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Soreness vs Injury - How Can You Tell the Difference?

Have you ever gone through a workout and the next morning you feel like you can’t get up out of bed? Was there a moment where you thought, “Uh oh, this is going to be bad,” only to completely forget about it three days later when the pain went away? Sometimes soreness can be so intense that it is very difficult to tell the difference between an injury and soreness following an activity or a workout. Here are a few ways that can help distinguish between the two.

1. When Did the Pain Start?

Soreness from an activity or workout is referred to as Delayed Onset Muscle Soreness or DOMS because the pain can begin from the conclusion of your workout to 72 hours later. On the other hand, an injury will usually be painful immediately (think hamstring strain) although this is not set in stone. Some injuries can have a delayed pain response which is why we need to look at other questions such as…

2. How Long Has the Pain Lasted?

DOMS will generally end following the 72 hour window after your workout and then it will feel like it never happened at all. At the very least, the pain should progressively decrease as you get further and further away from the initial workout. With an injury, the pain likely will last longer than 72 hours and can stay at a similar level of pain for the first 72 hours until the acute stage of inflammation has passed.

3. What Type of Pain Are You Experiencing?

Pain due to DOMS will usually feel like an ache or a dull pain but it should not feel sharp. Pain due to injury can feel similar to DOMS by feeling achy or dull as well, but a sharp pain is usually indicative of an injury (think of pain that catches your breath).

4. Was Your Workout Different Than Normal?

DOMS is much more prominent after completing a workout that involves new exercises or new ways to perform the exercises. Studies show that the eccentric movement (the opposite of lifting the weight, e.g. bringing the weight down during a bicep curl) influences the level of DOMS felt with prolonged eccentric time causing increased DOMS. There is also a neurological influence which is why starting a new training program will cause a high level of DOMS early on followed by less as you go through the program. If you have a significant level of pain and your workout or activity has been consistent, chances are you are looking at an injury.

If after going through this checklist, you think you may be experiencing an injury it is always a good idea to be evaluated by a medical professional. At Hamilton Chiropractic in Belmont, CA Dr. Ryan Hamilton, a musculoskeletal injury specialist, has extensive experience in diagnosing and treating injuries related to exercise and sports. Dr. Hamilton uses a variety of soft tissue techniques to get his patients out of pain as quickly as possible and takes his time to treat each patient on a case to case basis. Give Dr. Hamilton a call and start your road to recovery at (650)394-6045 or visit our website at

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