimization of the healing process after injuries or structural disorders of tendons

Pain in the shoulder: NSAIDs non-steroidal anti-inflammatory drugs

Pain and inflammation in the shoulder are usually treated with anti-inflammatory and at the same time pain relievers.The group of components of NSAIDs is used by doctors most often. The most famous medicines are Ibuprofen and Diclofenac. Long-term use or high dosage of these drugs can lead to pain, as well as side effects in the area of ​​the intestinal and gastric tract. If you feel pain in your shoulder, but are afraid of the side effects of the above medications, we recommend applying a special sports ointment to your sore shoulder. However, treating shoulder problems with cream or ointment is not as successful as with NSAIDs.

Shoulder pain: Simple exercises at home

The supply of the muscles and tendons of the shoulder joint is very often impaired due to lack of movement and overexertion, which causes pain, stiffness and impaired mobility in the shoulder. Simple exercise at home can prevent shoulder pain.

In the following image, we will present exercises for the prevention and treatment of pain that you can do at home. Please do not do them if you have severe shoulder pain.If these activities caused or increased shoulder pain, you must wait for the results of diagnostic test

1. Exercises with swinging movements in the shoulder joint

The arm hangs along the body, the movement of the head of the humerus is carried out under tension without loading the articular surfaces. © Gelenk-Klinik

With your good hand, lean on the table or chair back. Relax and lower the sore shoulder, start swinging movements of the arm in a hanging position.Repeat circular motions with your hand. If you want to improve the result of the lesson, take a bottle of water or a small weight in your hand. In this way, you will be able to enhance the stretch effect. Repeat this exercise several times a day. During this movement, the articular surface is lubricated and all muscles and tendons are stretched without overstraining the shoulder joint.

2. Shoulder shrug: “Shoulders up, shoulders down”

Exercise 1. Position: Shoulders up. © Gelenk-Klinik

Stand or sit with your back straight.Raise your shoulders towards your ears and hold for 5-10 seconds. Then relax your shoulders and lower them down. Contract your back muscles at the level of your shoulder blades and hold this position for 5-10 seconds. Repeat this stretch about 10 times. This exercise helps people working at a desk to restore shoulder muscles and posture.

Exercise 2. Position: The shoulders are lowered along the body, the shoulder blades are set behind the back. © Gelenk-Klinik

3. Stretching the front of the shoulders on the door frame

Shoulder pain: Stretching of the pectoral muscles on the door frame.© Gelenk-Klinik

Stand in the doorway and lean on the doorposts with your elbows. At the same time, the hands should be slightly above the head. Lean forward until you feel a stretch in the front of your chest. Hold this position for 15-30 seconds. Repeat the exercise about 3 times. If you have shoulder injuries or shoulder impingement, then this activity is not suitable for you.

4. Forearm pulls the therapeutic band outward

The forearm pulls the therapeutic band outward.In this case, the elbows are compressed in the waist region and the muscles of the chest are stretched. © Gelenk-Klinik

Pull the elastic band with your forearms horizontally extended. At the same time, the shoulder blades are compressed and the pectoral muscles are stretched. Hold this position for about 5 seconds. Do 3 sets of exercises with 10 repetitions.

Exercise without a therapeutic band: The arms are horizontally extended outward. In this case, the shoulder blades are compressed and the pectoral muscles are stretched. © Gelenk-Klinik

Shoulder Pain: Shock Wave Therapy

Shock waves are high-energy sound waves that are targeted at affected tissues.The liquid components of the body are the carrier of the energy of the impulse waves. This energy acts on foreign and solid bodies immediately, immediately destroying and crushing them. Initially, shock wave therapy was used in medicine to break up foreign bodies such as kidney stones. However, today, orthopedics uses this method to treat calcification of the forearm: At the same time, shock wave helps to eliminate painful calcium deposits in the supraspinatus tendon.

Shockwave therapy is also recommended for inflammatory changes in the shoulder such as periarthritis of the shoulder (frozen shoulder syndrome or adhesive capsulitis).
In this case, the effect of shock waves is based on changes in the metabolic process caused by mechanical irritation in the tissues.

Shoulder Pain: Injection Treatment

For inflammatory changes in the tendons of the shoulder joint or bursitis, orthopedic specialists often use cortisone injections.However, this substance is not entirely suitable for long-term therapy, as it causes certain side effects in soft tissues, tendons and ligaments.

Shoulder pain: Surgical treatment

Conservative therapy is the most suitable method for treating joint pain, and this method brings especially long-term results to patients who experience shoulder pain. Only if conservative treatment does not bring the desired effect and does not improve mobility within 3-6 months, the doctor will refer the patient to surgery.

Shoulder surgery is performed only in cases of clearly visible structural abnormalities, such as fractures, tendon ruptures (supraspinatus and biceps tendons) or severe arthrosis of the shoulder or acromioclavicular joint.

