PERSONAL HEALTH : When Aching Muscles Tell You You’ve Overdone Things

Just when you feel smug about going that extra workout mile, it hits: the quivery, achy feeling that can spell trouble. A day or two later, sure enough, your muscles are so sore you suspect internal bleeding.

It’s the overdo syndrome, or what exercise experts call “delayed onset muscle soreness” because the muscle pain sneaks up and then peaks in about 48 hours. It plagues novice exercisers, but can strike even very fit people, especially if they switch routines or intensify a regular workout.

Researchers and exercise experts concede that you can’t completely avoid muscle soreness--nor should you want to, because it’s a sign your body is repairing itself. But there are ways to minimize the pain and suffering.

What’s Happening Inside

If you’ve ever had sore muscles, you know the script: You’re working out more intensely than usual, impressed with yourself. “Then about 12 to 18 hours later, you’re going, Wow, “ says Scott M. Hasson, associate professor of physical therapy at Texas Woman’s University, Houston, who has researched the condition. Your muscles suddenly feel swollen. The swelling worsens for about two days before declining.

Here’s what’s happening beneath the skin: At some point during the intense exercise, your muscle reached a critical point and could no longer control the contraction, Hasson explains. Damage occurs in the form of “micro-trauma.”

Next, inflammation starts. It doesn’t feel good, but it’s good for you in the long haul. “If we could stop inflammation completely, we would not achieve healing or strengthening of tissues,” Hasson says.

Once damaged, muscles release prostaglandins, naturally occurring substances that attract white blood cells to the area. “Then more fluid moves in, so you begin to get swelling,” Hasson says. The entire damage and repair process might take a week and a half.

The Medical Approach

Taking ibuprofen, a non-steroidal anti-inflammatory drug, has been a mainstay of relief once sore muscles occur. Lower-strength ibuprofen (Motrin, Advil) is available without prescription.

But taking ibuprofen before a particularly grueling workout might be an even better strategy, Hasson found in a recent study. His research team compared 20 participants who all did the same exercise: stepping up on a very high step while carrying a backpack, completing 150 muscle contractions in all.

Those who took the ibuprofen after exercise had a decrease in soreness, but those who took it before exercise fared the best. They had about 50% less muscle soreness than people in the other group, says Hasson, whose study was published in Medicine and Science in Sports and Exercise.

The ibuprofen didn’t prevent the muscle damage that normally accompanies exercise. Taken ahead of time, the drug probably works by modifying the release of the prostaglandins, lessening swelling and soreness, Hasson speculates.

But he warns exercisers not to exceed the recommended ibuprofen dose and says they should not take it routinely before exercise. Chronic use can increase risk of stomach ulcers and kidney and liver problems. Consider taking ibuprofen, he says, before the first day of skiing or the first day of vigorous gardening, which might trigger soreness.

Taking acetaminophen (such as Tylenol) probably won’t help. In a study, Hasson found no difference between acetaminophen and placebo in alleviating muscle soreness. He has not studied the use of aspirin to relieve muscle soreness but suspects its effect would be similar to ibuprofen’s.

The Crystal Ball Factor

In another study, Hasson asked subjects to squat slowly after the exercise session and to notice any perceptions of shakiness and fatigue in the worked muscles. If they felt the symptoms, that was their cue to take anti-inflammatory medicine, says Hasson, who will present the findings this week at the annual meeting of the American College of Sports Medicine.

Instead of taking a drug beforehand, Hasson says, it might be better to notice if your muscles feel very shaky and weak after a vigorous activity and to take an anti-inflammatory medicine then.

Hair-of-the-Dog Approach

The temptation is to stop moving if your muscles are sore. Wrong approach, say experts. Work it out, gently.

“Active rest is better than doing nothing,” says Don Yakulis, a physical therapist and athletic trainer at St. John’s Hospital and Health Center, Santa Monica. Just decrease intensity and duration, he says. A sore runner might walk slowly; a swimmer could cycle slowly.

If you have muscle soreness and don’t think it’s a serious muscle tear, working the muscle with high-speed contractions (with low or no resistance) can reduce next-day soreness, Hasson has found.

Rub, Spray or Both?

Drugstore shelves overflow with remedies for athletic overachievers. Added to the arsenal of traditional rub-in pain-relieving creams are newer sprays, touted as more convenient.

One example is Mentholatum Deep-Heating Sports Spray, which works by “interfering with the pain sensation,” says a spokesman for the manufacturer. Active ingredients are methyl salicylate, menthol and camphor. Another option, Sportscreme, promises on the label that it actually smells good, a claim not made by some other manufacturers. The active ingredient is a kind of salicylate.

Some exercisers use the creams or sprays both before and after exercise to minimize soreness. They can also be used in conjunction with muscle massage.

Common-Sense Strategies

To minimize muscle soreness, Yakulis advises exercisers to alternate activity, such as swimming one day and walking the next.

Beginners should “build up intensity, frequency and duration gradually,” he adds. Stretch before and after exercise. Take rest days when your body tells you it needs them.

The Vitamin Solution

Vitamin E supplements seem to reduce the muscle damage that accompanies a vigorous exercise routine, says Mohsen Meydani, an associate professor of nutrition at Tufts University Human Nutrition Research Center, Boston, who compared exercisers who took the vitamin with those who took a placebo. Those on 800 international units of Vitamin E daily had less exercise-induced muscle damage, Meydani reported in the current Journal of Applied Physiology.

Such reduced muscle damage might reduce muscle soreness, says Meydani, but he did not measure muscle soreness for the study. For now, he says Vitamin E might be particularly helpful to those exercisers who work out long and hard. Even less than the dose used in the study might help, he says.

The recommended daily allowance of Vitamin E is 30 international units, but doses of 100 to 800 are often tolerated by adults. Even so, consulting your doctor is advised before taking supplements.