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The Athlete’s Guide to Muscle and Joint Pain

How to evaluate and care for your injuries

By Carolyn Mazur P.T., D.P.T., M.P.T., A.T.C., A.R.T.

Doctor of Physical Therapy

As a physical therapist and athletic trainer one of the most frequent inquiries I get is why do I have muscle and joint pain? Muscle and joint pain can be a huge obstacle to an athlete pursuing his or her fitness goals; they can interfere with the achievement of proper body mechanics, affect the daily training regimen and inhibit proper nutrition and hydration.

Why do I have muscle and joint pain?

In normal circumstances, muscle and joint pain are caused by “operator error,” which means that they are caused by something the athlete is doing or NOT doing. The following are some common reasons for muscle and joint pain and some suggestions on how to keep the problem pain away from your human motion machine.

DILEMMA: Not enough warm up before activity.

Solution:

Many athletes come to me with the same song: “I stretch before my activity -- I even do yoga.” Yoga is not a warm up for a workout; it is an activity of its own! A better choice for a warm up would be mimicking the activity that you are about to participate in. For example, if you are going out for a run, warm up with a fast walk first. Add some high knees and donkey kickbacks, windmills with your upper body mixed with some stretching of the large muscle groups. Hold each stretch 5-7 seconds. Pre-activity should last about 7-12 minutes and ease its way into the workout regimen.

DILEMMA: Use of heavy weight with low reps.

Solution:

Little compares to the beauty of the PUMP, but remember, those who pump heavy pay heavy. Heavy lifting takes a toll on muscles and joints! If you’re going to lift heavy, start with lighter weights, first making sure you are going through the full range of motion and concentrating on the muscle group you want to stress. Then, when ready to start the heavy pump, use a spotter who can assist you during those last few heavy reps. Take it from Hans and Franz, a workout buddy can keep you “pumping up” for a long time to come.

DILEMMA: Overtraining which includes working out long periods of time and/or working out too often.

Solution:

Work out smarter not harder! Make sure your workout meets your goals. Working out for long periods of time or too often can cause undue stress on your body, resulting in the breakdown of body tissue and over production of a steroid hormone called cortisol. Cortisol LOVES to eat muscle, so the overproduction of this hormone can cause the body to “eat away” at weakened muscle and tissue and can also compromise the body’s immune system. Overtraining could waste all your hard work, and you could deprive your body of what it needs to keep you healthy, lean and strong. Hiring a qualified athletic trainer, fitness coach or physical therapist to evaluate your unique sport to make sure you achieve your goals is the best investment any athlete could make.

DILEMMA: Lack of proper form during fitness activity.

Solution:

Without proper form exercise that is meant to keep you healthy could lead to injury that delays or even permanently blocks your road to health and wellness. Paying close attention to body alignment, keeping proper posture and focusing on the body’s core strength will help to prevent injury from happening. Working out in front of a mirror or with a friend who can give you positive feedback is always recommended.

DILEMMA: Improper nutritional intake and/or lack of hydration and electrolytes during and after workouts.

Solution:

You have to pay to play, and the payment required during exercise is nutritional fuel even if your brain is telling you that you are not thirsty and/or hungry. The tank has to be filled appropriately according to the intensity and duration of the workout. Once the body goes into a caloric deficit or becomes dehydrated, it could take days or even weeks to return to its normal state. That would take time away from your main squeeze – fitness! The best preventive medicine is making sure you replenish your body with the proper fluids and foods that were lost during the workout. If you question what your intake should be, seek the advice of a qualified nutritionist to evaluate your sport and the demands it places on your body.

DILEMMA: Not enough recovery time between workouts.

Solution:

Insufficient rest can result in repetitive muscle tearing and shearing of the joints causing scar tissue to form. Scar tissue is fibrous connective tissue that forms a scar; it can be found on any tissue in the body where injury has taken place and then healed. Thicker than the surrounding tissue, scar tissue has a limited blood supply and is limited in function, including movement, circulation and sensation. Its clumpy consistency can impair proper movement patterns of the body and lead to overuse and repetitive injuries. For that reason, giving the body proper rest between workouts can prevent scar tissue from forming

What is the muscle and joint pain I am feeling?

The pain and discomfort associated with muscle and joint pain could come from a variety of sources and needs immediate scrutiny. It could be arthritis, which isn’t just for “old “ people anymore. There are two types of arthritis, osteoarthritis and rheumatoid arthritis. Osteoarthritis is the most common for athletes and can be linked to working out; it is caused by wear and tear of the joints. What usually occurs is that the cartilage between the bones, which cushions the joint, becomes rough and calloused causing added friction and pain when the joint is put into motion. Pain caused by osteoarthritis is often alleviated by a well-designed workout regimen, but if pain persists and/or increases during the workout, the athlete should stop immediately and seek medical advice.

It also could be bursitis, which is caused by damage to the bursae sacks, which are filled with fluid and located at the end of the joints. The purpose of these sacks is to cushion the joints against friction. When the sack becomes damaged, it can’t do its job, so the joint is exposed to additional pressure and friction and becomes vulnerable to injury. If you experience bursitis pain, workouts should be modified to eliminate pain to the bursae area. Bursitis can be difficult to heal and repair of the sack can take anywhere from 4-12 weeks. To best prevent this injury, pay attention to the pain signals and watch out for any swelling, redness or hotness of the joint. If any of these symptoms occur, immediately discontinue activity. There are many ways to combat these symptoms once they rear their ugly heads – the modification of exercise, stretches and utilization of rest, ice, braces, compression bandages, kinesio tape and, of course, physical therapy.

Another common injury leading to pain and discomfort is tendonitis, an inflammation of the muscle tendon usually close to the origin and/or insertion on the bone, which can cause pain/discomfort, swelling and even burning at and surrounding the affected area. Tendonitis can be tricky because exercise can cause it to become inflamed and irritated, but, at the same time, the strengthening of the surrounding weaker tendons and tissues can decrease the stress placed on the affected tendon. Specific exercises should be implemented to encourage strengthening of the area, but you should be careful not to increase pain/discomfort to the area. Again, seeking the advice of a physical therapist to assist with treating symptoms is the best policy to avoid further damage or delay your return to the sport of your choice.

Pain and discomfort should grab your attention. If you experience any symptoms, they should be monitored. “No pain, no gain” does not always mean ignoring symptoms and pushing through to reach your goal. The pain you are ignoring could cost you valuable time away from your health and fitness goals.

Any questions, comments or further inquiries pertaining to the above information are welcome and can be addressed to: cmazur@fusion-pt.com.

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