Shoulder arthroscopy: Minimally invasive surgery to relieve shoulder pain

Shoulder arthroscopy is a minimally invasive surgical treatment for shoulder pain using the smallest instruments, 0.5–1 cm in length.The arthroscopic camera provides the surgeon with an accurate but limited view of the surgical site within the shoulder joint. © bilderzwerg / fotolia

In most cases, shoulder surgeries are minimally invasive using arthroscopy. This technique involves the surgeon making from two to four small incisions, 0.5–1 cm long, through which he inserts thin tubes with visual indicators into the shoulder joint. So, during the operation, a special camera and the smallest surgical instruments are used.

Which shoulder ridge surgeries can be performed arthroscopically?

  • Tendon suture or reposition of tendons (supraspinatus tendon, biceps tendon)
  • Bone milling (removal of osteophytes, acromyoplasty)
  • Removal of inflamed bursa (bursectomy)
  • Removal of inflamed synovial membrane 20 joints and articular
  • Mobilization of the joint under anesthesia for periarthritis of the shoulder scapula
  • Joint treatment (cartilage transplantation, bone microfracturing)
  • Repositioning of the labrum of the shoulder joint
  • Tendon transplantation, for example, for injuries of the acromioclavicular joint.
  • Treatment of the articular surface for arthrosis
  • Removal of articular mice

Open shoulder surgery

Shoulder pain is not always treated arthroscopically. Sometimes doctors have to carry out open surgery. During such a surgical procedure, the surgeon makes a large incision in order to fully see the operating field. For patients who have been prescribed shoulder arthroscopy, an orthopedist can also perform open surgery. It depends on the course of the surgical process itself, during which the surgeon can change his mind and switch to an open technique.

Shoulder prostheses: Endoprosthetics for painful arthrosis

Shoulder prostheses for arthrosis can relieve shoulder pain. © Viewmedica

Osteoarthritis of the shoulder joint (omarthrosis) can be treated with conservative methods (physiotherapy and pain relievers). If the patient’s limited mobility and shoulder pain continue for a long time and conservative treatment is unsuccessful, doctors recommend implanting an artificial joint.

In total shoulder arthroplasty, both articular surfaces of the shoulder are replaced with a prosthesis.

For mild arthrosis of the shoulder joint, another technique is proposed: If one of the articular surfaces, for example, the scapula, has intact cartilaginous tissue, partial arthroplasty can be performed, during which only the affected part of the shoulder joint is replaced. Sometimes surgeons also use rodless prostheses that preserve bone tissue as much as possible.With partial endoprosthetics, the articular surface of the scapula is preserved in full.

If one of the articular surfaces of the shoulder joint is intact, partial arthroplasty can help relieve pain and restore mobility in the shoulder. This technique preserves bone tissue. Unlike total arthroplasty, the head of the humerus remains unaffected. © Gelenk-Klinik

If the articular surfaces are severely worn out and rough due to the formation of osteophytes (bone spur), shoulder pain can only be eliminated by performing total arthroplasty in a specialized clinic.As in the case of hip arthroplasty, the head of the humerus is replaced and the prosthesis is fixed in the medullary cavity.

Shoulder endoprostheses are quite durable, as the shoulder is not a weight bearing joint. The total load in the shoulder joint is much less than in the knee, hip and ankle.

90,000 pain localized in the Achilles tendon

What is achillodynia and how does it develop?

Achillodynia is a pain syndrome resulting from inflammation of the Achilles tendon and the surrounding membranes.The disease usually develops after 90,059 excessive 90,060 exertion. Untrained people after overly intense training often suffer from Achillodynia. This applies not only to running disciplines, but also to other sports.

People with overweight also often have problems with the Achilles tendon. Rheumatism and Foot deformities increase the risk of developing achillodynia.


Being the most powerful tendon in the human body, the Achilles tendon (lat. tendon Achillis ) transmits the force of the leg muscles to the foot. This ensures the separation of the foot from the surface when walking and running. Running on the Achilles tendon is exerted by force eight times your own weight. 1

Anatomy of the Achilles tendon

Risk factors and causes

The main cause of Achillodynia is overstrain of the Achilles tendon.At the same time, the activities that can cause pain are very diverse.

Sports activities

  • Intensive running and jumping loads
  • Unusual loads, for example, too heavy loads after starting sports
  • Systematic overload

External factors

  • Unsuitable footwear
  • Smoking
  • Taking certain antibiotics

Anatomical factors

  • Aging
  • Foot deformities
  • Shortening of tendons or muscles
  • Increased uric acid levels
  • Rheumatic diseases
  • Overweight

Signs and symptoms

The clinical picture ranges from discomfort to Achilles tendon inflammation.In some cases, inflammation can cause a real rupture. Typical symptoms of inflammation are: pain, localized fever, edema and dysfunction .

At first, symptoms appear only at the beginning of physical activity and disappear after a short period of activity. In the future, pain and swelling persist for a long time.

Treatment of achillodynia

Treatment of achillodynia is almost always conservative .The earlier the treatment starts, the more successful it is. The most effective complex treatment, which consists of the items listed below.

