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Deep Muscle Soreness after Prolonged, Intense Exercise

You should stop exercising for several days when you feel deep muscle soreness after very long exhaustive exercise such as running a marathon (26 miles), cycling a century (100 miles), going on a very long hike or lifting heavy weights repeatedly for a long time. Prolonged deep muscle soreness after running a long distance very fast is characterized by severe damage to the muscle fibers themselves. The muscle fibers are torn, the cell membranes are ruptured and the internal content of cells leak outside into the surrounding tissue (J Neuro Sci 1983;59:185-203). Of course, you do not need to stop exercising for the mild muscle soreness that you feel after a normal hard workout.

The deep muscle soreness that follows hard running is far less likely to occur in cyclists, swimmers or athletes in other sports because running causes eccentric contractions, while swimming and cycling usually do not. Muscles move your body by pulling on bones when they shorten. However if your sport forces muscles to lengthen when they contract, the severe force on the muscles caused by eccentric contractions (stretching during contraction) tears the fibers and ruptures the membranes. When you run fast, particularly down hills, your thigh muscles try to keep the knee and hip from bending excessively when your heel hits the ground, and they are stretched and torn.

The severe soreness from muscle damage is virtually always reversible, will almost always heal completely without treatment, and is part of the training process. Mild casual exercise does not help you to heal faster, so you might just as well curtail your running for a few days until the soreness lessens. You should not resume intense exercise until the soreness disappears completely.

Highly trained, competitive athletes will recover faster by eating a diet rich in protein and carbohydrates. However, less-conditioned people with muscle soreness will only gain weight if they increase food consumption.

Although many athletes believe that massage, stretching, or cross training help to relieve deep muscle soreness, scientific research has failed to prove that they actually hasten the recovery process.

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Dear Dr. Mirkin: Do all people develop high blood pressure when they take in too much salt?

No! Only some people are salt sensitive and develop high blood pressure when they take in too much salt. A recent study showed that people who exercise are far less likely to suffer high blood pressure from eating food with excess salt intake (presented March 23 at the American Heart Association's Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention 2011 Scientific Sessions).

In this study, 1,900 Chinese adults were placed on 3,000 milligrams of salt a day and then 18,000 (ten times the recommended daily allowance for salt). Those whose blood pressure increased more than five percent when changed from the lower to higher salt are salt sensitive. Those who exercised the most had a 38 percent lower risk of being salt sensitive than those who exercised the least.

Regular exercise increases your need for salt because you lose salt though sweat. Most people should not add a lot of extra salt to their food. All healthy people should think about getting more exercise.

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Dear Dr. Mirkin: Can vitamin D stop the muscle pain and damage caused by statin drugs used to lower cholesterol?

Possibly. Although not proven, two studies associate vitamin D deficiency with muscle pain and damage in people taking statin pills (Atherosclerosis, March 2011). Before vitamin D can perform its many health benefits, it must first attach to special receptors on cells. All muscles have the vitamin D receptor and a deficiency of that vitamin can cause muscle damage. Therefore, anyone who suffers muscle pain and damage after taking statin drugs should have a blood test for vitamin D3. If it is below 75 nmol/L, a trial of 2000 IU of vitamin D may be indicated.

Statins incude Crestor® (rosuvastatin), Lescol® (fluvastatin), Lipitor® (atorvastatin), Mevacor® (lovastatin), Pravachol® (pravastatin), and Zocor® (simvastatin).

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Recipe of the Week:

Creamy Asparagus Soup

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April 3rd, 2011
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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