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How to Recover from Muscle Soreness Caused by Intense Exercise

Muscle soreness should be part of every exercise program. If you don't exercise intensely enough on one day to have sore muscles on the next, you will not gain maximum fitness and you are also losing out on many of the health benefits of exercise. The benefits of exercise are much greater with intense exercise than with casual exercising.

You must damage your muscles to make them grow and become stronger. When muscles heal, they are stronger than they were before you damaged them. All athletes train by "stressing and recovering". On one day, they take a hard workout in which they feel their muscles burning. Eight to 24 hours after they finish this intense exercise, their muscles start to feel sore. This is called Delayed Onset Muscle Soreness (DOMS). Then they take easy workouts until the soreness is gone, which means that their muscles have healed.

DOMS IS CAUSED BY MUSCLE DAMAGE. Muscles are made up of fibers. The fibers are made up of a series of protein blocks called sarcomeres that are lined in a long chain. When you stretch a muscle, you stretch apart the sarcomeres in the chain. When sarcomeres are stretched too far, they tear. Your body treats these tears in the same way that it treats all injuries, by a process called inflammation. Eight to 24 hours after an intense workout, you suffer swelling, stiffness and pain. The most beneficial intense exercise program is:

• severe enough to cause muscle pain on the next day, and
• usually allows you to recover almost completely within 48 hours.

ACTIVE, NOT PASSIVE, RECOVERY: When athletes feel soreness in their muscles, they rarely take days off. Neither should you. Keeping sore muscles moving makes them more fibrous and tougher when they heal, so you can withstand greater forces and more intense workouts on your hard days. Plan to go at low intensity for as many days as it takes for the soreness to go away. Most athletes try to work out just hard enough so that they recover and are ready for their next hard workout in 48 hours.

TIMING MEALS TO RECOVER FASTER: You do not need to load extra food to recover faster. Taking in too much food fills your muscle cells with fat, and extra fat in cells blocks the cell's ability to take in and use sugar. Sugar is the main source of energy for your muscles during intense exercise. Using sugar to drive your muscles helps them to move faster and with more strength.

Timing of meals is more important than how much food you eat. Eating protein- and carbohydrate-containing foods helps you recover faster, and the best time to start eating is as soon as you finish a hard workout.

At rest, muscles are inactive. Almost no sugar enters the resting muscle cell from the bloodstream (J. Clin. Invest. 1971; 50: 2715-2725). Almost all cells in your body usually require insulin to drive sugar into their cells. However during exercise your muscles (and your brain) can take sugar into their cells without needing insulin. Exercising muscles are also incredibly sensitive to insulin and take up sugar into their cells at a rapid rate. This effect lasts maximally for up to an hour after you finish exercising and disappears almost completely in around 17 hours. The best time to eat for recovery is when your cells are maximally responsive to insulin, and that is within a short time after you finish exercising.

Not only does insulin drive sugar into muscle cells, it also drives in protein building blocks, called amino acids. The sugar replaces the fuel for muscle cells. The protein hastens repair of damaged muscle. Waiting to eat for more than an hour after finishing an intense workout delays recovery.

WHAT TO EAT AFTER YOUR INTENSE WORKOUTS: Fatigue is caused by low levels of sugar, protein, water and salt. You can replace all of these with ordinary foods and drinks. If you are a vegetarian, you can replace your protein with combinations of grains and beans. You can replace carbohydrates by eating virtually any fruits, vegetables, whole grains, beans, seeds and nuts.

A recovery meal for a vegetarian could include corn, beans, water, bread, and fruits, nuts and vegetables. If you prefer animal tissue, you can get your protein from fish, poultry or meat. Special sports drinks and sports supplements are made from ordinary foods and therefore offer no advantage whatever over regular foods.

BODY MASSAGE: Many older studies have shown that massage does not help you recover faster from DOMS. Recently, researchers at McMaster University in Hamilton, Ontario showed that deep massage after an intense workout causes muscles to enlarge and grow new mitochondria (Science Translational Medicine, published online Feb, 2012). This is amazing. Enlarging and adding mitochondria can help you run faster, lift heavier weights, and even prevent heart attacks and certain cancers.

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NSAIDS DELAY DOMS RECOVERY: Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may help relieve pain, but they also can block muscle repair and delay healing.

HOT BATHS: Most research shows that a hot bath is not much better than doing nothing in helping muscles recover from exercise (European Journal of Applied Physiology, March 2006),

COLD OR ICE BATHS: A recent review of 17 small trials, involving 366 participants, showed a minor decrease in DOMS with ice water baths. They found "little quality research" on the subject and "no consistent method of cold water immersion" (Cochrane Library, published online February 15, 2012). Cold water immersion can reduce swelling associated with injury, but has not been proven to speed the healing of DOMS.


