Is this normal soreness from exercise or do I need to see someone? A sports medicine physician explains what to look out for
Learn to identify when post-workout pain is something you need to worry about
Have you ever been worried after a workout that something in your body just doesn’t feel right?
It can be a niggle, an ache, soreness or a sharp pain; all you know is that something is off.
You don’t want to make a fuss, but the worry is there—what if something is wrong?
It’s a concern Dr Shady Hassan, MD, an interventional pain and sports medicine physician and the founder of NefraHealth, encounters a lot with his patients.
“The question I get most, from new lifters and seasoned ones alike, is: Is this normal soreness or do I need to see someone?" he says.
So I asked Hassan to outline what he considers normal, as well as the abnormal sensations that require professional investigation.
Abnormal pain
Here are three signs that your pain may need further investigation.
If you experience any of the following sensations, contact your healthcare provider.
1. Unilateral pain
Hassan explains that if your pain is one-sided, that is a red flag. It is abnormal for pain to only appear in one limb or joint when you’ve worked out both sides equally,
“Normal soreness is usually bilateral. Both quads, both shoulders.”
2. Sharp pain
“Sharp or stabbing sensations are the body's primary alarm for structural distress,” says Hassan.
This sort of sensation points to issues in hard tissue, such as bone, meniscus (hard cartilage between joints), or labrum (the fibrocartilage of a socket joint).
“If pain increases as you work out, that points toward something structural, like a stress fracture or a worsening tear.”
“When a patient describes a movement that triggers a sharp, lightning-bolt sensation, the directive is simple: stop the movement and come in,” says Hassan.
“If a patient is having night pain that wakes them up, joint locking, or a limp they've developed to keep moving, those are signs to come in for a workup. Those aren't things to train through.”
3. Numbness
“Numbness, tingling, or pins and needles is a neurological signal,” says Hassan.
“It tells me the issue is pressing on a nerve, either peripherally or at the spine level. Unlike muscle fatigue, this needs an exam quickly.”
Normal pain
These three types of pain are less worrying and do not require immediate medical attention.
1. Soreness
Delayed onset muscle soreness (DOMS) tends to start about 12 hours after you’ve put the weights down, when your muscles start to feel stiff and sore. If you’ve ever done a workout, felt fine after, gone to sleep and then woken up feeling like the rusted-up Tin Man in The Wizard of Oz—that’s DOMS.
“Normal DOMS peaks at 24 to 48 hours and is significantly better by 72. Pain that stays flat or gets worse after three days is worth a clinical look,” says Hassan.
2. Pain that disappears with movement
“If pain disappears once you start moving and the blood is flowing, it’s usually a functional mobility issue,” says Hassan.
3. Aching
“Dull, achy, diffuse pain is generally lower priority,” says Hassan.
“That heavy feeling usually points toward muscular fatigue or normal soreness, and it responds to active recovery.”
Dr Shady Hassan MD is the founder of NefraHealth, an interventional pain and sports medicine practice. He is board-certified in physical medicine and rehabilitation with subspecialty certification in both interventional pain medicine and sports medicine.
He completed his fellowship in interventional spine and sports medicine at Alabama Orthopedic Spine and Sports Medicine Associates. He also served as chief resident during his residency at SUNY Downstate Medical Center in Brooklyn.
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