Should I work out with sore muscles? A physical therapist explains

Many different activities can cause muscle soreness, including lifting weights, trying a new sport like pickleball, or a long weekend of gardening. Sometimes you feel it right after an activity, but other times, muscle soreness shows up hours later. In some cases, you may feel the most sore two days after. Whether you experience muscle soreness immediately or a few days after the fact, you may wonder, “Should I work out with sore muscles?” 

“Soreness can feel uncomfortable, but it’s a normal part of how your body responds to activity and doesn’t mean you should stop exercising,” says Laura Plankis, PT, DPT, a physical therapist at Hinge Health. In fact, feeling sore after physical activity is often a sign that your body is getting stronger. Instead of skipping all activity when your muscles are achy, try low-intensity movement, such as low-impact cardio and dynamic stretching, to help reduce soreness and support muscle recovery. In fact, not moving while feeling sore can cause your muscles and other soft tissues to tighten or stiffen. And this can make you feel even more sore.

Read on to learn more about working out when sore, including what causes muscle soreness, plus how to prevent and treat it, especially with exercises from Hinge Health physical therapists.

What causes muscle soreness after movement

Muscle soreness might show up right after you exercise, or it could appear hours or even days later. 

Acute muscle soreness. Soreness right after a high-intensity workout often happens because your muscles are working hard and producing waste products as part of your metabolism. This type of muscle soreness tends to be mild and usually resolves within a few hours, making it less likely to interfere with your next workout or activity. 

Delayed onset muscle soreness (DOMS). Muscle soreness that kicks in about 12 hours after a workout and peaks around 48 hours later is known as DOMS. Think of your muscles as a road. When heavy traffic creates small cracks, road crews don’t just patch them up — they rebuild them with stronger materials so the road can handle even more weight next time. Your muscles work the same way: exercise causes tiny microtears, but your body repairs them to be even stronger, preparing you for bigger challenges ahead. “The soreness you feel is your muscles healing and becoming more resilient,” says Dr. Plankis.

Another possible cause of DOMS may be related to changes in your nervous system. If you’re stressed at work or you haven’t been sleeping well recently, for example, your body may have a heightened sensitivity to soreness and pain, Dr. Plankis says. This can make you feel more sore. 

So, should I work out with sore muscles?

“Most of the time, you can — and should — safely work out with sore muscles,” says Dr. Plankis. “Movement increases oxygen-rich blood flow to sore muscles. It also helps your nervous system adapt, so your body becomes more comfortable with activity and less sensitive to soreness.”

Not all types of movement support recovery when your muscles are sore. Jumping right back into an intense workout — especially the one that led to soreness — may delay recovery and increase sensitivity. “If soreness shifts from mild or moderate to severe, it’s a sign to adjust your intensity,” says Dr. Plankis.

You can rest the area that’s sore (say, your shoulders) while doing lower body exercises or a core workout, for example. You can also modify exercises for the sore area. “If your shoulders are sore, instead of using weights or resistance bands when your shoulders, switch to gentle movements or stretches” Dr. Plankis says.

Pain vs. soreness: key differences 

Your body is telling you something when you feel soreness or pain. “An achy, dull sensation is usually a normal sign of post-workout soreness,” says Dr. Plankis. “Sharp, or constant pain, burning, or tingling could indicate that something else is going on.”

There’s a big difference between feeling some discomfort when you challenge yourself and being in a lot of pain. Assess your post-workout soreness on a scale of zero to 10, with zero being no pain or soreness and 10 being the worst imaginable pain. “Soreness after working out  should be far below a five,” Dr. Plankis says. “If it’s creeping toward five and beyond, your body is letting you know it needs more rest or that you need to make modifications to your workouts.” 

The “no pain, no gain” philosophy has been debunked — that strategy doesn’t lead to better athletic performance or health outcomes. “But it can lead to injuries,” says Dr. Plankis. Listening to your body, and gradually progressing the intensity and frequency of your workouts is a more pleasurable, safer, and sustainable way to become stronger.

If you’re experiencing any of the following symptoms, you may have an injury and should consult with a healthcare provider:

• Swelling

• Bruising

• Sharp, acute pain

• Difficulty moving

Movement for muscle soreness

Movement is medicine. It’s the key to keeping muscles and other tissues flexible and mobile, so that they don’t become stiff or tight and cause discomfort. Doing yoga, tai chi, a low-intensity elliptical workout, or swimming laps at an easy to moderate pace are all examples of active recovery, or exercises you can do to help heal your muscles. These movements, and many others, help deliver nutrients to muscles that are actively repairing, which can reduce muscle soreness more quickly.

You can do all of these movements in a routine to help combat muscle soreness across your body. Or, you can choose the ones that are more directly related to the parts of your body that are feeling sore. Dynamic stretches like these can help break up any tension in your muscles, which can reduce soreness and discomfort.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for muscle soreness after exercise

Muscle soreness is a normal response to activity and usually fades on its own within a few days. You can support your recovery and stay comfortable with these tips:

• Keep moving. “You don’t want to aim for your personal best on days you’re really sore, but continuous movement promotes blood flow and helps the recovery process,” says Dr. Plankis. Try dynamic movements to gently stretch and warm up sore muscles before your workout so you can move more comfortably.  