  • Physiotherapy exercises: Special eccentric exercises 2 promote the rebuilding of the tendon tissue. It is recommended that you exercise for a few minutes twice a day. Depending on the clinical picture and phase of the disease, the doctor may prescribe physiotherapy (ultrasound), electrotherapy (TENS), cross kneading (special massage), shock wave therapy or acupuncture.
  • Bandages: Specialized medical devices (eg Achimed by medi) reduce stress and strain on the Achilles tendon. The compression band and the built-in silicone insert work together to gently massage the Achilles tendon and improve blood circulation in the inflammation area, which reduces pain. Additionally, in the acute phase, patients can relieve pain in the Achilles tendon by using heel pads that are used simultaneously in both shoes.
  • Insoles: Orthopedic insoles (eg igli Heel Spur Light) reduce stress on the Achilles tendon.
  • Cold : cooling compresses relieve pain and swelling (temperature of the compress is about 7 ° C).
  • Heat : A heating pad, hot water bottle or massage with a towel soaked in warm water improves blood circulation in the area of ​​inflammation.
  • Medication : Patients take anti-inflammatory drugs such as ibuprofen or diclofenac for one to two weeks as needed and as recommended by their healthcare provider.
  • Ointments : Anti-inflammatory creams or ointments can be rubbed into the affected area several times a day.

The treatment plan is drawn up by the attending physician individually for each patient. This takes into account the special needs of the patient and the clinical picture at the current time.

Physiotherapy exercises

Eccentric exercise 2 is an effective treatment for achillodynia.This has been proven by various studies 3 . Among such exercises , the calf lift is considered the main one.

Exercise should be done twice a day for a minimum of 12 weeks.

The exercise can be performed on a step (eg a ladder) and does not require fitness equipment.

Important to know:

During the first two weeks of doing the exercises, pain in the muscles of the lower leg is possible.Be patient and continue to do the exercise conscientiously. If the pain gets too severe, reduce the number of sets. If this does not help reduce pain, and if you experience pain during daily activities, stop exercising and see your doctor.

A set of exercises for achillodynia

In addition to the main exercise, you can do other exercises to strengthen the Achilles tendon.Medi has partnered with Dr. Mathias Marquardt, a sports physician and active athlete, to create a set of exercises for the home. In the videos, Dr. Mathias Marquardt teaches with professional triathlete and physical therapist Laura Philippe how to do the exercises correctly. The optimal frequency is three to four times a week .

Consult your doctor before exercising to see if it is right for you.

Coordination – standing on one leg

Stabilizing pad (alternative: rolled towel, folded training mat).

Starting position:

  • Standing barefoot on exactly one leg on a pillow
  • Keep the knee of the leg on which you are leaning slightly bent
  • Raise the other leg up (stand on one leg) (Fig. 1)
  • The soft surface of the pillow creates instability that must be compensated for.
  • Exercise activates the muscles of the foot and thigh.
  • Make sure your torso is tense and you are standing up straight.
  • To do this, tighten your abdominal muscles and straighten and straighten your shoulders.


  • You can simplify the exercise by performing it on a hard surface (without a pillow)
  • To complicate the exercise, draw the number 8 with your free leg (Fig. 2)
  • You can complicate the exercise by lifting the knee of your free leg (rice.3)
  • You can complicate the exercise by raising the knee of the free leg (Fig. 3)

Execution mode:

  • Three sets for each leg, each hold for 30 seconds
  • Take a 15-second break after each set

Muscle training

Straight Knee Calf Raise


  • Steps
  • Optional: side rail

Starting position:

  • Stand on the edge of the step with the front of your foot
  • Heels should not be on the step
  • Stand on tiptoe without bending your knees
  • a healthy leg in the knee (Fig.1)
  • Slowly lower yourself on the supporting leg so that the heel is below the level of the step (Fig. 2)
  • Raise so that the heel is at the level of the step
    – keep your back and head straight
    – make sure that the knee joint does not deviate inward or outward


  • You can complicate the exercise by doing a tiptoe lift with bent knees
  • You can complicate the exercise by doing it with weights (for example, with a backpack)

Execution mode:

  • 3 sets of 15 repetitions with each leg
  • Take 30 second breaks between sets

Calf Raise with bent knee


  • Steps
  • Optional: side rail

Starting position:

  • Stand on the edge of the step with the front of your feet
  • Heels should not rest on the step
  • Stand on tiptoe with slightly bent knees (approximately 60 °)
  • Bend your good leg at the knee (Fig.1)
  • Slowly lower yourself on the supporting leg so that the heel is below the level of the step (Fig. 2)
  • Raise so that the heel is at the level of the step
    – keep your back and head straight
    – make sure that the knee joint does not deviate inward or outward

Execution options:

  • You can make the exercise easier by doing a tiptoe lift with straight knees
  • You can complicate the exercise by doing it with weights (for example, with a backpack)

Execution mode:

  • 3 sets of 15 repetitions
  • Take 15 second breaks between sets

Stretching – roll of the lower leg on the roller


  • Roller
  • Optional: Training mat

Starting position:

  • Sitting on the floor
  • Bend one leg and place the calf of the other leg on the roller
  • Put your hands on the floor (Fig.1)
  • Raise your pelvis.
  • Now slowly roll the roller back and forth along the entire length of your calf, from the Achilles tendon to the hamstring.
  • You will feel the pressure point moving across the calf muscle.
  • The muscles of the trunk are involved in movement (Fig. 2).
  • Bend your toes to relax the posterior calf muscle group.
  • The exercise may be a little painful at first, but the pain should not be unbearable.

