Search Results: hangover

Avoiding the Exercise Hangover – Muscle Soreness

This morning I woke up suffering from DOMS.  You may be wondering why a health and wellness blog is writing about avoiding self-inflicted excess but the lesson in this case is not to moderate my consumption of expensive champagne but rather to reconsider my approach to exercise.  Good pain, sweet pain or the more formally designated term Delayed Onset Muscle Soreness (DOMS) refers to sensations of stiffness, discomfort or pain that doesn’t come on immediately, but is felt for several days after exercise.

Some consider these sensations as essential.  They don’t believe they have had a good enough workout unless this deep ache reassures them that they have taken it to the Max.  Although these pains are not uncommon when starting a new workout, like the hangover, DOMS is a marker that not only did we reach our limit, we have overdone it.

Why do I feel muscle soreness after exercise?

Looking at DOMS from the cellular level provides insight into the cause of these sensations as they are markers that the intensity of your workout has been sufficient to destroy muscle cells.  It is the process of myonecrosis (muscle death) that comes from tearing tissues which creates the irritation you feel. Fortunately, unless you have over done it, this localized tissue injury does not affect the entire muscle. This micro-trauma acts as a catalyst, telling your body that these muscles need to be rebuilt stronger to prevent future strains.

Rest builds strength

Creating a catalyst to build strength is the primary goal of exercise however it is not the exercise that builds the strength but rather whether you have provided sufficient time for recovery.  It is important to shift your thinking to recognize that exercise causes weakness. During the process of myonecrosis you have fewer muscle cells to draw on and your strength is less, not more. During the DOMS period you are more prone to injury and the harder you have exercised the longer you are at risk.

Our knowledge that this initial period of weakness is followed by the rebuilding of the muscle is why most exercise programs are built on a day on, day off strategy.  Providing you have not done too much damage, following this format will give your muscles sufficient time to repair before you expose them to the next catalyst – when we demand even more than we asked for the last time. The key is to repeat the exercise to keep getting stronger, but not until the DOMS is gone.

Although it is occasionally okay to experience DOMS in an exercise program I prefer to avoid it in therapy.  I find the period of waiting for DOMS to abate slows your recovery as it can take days or weeks before your recovery allows us to apply the next catalyst.  I also find that for some people the line can be too fine for avoiding injury if we select the maximum level to build strength.  Working at a lower intensity still gets me what I want, and lowers your risk for set-backs.

This perspective is permeating the training world as even for athletes the presence of DOMS is now controversial.  My exercise physiology text tells me that a good workout prevents DOMS, not causes it.  In other words, you may get some soreness when you first start a program but the right exercises ultimately protect you from these symptoms.

How to build strength and avoid injury

To build strength and avoid DOMS I use the following guidelines:

  1. Begin by thinking about your current level of strength. How active have you been recently?  What does your activity APP tell you about the number of steps you have been taking per day[1]?  This provides a baseline for the intensity of your program.
  2. If you are returning to exercise after an hiatus consider having a fitness assessment with a knowledgeable fitness professional. This should help you to select the initial level of demand.
  3. If you are returning to fitness after injury or have had difficulty avoiding injury when you exercise, then I recommend you work with a health professional who looks for underlying problems.  Often injuries leave behind specific weakness, tightness and/or compensatory patterns which need to be corrected before you can successfully engage in a general fitness program.
  4. Tax your muscles at a level to create the catalyst to build strength but below the level of DOMS. As my colleague, John Gray referenced in his recent Blog you should increase your exercises by 5-10% to avoid re-injury.  Working at a 4-6/10 effort level is another good rule which I find prevents over-strain.
  5. Use a higher repetition, lower load format. A good general rule is if you can’t do at least 8 reps, the exercise is too hard.  If you can do over 25 – you are likely dogging it, go to the next level.
  6. Always build in recovery time. The harder you exercise the longer you need to recover.  If you want to work out every day have more than one workout.  A well-planned program will allow you to rest one set of muscles while you work out another.

Training for success

Right now I am rethinking my exercise strategy.  As my DOMS recedes I know I dodged the bullet.  I pushed to the Max but fortunately avoided injury.  However I don’t plan to keep testing my luck even though I am still planning to go back to that killer Yoga class. Right now I am including some treatment with our registered massage therapists as research shows that this treatment hastens exercise recovery. I am starting to do a bit more work on my own.   I plan to take some instruction from my physiotherapy colleague and Yoga instructor to improve my technique.  This prep will help me to raise my strength and limit my exercise hangover.