• Prioritize recovery. Rest is essential for muscle recovery, but inactivity can cause tightness and exacerbate muscle soreness. Instead of skipping exercise altogether, try gentle mobility-based exercises, stretching, or restorative movements like easy walking, swimming, cycling, or yoga. All of these movements can improve blood flow and promote healing.

• Apply heat or ice. Research has shown that heat or cold therapy reduces soreness after intense exercise. Heat increases blood flow and can loosen stiff muscles, which can be helpful before you work out. Try using a heating pad on the sore area, or take a hot shower. Cold therapy, such as an ice pack, ice massage, or ice bath, reduces inflammation and numbs pain, making it a good post-workout recovery method. Or, if one feels better than the other, just stick with that one.

• Get a massage. Whether you choose deep tissue, sports, or trigger point massage, the kneading actions ease muscle tension, increase blood flow, and work out kinks or tight spots contributing to soreness. Research suggests a post-workout massage can be helpful in reducing DOMS symptoms. Using a massage gun can also help provide relief to sore muscles.

• Try foam rolling. This technique can be used before exercise to warm up your muscles and after exercise to kickstart muscle recovery. Research shows foam rolling decreases DOMS: A study in the journal Frontiers in Physiology found post-workout foam rolling to be an effective strategy for reducing muscle soreness.

• Work with a physical therapist. If muscle soreness persists or you think you may have an injury, a physical therapist can discuss your symptoms, provide targeted exercises, and help you get back to doing the activities you love. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

Tips to prevent muscle soreness from working out

Muscle soreness may be a part of an active lifestyle, but there are steps you can take to minimize or prevent it. Follow these tips to prevent muscle soreness:

• Ease into activity. Start walking before you run. Lift lighter weights. Limit yourself to  one hour or so of gardening on the first day of the season. Do a 30-minute hike or bike ride instead of a three-hour outing. “Progress gradually to avoid doing too much, too soon, and prevent extreme muscle soreness,” says Dr. Plankis.

• Mix up your movements. “Muscle soreness often occurs in areas of your body that you don’t use as frequently,” Dr. Plankis says. Doing a variety of workouts or sports can help make sure you’re working several muscle groups, which can make them less susceptible to soreness. 

• Stay hydrated and eat well. Eating a healthy diet, rich in protein, complex carbs, and healthy fats supports muscle recovery. Drinking water can help flush out waste products from your muscles that build up after workouts and cause soreness. Both water and healthy foods supply your muscles with the nutrients and energy they need to rebuild.

• Move throughout the day. Staying in the same position for long periods of time can set your muscles up for soreness because they’re not prepared for activity. “The more you move and use your body throughout the day, the more resilient your body will be when you increase weight at the gym or try a new exercise,” says Dr. Plankis. Take movement snacks throughout the day to prevent prolonged sitting.

• Warm up before working out. A five- to 10-minute warm-up routine helps your body get ready for exercise. According to research, pre-workout movement reduces post-workout soreness.

• Schedule a massage. When you know you’ll be doing an especially challenging workout or activity, consider getting a massage afterward. A review in the journal Frontiers in Physiology found a 20- to 30-minute massage reduced soreness after intense activity.

• Wear compression garments. After strenuous work, slip on compression leggings or a top that applies gentle pressure to the muscles they cover. The tight-fitting clothes have been shown to reduce post-workout muscle soreness, according to research. 

PT tip: Get a good night’s sleep

Sleep is a time for your body to heal. “Muscle repair processes increase as you sleep,” says Dr. Plankis. “Sleep also benefits your nervous system.” Aim for seven to eight hours of quality sleep each night to maximize muscle recovery and minimize pain. Research shows that getting enough quality sleep each night can support pain reduction. 

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

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2. Wang, Y., Li, S., Zhang, Y., Chen, Y., Yan, F., Han, L., & Ma, Y. (2021). Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Physical Therapy in Sport, 48(1), 177–187. doi: 10.1016/j.ptsp.2021.01.004

3. Wiewelhove, T., Döweling, A., Schneider, C., Hottenrott, L., Meyer, T., Kellmann, M., Pfeiffer, M., & Ferrauti, A. (2019). A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Frontiers in Physiology, 10(376). doi: 10.3389/fphys.2019.00376

4. Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B. (2018). An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Frontiers in Physiology, 9(403). doi: 10.3389/fphys.2018.00403

5. Davis, H. L., Alabed, S., & Chico, T. J. A. (2020). Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 6(1), e000614. doi: 10.1136/bmjsem-2019-000614

6. Olsen, O., Sjøhaug, M., Van Beekvelt, M., & Mork, P. J. (2012). The Effect of Warm-Up and Cool-Down Exercise on Delayed Onset Muscle Soreness in the Quadriceps Muscle: a Randomized Controlled Trial. Journal of Human Kinetics, 35(1), 59–68. doi: 10.2478/v10078-012-0079-4

7. Marqués-Jiménez, D., Calleja-González, J., Arratibel, I., Delextrat, A., & Terrados, N. (2016). Are compression garments effective for the recovery of exercise-induced muscle damage? A systematic review with meta-analysis. Physiology & Behavior, 153, 133–148. doi: 10.1016/j.physbeh.2015.10.027

8. O’Connor, E., Mündel, T., & Barnes, M. J. (2022). Nutritional Compounds to Improve Post-Exercise Recovery. Nutrients, 14(23), 5069. doi: 10.3390/nu14235069