Execution options:

  • Complicate the exercise by rolling both legs at the same time
  • Complicate the exercise by crossing your legs

Execution mode:

  • 3 sets of 10 repetitions (forward and backward) with each leg
  • Rest 30 seconds between sets

Medi products


Achimed Brace will help reduce pain in the Achilles tendon without limiting the range of motion in the ankle joint.

Silicone inserts in the projection of the Achilles tendon have a massaging effect and protect the tendon from external mechanical stimuli.

Learn more about the Achimed brace.



1 Klein, C.: Orthopädie für Patienten [ Orthopedics for Patients ]. Publisher: Michels-Klein, Remagen 2014

2 Eccentric training means loading a muscle or a tendon by slowing down a weight or resistance.

Human body

Ligament damage often occurs during sports.

Tendons and ligaments

Healthy lifestyle

Find out which sport suits you best

Sports and recreation

90,000 Discomfort in the morning.What Stiffness Signals After Sleep | Health | HEALTH

Often, joint stiffness immediately after waking up is attributed to an uncomfortable sleeping position or a hard mattress. You seem to go back and forth about your morning household chores, and it’s better. After 2-3 hours, stiffness in the joints disappears completely without a trace. To repeat the next morning with renewed vigor.


It is understandable when such discomfort is experienced by elderly people whose joints are worn out, but lately people under 45 have been complaining about morning stiffness more and more often.

Experts recommend taking such symptoms as seriously as possible. This is how the body warns us about the possible onset of a pathological process with irreversible changes.

The main task of any joint is to provide the body with freedom of movement, provided for by physiology. For this, all articular components work simultaneously and harmoniously. Bone structures slide relative to each other due to the smoothness and elasticity of the hyaline cartilage.

The synovium produces a lubricating fluid and delivers oxygen and nutrition to the cartilage tissue. If any failure occurs in this mechanism, then the amplitude of movements immediately becomes noticeably less. Hence – stiffness or tight mobility.

Such discomfort in the morning is one of the symptoms of rheumatoid and reactive arthritis, rheumatism, ankylosing spondylitis, osteoarthritis.

By the way, people with great excess weight often suffer from false joint stiffness.A decrease in the range of motion in these situations is associated with general muscle weakness due to a sedentary lifestyle.


You don’t need to make difficult diagnoses yourself. If you feel stiffness in movements in the morning, it is better to see a specialist. A good doctor will not limit himself to an initial examination, but will send the patient to a whole series of studies. An accurate diagnosis will most likely require an immunological blood test, radiography and computed resonance imaging to determine the extent of damage to the joint capsules.

Treatment of the same rheumatoid arthritis will be a long one. You can’t do without drugs. You need to seriously reconsider your lifestyle. It’s good to start the morning with simple exercise therapy exercises: stretching, twisting movements for the spine, bending to the side, static exercises for the neck. Ideally, such a warm-up should be given up to half an hour in the morning.

Physiotherapy procedures using modern medical equipment will also help. You can’t do without a diet.Its main principle is fractional nutrition with an energy value of about 2200-2400 kcal / day.

See also:

90,000 “I stopped feeling my legs”: how I was recovering after coronavirus


“You seem to have returned from the war. Do you remember, there was such an “Afghan syndrome” – and so you have “covid syndrome”, – one doctor-psychotherapist, looking into my eyes, said. He also said that he could not reassure that it would not last long.

Maybe a week. Maybe a month. Or maybe I’ll never be the same. It is called reassured.

This is what distinguishes real doctors from home-grown “experts”. The real ones honestly admit that they do not yet know all the consequences of covid – physiological, psychological, mental, social. It should take at least a year to present possible prospects.

“Homegrown” are still trying to convince themselves and others that it is not worse than any ARVI.Does the usual seasonal flu need rehabilitation?

“It’s easier to say what doesn’t hurt than to list what problems have arisen after the coronavirus,” is a typical answer of any of my “comrade in misfortune”.

Rehabilitation after coronavirus infection is necessary even for patients with a mild and asymptomatic course of the disease, as the Ministry of Health of the Russian Federation carefully stated.

Deputy Prime Minister Tatyana Golikova also confirmed that long-term dispensary observation should be mandatory for those who have had coronavirus infection in the Russian Federation.

What does this mean?

Yes, ex-KVIDs certainly need full medical support even after tests have shown that they are no longer carriers of the virus. That they are healthy.

But the least of all this help should be to follow us and make endless reports about how everything is good or … bad with us.

Nothing better than this.

Photo: Ekaterina Sazhneva


Saturation 96,





“We’re losing her!” Her – that is, me.

More precisely, no. We do not lose.