Moderation learned!



[1] Your goal should be to average between 8-10,000 steps per day.

Improving your Results with the New Exercise Tracker

The therapists at the Orthopaedic Therapy Clinic (OTC) are always looking to improve how you can achieve your goals.  Recently we have been working in partnership with our exercise software provider to improve your experience.  They are piloting an exercise tracker and we are on-board to try this upgrade with our clients.

What does this mean to you and your recovery?  View the video here.

How often are you doing your exercises?

You can now record your consistency in your exercise tracker.  The tracker allows you to mark off each exercise on a calendar.  This can help you to stay motivated as well as showing your therapist your consistency to your program.

How long does it take to do your exercises?

You can now time your sessions. The program has a built-in timer.  Just click on the stopwatch feature and it will time how long your program takes.

Get interrupted in mid-program?  No problem! Hit the pause button and then resume when you are back on track.

Why do we care how long it takes to do your exercises?

We know that as you improve the exercises are completed more quickly.  This can be a good measure of progress.

We also don’t want you to spend too long on your program.  Our goal is to provide an efficient and effective program.  This data  assists in creating a good dialogue on what is enough and what is too much in your recovery program.

Pain tracking

There is an option to record your pain during each exercise.  This helps us to know if an exercise appears to be irritating and to see if it is getting better or worse over time.  Remember that we don’t like pain increases to last more than a short duration (under 30 minutes) and that it should not be substantial increase i.e. more than 2 points from your baseline pain.

Ready to participate?

Next time you are in the clinic ask your therapist to show you how to use tracker function.  There are some features that are customizable.  For example if pain is a concern this feature needs to be enabled by your therapist for each exercise that you want to track.

If you are managing well and want to update your exercises or just learn to use the tracker – book into our see our kinesiologist John Gray.  If you need modifications in your exercises to manage your injury or pain then book into to see your physiotherapist and he/she can show you the tracker as part of your appointment.  Call us at 416-925-4687 or email to book an appointment.

Remember this is a pilot so there may be a few glitches.  Let us know what you encounter and we will feed it back to the software company for improvements.

Run, Walk or Jog your Discs to Health

Degenerative disc disease, black disc disease, dehydrated or desiccated discs. When faced with these seemingly bleak diagnoses you may wonder if there is anything you can do to have healthy discs again?

Knowing that these diagnoses indicate a lack of hydration could a type of food help?

Is there a vitamin to take?

Or should we simply drink more water?

female and male runners outdoors


Up until recently the answer was an unequivocal “we don’t know”.  There was little to no research directing us in how to heal or improve the health of your disc.  The widely-held view in the spine community is that the disc as a structure, unless protected, only gets worse.

That is until a study recently published in Scientific Reports convincingly demonstrated that discs are like many other tissues in the body.  Stress them and they get stronger.  The key message is that if you walk, jog or run – the right amount – your disc becomes more hydrated!

Discs are better when they are stressed

How much is enough?

Before getting on the bandwagon and starting a running routine, the question to consider is how much is enough and what is too much.  Up until now, running was perceived by the spine treatment community as injurious to the discs.  We medical-types watch the joggers, cringing at the stresses they put through their joints.  The high level of compression generated with every step sounds to us like nails on a chalk board.

Looking at articles published on the forces associated with running provides some insight as to why the medical community thinks the way we do. Many articles have looked at the ground force[1]  generated when we run.  Ground force is a measure of how hard we hit the ground.  An average jogger is estimated to hit the ground at a minimum of 3x body weight whereas the 100 M sprinters generate upwards of 7x body weight.  Calculate the forces for a 150-lb. person and the math tells the story.  The pressure ranges from 450 lb. to 1050 lb. for every step they take.  It’s no wonder that the medical community’s general perspective is that running is ill-advised for our spine’s health.

Tissues adapt to stress

Discs improving with exercise represents a seismic shift for the spine community.  Up until now we have only looked at what harms the disc.  However, when we look at the science of physiology this conclusion seems logical as it is supported by our knowledge of how other tissues function.  We know that for many tissues in the body there is an optimum level of stress.  Do too little or too much and your tissues won’t be healthy.

We explored this concept last month in my article on Delayed Onset Muscle soreness (DOMS[2] and its relation to injury.  The concept of strain causing muscles to adapt is well known. We understand that if we exercise the right amount we become stronger.  If we exercise too hard or repeat a stress before our muscles have had time to recover these tissues weaken and ultimately damage (tear, sprain, etc.).