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Testosterone for Older Men

Six million North American men spend more than 1.6 billion dollars each year to take the male hormone, testosterone, by shots, pills, gels and patches. Many of them should not be taking testosterone because they do not need it. Furthermore, they may be harming themselves because testosterone can cause blood clots, strokes, infertility or liver damage; and increase the growth and spread of existing prostate tumors.

MEN SHOULD NOT TAKE TESTOSTERONE IF THEY HAVE ERECTILE DYSFUNCTION WITH HIGH DESIRE. Lack of testosterone almost always causes lack of desire, so men with erectile dysfunction and high desire need a careful work up of their hearts rather than a prescription for testosterone. The most common cause of erectile dysfunction is blocked arteries to the penis. Men who have this condition also usually have blocked arteries leading to the heart and are at significant risk for heart attacks.

WHAT IS A NORMAL TESTOSTERONE? 13.8 million North American men over 65 have low blood levels of testosterone. A normal blood level of testosterone is 250-800 ng/Dl. Testosterone levels start dropping after age 30, and continue to drop at the rate of one percent per year. Testosterone levels vary throughout each day and from season to season. Levels can drop in the winter, and rise after you exercise or make love.

WHAT ARE THE BENEFITS OF TAKING TESTOSTERONE? Low testosterone can cause depression, lack of interest in making love, bone loss, and muscle weakness. Therefore, a man with low levels of testosterone and loss of libido, depression, bone loss or muscle weakness may benefit from taking testosterone. However, many men who have blood levels below 150ng/Dl have no symptoms whatever and usually should not take testosterone.


• A man's pituitary gland in the brain produces a hormone called FSH, which stimulates the testicles to make a hormone called inhibin, which circulates in the bloodstream back to the pituitary to shut off FSH.

• The pituitary also produces another hormone called LH that stimulates the testicles to make testosterone.

• FSH and LH are both produced by the same cells in the pituitary, so the levels of FSH and LH rise and fall together.

• FSH causes inhibin levels to rise and LH causes testosterone levels to rise, so inhibin and testosterone levels rise and fall together.

• Since inhibin shuts off FSH and testosterone levels parallel inhibin levels, a rise in testosterone is associated with a fall in FSH, and a fall in testosterone is associated with a high rise in FSH.


As a general rule, no man should take testosterone unless he has:

• symptoms of a deficiency,
• low blood testosterone levels and
• very high levels of FSH.

MEN SHOULD NEVER TAKE TESTOSTERONE FOR INFERTILITY. Since taking testosterone raises blood levels of testosterone, it shuts off the brain hormones that stimulate the testicles. A man who takes testosterone will shut off the brain hormones (LH and FSH) that cause the testicles to make testosterone.

WHAT IF A MAN HAS LOW TESTOSTERONE AND LOW FSH? If a man has low blood levels of testosterone and low levels of the brain hormone, FSH, his brain is not producing enough FSH and LH to stimulate the testicles to make testosterone. This can have a very serious cause, such as a dead pituitary or a brain tumor. Therefore, he should not be started on testosterone until he has been cleared by an endocrinologist who has checked the brain with a special MRI. Other hormone levels should also be checked.

IF YOU DO TAKE TESTOSTERONE: Since testosterone can stimulate a prostate cancer to grow and spread, you must be checked by your doctor for prostate cancer. Testosterone can also raise red blood cell levels high enough to form clots, so you must get tests for red blood cell counts (hemoglobin and hematocrit). It can damage your liver, so you should be followed with liver tests.


Eating Vegetables Helps to Treat Diabetes

Many studies show that eating vegetables helps to prevent and treat diabetes. A new study from Japan shows that the more vegetables diabetics eat, the better their diabetes is controlled (Geriatrics & Gerontology International, April 2012;12(s1):50-58). The participants, 417 male diabetics over 65 years of age, were divided into five groups by their grams per day of vegetable intake: less than 100 grams, 100-150 grams, 150-200 grams, 200-300 grams, and more than 300 grams. Those who took in more than 200 grams per day of vegetables had lower:

• HBA1C (a measure of cell damage from high blood sugar levels);

• Triglycerides (the fat that is made primarily from sugar when blood sugar levels rise too high);

• Waist circumference (when cells cannot respond well to insulin, the pancreas releases large amounts of insulin which causes fat to be deposited in the belly and around organs); and

• Body weight (high insulin makes you fatter and causes you to gain weight).

Read my report on treatment of insulin resistance


Recipe of the Week:

Spicy Peanut Dip

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May 6th, 2012
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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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