I am lying on the bed with an oxygen mask on my face that completely covers my nose. Oxygen is supplied to me. There is less of it. Artificially, my lungs are injected into a condition that is usually experienced by patients with covid pneumonia. Severe form. Hypoxia.

When you can’t breathe. Everyone who has suffered from COVID-19 has long remembered that oxygen saturation is the level of oxygen in the blood.

The lower the saturation values, the greater the lack of air a person experiences.

After the patient has recovered, due to a decrease in the volume of the lungs – those alveoli glued together with “frosted glass” on CT, the body still continues to receive less oxygen, and fibrotic changes occur. The lungs are covered with scars.

Sooner or later you get used to it, people get used to everything, for example, I don’t even notice that something is wrong with my breathing. Here are just going up 2-3 flights of stairs now causes shortness of breath, as if you ran three kilometers.

They reduced my saturation artificially, after which they looked at how, at what indicators a person could hold out.

Feels like you are climbing a mountain, the lower the oxygen level, the more serious the peak.

Then, after a five-minute oxygen starvation, it was time to supply pure oxygen (in my case, 12%, these are average values ​​- like a sip of ice-cold brut), and the lungs straighten …

I’m lucky. This is where I am trained to breathe again.While I was lying, I wondered how I came to such a life.

On June 11, the day the first restrictions on coronavirus were lifted, I started hysterical. It seemed to me that they had already ended, froze, stopped – these damn covid “swing”, when day after day does not fall, then you are full of energy and literally flutter, the next – you just can’t get out of bed. Almost 2.5 months have passed since the onset of the disease.

But again measured the temperature – 37.4. I was even ready to believe that somewhere I had caught the virus again, doctors at covid hospitals confirmed that this seemed to be quite possible, I was angry with others because they still do not understand the whole danger of the epidemic and how small children are happy the fact that from now on they can walk without masks.

But the worst thing is that I no longer felt my legs. And it was as if tight gloves with thin spikes inside were pulled on their hands.

I could walk and even run perfectly, fingers on my hands, despite the feeling of constant tingling, also did not lose their functionality, but at the same time sensory sensations were completely absent in my legs, even if you beat them with a hammer – nothing. Neuropathologist on the Internet – telemedicine rules today! – after conducting simple tests, I suggested that myelin sheaths of nerves were damaged.It’s like insulating an electrical wire, they are responsible for the speed at which electrical impulses are transmitted to the brain. And now, most likely, the insatiable virus gobbled up these very shells. “For him, they are like a delicacy,” the doctor delighted me.

Well, yes, most believe that after the coronavirus, the lungs suffer the most. No matter how it is – where it is thin, there it breaks, the cardiovascular system, kidneys, liver, central nervous system … That’s all!

In my case, the reason for the complications, all experts agree on this, is that I worked too much, wrote in the infectious diseases clinic, then at home, someone, according to my editor, has to tell the truth about the coronavirus.Experience everything personally for yourself. Including complications after covid.

But I am wildly tired of falling asleep, not knowing in what state I will meet tomorrow morning. I couldn’t do that anymore.

I started looking for where in our country it was possible to undergo rehabilitation after the coronavirus, and it turned out that there was nowhere in droves, although the same Tatyana Golikova speculates that the state plans to take Kovidnikov under its vigilant control, who are currently former patients , except for themselves, by and large are not needed by anyone.

Photo: Gennady Cherkasov


“No rehabilitation was offered. At the time of discharge, the district police officer said in words: do breathing exercises and walk more, that’s all, ”says Alexandra Sh. From Moscow.

“Rehabilitation was not offered at all, – says Margarita Y. – When the hospital was closed, they offered to donate blood for biochemistry and general analysis.

My daughter for 10 years was ill with me. In the children’s polyclinic, the doctor told me in plain text that the child was not entitled to any rehabilitation. I had a lot of scandal with the children’s clinic ”.

“No rehabilitation or further examinations. But they called twice and tried to persuade them to hand over the plasma, “Tatiana K. shrugs.

And there are hundreds of such doomed reviews on the Internet. All around Russia. To my request to the groups created by those who had been ill with covid: they recommended that one of them recover from a serious illness, for example, go to a rehabilitation center or, perhaps, get a free ticket to a sanatorium – people answered very honestly and very bitterly.Not a single positive example. The attitude is simple. Recovered, removed from the register for covid – and thank God!

“In March, a decree was adopted that all medical examinations were canceled. So I can’t even check what is specifically affected in the body. As for rehabilitation, those who were seriously ill, and especially with treatment in a hospital, certainly need it. It seems that private clinics are already offered for a fee, but this is not even included in the VHI. Way out: go with complaints to specialized doctors – cardiologist, nephrologist, etc.etc. without any connection with the coronavirus. ”

“They put hypertension as a consequence and prescribed a concor from a scaling pulse, they said – make an appointment with a therapist, maybe they will give you a referral to a cardiologist.”

“Oh, what are you talking about? What kind of rehabilitation? This is probably a joke. Take pills and do not worry, do yoga, breathing exercises, find information on the Internet. ”

“In the recommendations in the extract they prescribed -” airing the room. ” I can imagine what will happen as a rehabilitation.Watching TV?”