We also know this principle holds true for the bones.  The oft-quoted Wolff’s law states “bones conform to the stresses placed on them”.  This principle forms the basis of exercise treatment used in osteoporosis and bone fracture prevention.

The same can be now said about your discs.  Put the right amount of strain on the tissue and your discs will adapt and strengthen, too much and they dehydrate.

The science behind pushing your disc

The walking effect is not surprising.  For decades we have known that this is one of the best treatments for back and neck pain.  What we haven’t known is why.  In this Australian study the results were confirmed using MRI.  Applying a T2 protocol, where the water in the disc is white, they measured the T2 times[3] and the glycosaminoglycan[4] content.  These proven measures of disc hydration were better in the group that exercised regularly at the optimum intensity.

This study gives insight into what can make our discs better.  To be healthy the disc needs to be stressed.  But the most important point is that the stress needs to be at the right amount.  The researchers called this the “right anabolic window”.

When it comes to exercise there are two basic ways to work out.  The steady paced aerobic workouts or the anabolic programs where the intent is to create an oxygen deficit.  This anabolic deficit is the principle behind the current trend of short, high intensity bursts.  Based on this study it is now the principle to follow to stress the discs.

The key to using an anabolic approach is to not incur too much of an Oxygen deficit.  Fortunately, this study gives us the ideal stresses to promote a healthy disc. They found that when the movement was too slow (<1.5 m/sec) the hydration in the disc did not improve.  When the movement was too fast (>2.5 m/sec.) the disc hydration worsened.

How to strengthen your healthy discs 

Consider speed

You need to apply the right amount of strain. Target the optimum anaerobic window of between 1.5 m/sec and 2.5 m/sec. This means you should set a pace of between 7 and 11-minutes per kilometer. At our clinic, we are measuring your speed of walking to determine your baseline.  Once we know if you need to slow down or speed up we provide music choices to help you maintain the optimum speed.

Consider age

This study was conducted on 25 to 35-year-old, experienced runners. If you are over the age of 35 and/or not a regular runner, get advice before you start.  Imbalances, postural problems and/or weakness can change your health initiative into a recipe for injury.  My associate, Svetlana Marianer’s articles on running shows that applying excessive stresses is a major factor in a wide range of running injuries.

Consider distance

This study looked reviewed a range of distances.  The minimum they considered was 20 km. per week and this distance was sufficient to see an improvement.  Some runners did in excess of 50 km. per week and providing the speed was within the optimum rate there was no negative impact on the disc.

Consider injury

If you are coming off an injury, consider seeing your health professional prior to starting your program. Have them assess for imbalances and prepare a program to correct any lurking problems before your healthy initiative is derailed into a painful injury.

Consider your baseline fitness

Many of us have just come off an inactive winter.  If you have been less active then start your program a bit slower or see your fitness professional for an assessment prior to starting your program.

Where to start

There is still a lot more research to do in this area and we hope that these scientists have just gotten started.  We have yet to see what the impact of exercise is on people with known disc degeneration but this looks promising as we know that exercise is one of the most effective tools in improving physical function with low back pain. This study is an amazing start into prevention of degenerative disc disease and ultimately should help us with tailoring your exercise programs to help you heal your discs.

Who to see

To get started if you are otherwise healthy but inactive and need help in implementing these recommendations into your exercise program, see a member of our therapeutic fitness team.  Claire Curtis and John Gray will help you to know whether you are within the therapeutic range when you exercise.  If you are injured or coming off an injury we recommend seeing one of our physiotherapists to look for imbalances prior to resuming a full and active exercise program.  Svetlana Marianer is our go-to physiotherapist for analyzing your walking or running techniques to reduce risk of injury. Gareth Sneath, is certified in bonefit, and provides guidance on how to exercise to prevent and manage osteoporosis.  Contact us at 416-925-4687 to book an appointment or go to to read more on these topics.

[1] There have been a variety of reports on ground forces, all indicate high pressures with running

[2]Delayed Onset Muscle Soreness

[3]T2 times have been shown to correlate with water and proteoglycan content in the disc.

[4]Glycoaminoglycan’s are protein and sugar based substance found in the disc.  One of its function is to promotes water to return into the disc.The pressure of our body on the disc encourages water to leave the disc resulting in the well known phenomena of being taller in the morning that at the end of the day.