“Good afternoon, Ekaterina! I read your article in Moskovsky Komsomolets. We have created an international group for Russian-speaking post-viewers. Everyone, as you can imagine, has a lot of strange symptoms and complications. Please join us. We really lack publicity. Many participants are discouraged and lost, ”Daria Darmodekhina wrote from France.

Daria Darmodekhina created a group of covid survivors.

Photo: Ekaterina Sazhneva

In France, the peak incidence was in mid-March.When we still have no sleep and no spirit. My interlocutor fell ill on the 17th. Four months have passed since then, but the consequences of what happened are still making themselves felt.

“In France, therapists also do not yet have an official protocol for the treatment of postcovid patients. My therapist has just graduated from the medical faculty and treats such discussions with professional interest, ”explains the girl.

I decided to create the Atypical Coronavirus: Sharing Experience Group because I thought that I was still suffering from the disease and decided that it was some kind of strange form.It was later that I realized that we are talking, rather, about the consequences, – says Daria. “I’m afraid there will be confusion among doctors about the postcovidians. In fact, I have a very commonplace situation. And the problems are the same as everyone else in the group. ”

Dasha says that when she created the group, she thought it would include ten people, but in a very short time, 2.5 thousand Russian-speaking patients from all over the world joined. All have mild to moderate covids.

The geographical spread of the recovered participants – from Ecuador, Nigeria, Switzerland, the Netherlands to Kazakhstan and Belarus.

They are together for a quick exchange of information. Many did not understand at all which doctors to go to and what to complain about. Maybe this is generally psychosomatics, and it is necessary to treat the head? There are too many discrepancies in the symptoms.

Special centers for post-ovarian patients are already being created on the basis of some European public hospitals, for example, in France, in Holland, but so far there is no general protocol and systemic approach to treatment, and only former severe patients are rehabilitated, helping others is a matter of time.

Will similar centers appear in Russia in the near future?

Moderator Nastya gathered together the main directions of covid complications and depicted them in a table against the background of a funny paper man. More precisely, not funny, but confused. What to do? How to live on? The hopes that the group will not last long (this main wish is written on the first page), that everyone will soon be cured and quickly forget about their troubles until they are justified.

Fatigue, weakness, temperature fluctuations, wandering myalgias, tremors, aches, numbness of the extremities, tachycardia, pressure, vasculitis, autoimmune disorders… In short, a complete set. Another unexpected consequence of covid: damage to the thyroid gland. Young women from 35 years old, who had not experienced any problems with hormones before, after suffering a coronavirus – a lung, almost asymptomatic, without pneumonia, suddenly found themselves in an endocrinologist’s office.

In a few months the goiter has grown to the size of a quail egg. Suffocate. Although, other than this, there are no symptoms. There are such numerous cases among my acquaintances in Moscow, in France.

Photo: Ekaterina Sazhneva


“Tell me, please, how to get rid of attacks of suffocation. It rolls like a lack of air, a heaviness on the heart, you try to breathe deeply – it does not work. The head is spinning, it seems that you are about to lose consciousness … And it lasts a day or two. It started in April, it wasn’t before ”.

“These constant waves … Yesterday the whole day was bad, before that the night could not sleep at all.I worked at the computer for five hours and fell asleep. The day before, I felt normal, walked for an hour and a half … My husband says that she has hammered all this into her head. And I can’t get up in the morning, I wake up, all my muscles ache, I feel sick in the morning. There is no talk at all about getting up at eight and going to work. When will we be able to live a fulfilling life? ”


Head of the Department of Sports Medicine and Medical Rehabilitation of the First Moscow State Medical University.Sechenov, Professor Yevgeny Achkasov is optimistic about the rehabilitation of coronavirus patients.

– Is rehabilitation after covid different from rehabilitation for other viral diseases?

– Until recently, very little attention was paid to the rehabilitation of patients with infectious diseases. If you look at the scientific conferences, it was mainly about neuro- and cardiac rehabilitation, recovery from injuries. But today it is already clear that in the very near future, hundreds of thousands of people in Russia will need rehabilitation after suffering from the coronavirus.And we must consider all its aspects: physiotherapy exercises, nutrition, physiotherapy, psychological support.

– What are the consequences for the survivors?

– The consequences are still unpredictable for different organs. First of all, as you know, the respiratory system suffered. Only time will tell if there is a trend towards recovery. A person will not have enough air volume, he will not be able to perform physical activity, fatigue will develop. It is possible that over time he will have to change jobs, so that we can talk about medical and social rehabilitation.It was officially announced that in our country about half a million people were infected and ill. The real picture, I think, is much higher. Many people did not even need to seek medical help, they suffered the disease on their feet. Even in my professional environment there are such people. It is possible that they will need help too. Many diseases seem to have no irreversible consequences, but at the same time we see a persistent decrease in adaptive resources, which also need to be restored. But there are those who have suffered a very hard covid.Early rehabilitation for any infectious disease should be started in the intensive care unit. At first, it can be passive exercises, then more active ones must be started. Even with intact lung function, prolonged bed rest leads to physical inactivity and muscle atrophy. All this is a rather lengthy process, and each person needs to choose their own program.

– What do you think, if the state takes care of all this seriously, will it be necessary, for example, to open special rehabilitation covid centers?

– I think that any rehabilitation center can deal with the rehabilitation treatment of such patients.With the availability of appropriate equipment aimed at respiratory rehabilitation. Patients’ lungs can be rehabilitated on an outpatient basis using telemedicine technologies. I believe that in the Russian regions, in all hospitals, doctors should learn not only how to treat, but also how to rehabilitate after suffering COVID-19.

Photo: Ekaterina Sazhneva


…It seems that once in this mansion, where the Medical Rehabilitation Center of Sechenov University is located today, there was a huge dance hall. Here gentlemen could circle beautiful ladies in polonaises and waltzes.

By the way, balls are one of the ways to train the lungs, especially for those who are not engaged in heavy physical labor … In fact, this building was originally built as a medical clinic, it was here that the film “Heart of a Dog” was filmed – an episode where Professor Preobrazhensky introduces Sharikov to his colleagues.

Hall for rehabilitation physical education and medical simulators – the same former lecture hall. I pedal my bike, then work out numb hands …

But the ceilings! .. But the curtains! But the rustle of old skirts!

Such interiors are conducive to appropriate thoughts and conversations.

Observed in the morning one elderly intelligent lady, moving on the treadmill, told the accompanying nurse about the times of Napoleon.

Most of all, of course, patients are aged. Especially after strokes, young people after accidents.

After coronavirus pneumonia, I am alone. And even then this diagnosis goes as a concomitant disease, one line in the history of the disease.

It is said that a massive influx of postcoid patients is expected in hospitals in September. If, nevertheless, a state decision is made to rehabilitate under the compulsory medical insurance.

Rehabilitation specialists of the Ministry of Health emphasize that those with moderate and severe infections will especially need recovery.Medical activities should last continuously for two to three months. In cases of the development of disabling processes, recovery may take more than a year.

So far, few clinics offer such programs. Private rehabilitation will cost around 100 thousand per week. The price list includes a separate room and four meals a day.

It is clear that if the state does not join, not all Russians will be able to afford such treatment, even those who are in dire need of it.

… Only with years and suffering do people come to the conclusion that health must be protected. And only when it is real to do something – either impossible, or very difficult. Seemingly banal truths.

The current epidemic has shortened the way to understand yourself, what is important and what is not. Yes, none of us is to blame that the virus chose him.

But, only having survived the disease, you begin to understand how scary it is to try to breathe and not feel the air.

When legs fail… When the temperature does not drop from pills and injections …

When doctors are unable to help. Because they themselves are tired, sick, and dead.

But what happiness is when you get out of bed in the morning and breathe deeply. Even if in gas-polluted Moscow. You just breathe.

In short, whoever survived the covid will understand what happiness it is – 100% saturation.

90,000 Causes of development, symptoms of muscle atrophy, principles and methods of treatment

Symptoms and treatment of atrophy of the muscles of the legs and arms

Muscle atrophy is the thinning of their fibers and a decrease in the total muscle volume.In this case, muscle tissue can be replaced by connective tissue that is not able to contract. This is how atrophy of the muscles of the hand, lower leg and other parts of the body develops.

Reasons for the development of muscle atrophy

The pathological condition under consideration can develop under the influence of various provoking factors. Most often, muscle atrophy is observed in the elderly, which is associated with natural aging processes: metabolism slows down (metabolism in muscle tissues), physical activity decreases.But there are other reasons for the development of pathology:

  • violation of the hormonal balance of the body – it can develop with pathologies of the pancreas and thyroid gland, adrenal glands and ovaries;
  • diseases of the gastrointestinal tract;
  • connective tissue pathology;
  • lesions of peripheral nerves.

In some cases, hereditary diseases can provoke the problem – for example, the cause of spinal muscle atrophy is genetic changes in the structures of the nervous system that make voluntary muscle contractions impossible.Such diseases are manifested by muscle problems already in early childhood. Often, it is muscle atrophy that is the only pronounced symptom of the disease, which must be taken into account in the diagnosis.

Nutrition and lifestyle play an important role in the development of muscle atrophy – a lack of vitamins and trace elements in the body, alcohol abuse eventually lead to the pathology under consideration.

Symptoms of muscle atrophy

Treatment of atrophy of the muscles of the legs and arms should be preceded by a diagnosis of pathology.Doctors emphasize that it is necessary to pay attention to the following signs:

  • fast onset of fatigue;
  • muscle weakness during exercise;
  • decrease in muscle volume;
  • Difficulty doing physical work.

Symptoms of muscle atrophy never appear acutely, they are characterized by a gradual increase. The pathology develops gradually, it may take years before it is diagnosed.But a decrease in the volume of the affected muscle can be observed at an early stage of the development of pathology.

Over time, atrophy of the thigh muscles leads to the inability to walk for a long time and quickly, climb stairs, even getting out of bed can be difficult.

With atrophy of the heart muscle, the patient complains of an uncontrolled increase or decrease in heart rate, sudden flushes of heat to the face, periodic numbness of the fingers of the upper extremities, shortness of breath during physical exertion, and then at rest.Atrophic changes in the heart muscle are considered the most dangerous, since in the absence of adequate treatment they can lead to death.

Treatment of muscle atrophy

Even knowing what diseases are accompanied by muscle atrophy, the doctor must prescribe additional examination methods and only after making an accurate diagnosis will determine the treatment. Often, after stabilization of the general condition, stopping the progression of the underlying pathology or transferring it to a state of remission, signs of atrophic changes in muscle tissues also disappear.With genetic diseases, it is impossible to completely stop the progression of the described pathology, but it can be slowed down.

General principles of treatment of muscle atrophy imply:

  • drug treatment;
  • 90,019 physiotherapy procedures;

    90,019 sports activities.

Drug therapy is prescribed on an individual basis. These can be pain relievers, non-steroidal anti-inflammatory drugs, which will be relevant for severe pain syndrome.An individual approach is especially important when choosing a treatment for pathology in children – for example, in the treatment of atrophy of the leg muscles in a child.

Therapeutic exercises and massage are of great importance in the treatment. Exercises for muscle recovery with atrophy are developed on an individual basis. At first, they are performed under the supervision of a specialist, further classes can be conducted independently at home.

Competent treatment, compliance with all the recommendations of doctors prevent the progression of pathology, the patient can live a full life for a long time.

For more information about the pathology, as well as about which of the specialists performs massage for atrophy of the muscles of the lower extremities, you can find out on the pages of our website Dobrobut.com.

Mash me completely – how to thank the body before, during and after the hike

Healthy sleep

The first and most important thing before the hike is to get some sleep. Your cardiovascular system will express gratitude for such a task for many years to come. Get at least eight hours of sleep.Otherwise, during the ascent, hi shortness of breath, tachycardia and general weakness. Lack of normal sleep + physical activity – a cocktail, in principle, is not useful, but it even sounds so-so.

You are already in the mountains, the sun is shining, the birds are singing, which means it’s time to do a little exercise. Warm up your joints, remember school and physical education lessons. A banal exercise will help you. Try to do it not once a month, before the hike, but every morning. Muscles in good shape are the main protection against injury. Squats, bends left and right, circular rotation of the pelvis, every morning such a half-hour “party” with invigorating music, will help you wake up more than a double coffee.

The main work today is performed by the legs; you can alleviate their fate with the help of a warming ointment or newfangled sports tapes.

Catch your pace

Trekking is not a race. Enjoy the scenery, breathe and walk. Slowly but surely. Musculoskeletal experts advise taking a wider step and walking with as few stops as possible. Not trying to keep up with someone quicker. You cannot jump higher than yourself, but you will have to stop to restore your breathing every five minutes.When children start to overtake you, who have caught their pace and are not trying to prove anything to anyone, it will become completely offensive. Basic principles: step wider, breathing evenly. Do not monitor the speed of movement, the decisive factor when trekking is to track changes in well-being and be on the alert.

Contrast shower

The hike is over, you are at home, proud, happy, rich in endorphins. It’s time to pay your respects to your feet. Five to ten minutes of a contrast shower is enough to relax tired muscles.Apply on the feet a cooling venotonic cream, such as “Shark fat”, the cost of a tube in any pharmacy is about 1500 tenge. A series of gel-balms “Foot Care” with a cooling and toning effect will also help your feet to relax. In the Central Pharmacy, the price for it starts from 700 tenge. The body is your transport, make sure it stays on track.

Ice massage or cryotherapy

Ice can be prepared in advance or purchased at the supermarket on the way home.You wrap a couple of ice cubes in cheesecloth and massage your legs from thighs to feet. Continue for 20 minutes. The main task is to lower the body temperature, then it will become easier for the muscles, and more pleasant for you. Agree – it’s great to walk briskly, not only uphill, but also the next day.

Lymphatic drainage underwear

It would seem, what does “shaping” underwear and hiking in the mountains have to do with it, unless you plan to lose a couple of kilos. It turns out that sports compression underwear helps not only to get rid of excess weight, but also to recover after a hike.All you need is to put on your legs in cute special leggings, and – in a bunk. In the morning, no swelling and muscle pain.

Warm salt bath

The water temperature should be as hot as possible, which is strictly individual in each case. Be careful. You are not a chicken, and a bath is not a pot of broth. Here, sea salt is added not to taste, but 1 tablespoon per container. Don’t forget to enjoy the immersion. Hot water improves blood circulation and speeds up metabolic processes.Sea salt removes toxins from the body, so muscles regenerate faster. The playlist “total relaxation” will relax you mentally. Get ready to sleep sweetly and wake up like a cucumber.

Try to follow the above tips before the next ascent, and the stairs on the way the next day after the hike will not seem like a test.

“Cancer on the mountain” says hello to the chiropractor, chiropractor and just a pleasant companion Ermek Koilyubaev.