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Вміст надано Christopher A Morrissey, DO FACOS, Christopher A Morrissey, and DO FACOS. Весь вміст подкастів, включаючи епізоди, графіку та описи подкастів, завантажується та надається безпосередньо компанією Christopher A Morrissey, DO FACOS, Christopher A Morrissey, and DO FACOS або його партнером по платформі подкастів. Якщо ви вважаєте, що хтось використовує ваш захищений авторським правом твір без вашого дозволу, ви можете виконати процедуру, описану тут https://uk.player.fm/legal.
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Episode 2 - DOs and DOMS

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Manage episode 310942975 series 3009095
Вміст надано Christopher A Morrissey, DO FACOS, Christopher A Morrissey, and DO FACOS. Весь вміст подкастів, включаючи епізоди, графіку та описи подкастів, завантажується та надається безпосередньо компанією Christopher A Morrissey, DO FACOS, Christopher A Morrissey, and DO FACOS або його партнером по платформі подкастів. Якщо ви вважаєте, що хтось використовує ваш захищений авторським правом твір без вашого дозволу, ви можете виконати процедуру, описану тут https://uk.player.fm/legal.

Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? This is Dr. Chris Morrissey here with another episode of The Morrissey movement. For those of you that listen, thank you so much feel free to leave any type of feedback that you feel is necessary. So this is episode two. So today I decided to discuss a few different topics. The medical topic for the day is actually going to be the differences in physicians meaning MD versus DO me being an osteopathic physician or a do I've been asked that throughout my career as far as what are the main differences? So I thought I'd spend some time kind of discussing this and maybe giving some light on the subject for people that don't know. And then the fitness aspect I'm going to talk about is what's called Dom's or delayed onset muscle soreness, because there's a lot of controversy of what this actually is. So I felt I would talk about these two things today. All right, so let's get started. So as far as talking about MD versus DO so an MD or a doctor of medicine or an allopathic physician versus a DO which is a doctor of osteopathy or osteopathic physician. So as far as an allopathic physician goes the, the word allopathic comes from the Greek aulos, meaning opposite and Pathos, meaning to suffer. So the phrase of allopathic was coined by the German physician Samuel Hahnemann, which I may have not said that correctly back in the 1800s is roughly refers to treating a symptom with its opposite. So an example would be if you're constipated, you would give someone the laxative, so you're kind of doing the opposite of what it would be. So if you have hypertension or high blood pressure, you're going to give a medicine that will make your blood pressure go down or an anti hypertensive. So that is the kind of the rough definition of allopathic osteopathic actually is a branch of medical practice that emphasizes the treatment of medical disorders through the manipulation of massage of bones, joints and muscles. So, in general terms allopathic physicians are thought to have focused on treatment of disease whereas osteopathy traditionally refers to treating the patient and not the disease. So where did osteopathic medicine come from? There was a Dr. Andrew Taylor still, who actually was an MD. Back in the late 1800s. He was the very first osteopathic physician in the United States. He had lost a few of his children to disease, one with pneumonia and one from like cholera, dysentery or something like that. And he just felt that modern medicine was failing. So we actually took about eight to 10 years sabbatical from medicine and studied the human body more intensively on an Indian reservation. So throughout his studies, he discovered that the spinal cord was more intimately related to the organs than previously thought. So he came up with the idea of manipulating the spine in order to alleviate pain and some diseases. Thus, osteopathy was born. The first osteopathic medical school was actually opened in Kirksville, Missouri, which is actually a fairly small town. I think today, they may have a Walmart and a few other things and then a medical school. So he actually migrated there from Baldwin, Kansas, so you can actually stay that osteopathic medicine was created in Kansas. As far as schooling go, there are approximately 155 accredited MD schools in the United States currently versus 37 accredited Do schools across the country both do an MD is you have to have an undergraduate degree. For the most part, there's a few early decision programs but for the most part, you have to have some sort of undergrad degree. And actually this can be in anything. It's a common misconception that all physicians have to be biology or chemistry majors. You know, what I recommend to people is do something you love. So if your loved music and you want to get a music major, you just have to take the prerequisite courses to get into medical school but you do not have to be a science bachelor's to get into medical school. So then once you go through medical school, you do typically four years of that and then you move on to residency anywhere between three to eight years depending on your area of focus.

Unknown Speaker 4:50

So during medical school do is actually learn OMM or osteopathic manipulative medicine or OMT, which is osteopathic manipulative therapy. You learn it for the first two years of medical school. So we typically begin by focusing on physical assessment, learning how to assess the spine searching for any type of dysfunctions or differences in the tissue. As we fill in our hands. We then learn how to attempt to correct any of these dysfunctions through a variety of ways, including myofascial release, which is basically firm pressure on different areas to try to get the tissues to relax. There's triggerpoint type therapy, there's a therapy called muscle energy, which is actually like a resistive type treatment. And there's also the ever popular hvla Or you know, the cracking backs and necks, which you kind of, most people have at least heard of, or seen that before. So anyway, after the first two years of classroom work, then we all go to rotations for third and fourth year, going through different areas of specialties. So typically, most of the time, you have two months of Internal Medicine, two months of Family Medicine, two months of surgery, two months of arms are one month of OBGYN one month of Pediatrics, one month of Psych and then some sort of elective, and then the fourth year is focused on your desired specialty. So about half of the fourth year is going to be in different programs trying to make a good impression on places where you would like to train at a particular facility. This is somewhat of a working job interview so to speak. Once you have to decide what kind of field of medicine you go into, which can very be very difficult to sometimes then once you get this figured out, then you go through a process called the match. This is where you basically decide what program you want to train in, you know in what certain city or state or hospital system. And then you basically make a list going from favorite to least favorite. And then the programs that you are choosing also do the exact same thing with his applicants. And then it goes through some sort of random computer algorithm. And then hopefully you get what you wanting to do. So this is a fairly stressful process because it's a lot of unknowns. And you feel like you have really no control over where you're going to end up. When you're looking at MDS versus DOs. They can be any type of physician. Traditionally, back in the day, osteopathy was primarily focused on family practice. However, there are deals in every single specialty in medicine, me myself and I, you know, I'm a general surgeon. So this is obviously an issue or, I mean a a specialty selection. But there's family medicine, there's gi radiology, emergency room, ENT, cardiothoracic surgeons, etc. I'm sure a lot of you have actually seen it do in your lifetime. And maybe you didn't realize this is what you had me growing up personally, up in Northwest Kansas, all of our hometown positions were DOs. And I had no idea there was even a difference until I started really looking at applying to medical school. If I had to venture a guess only about 10% or so of do is actually performed the manipulation. You some people just don't feel comfortable doing it. I actually utilize this in my practice, I would say around eight to 10% of my patients that I see is only for manipulation. So I thoroughly enjoyed doing it. And I've helped a lot of people with it. There are so many forms and uses of manipulation. So if you're having certain ailments that aren't being addressed or improving, seeking out someone that does manual therapy may be a benefit from you. However, you know, it has its specific place in medicine. Can it cure cancer? Absolutely not. It's just simply one tool in your bag that you can use to try to alleviate symptoms. There were times in history that deals were actually viewed as inferior to MDS. This was kind of true mid 1900s or so. Sometimes, osteopaths are lumped into alternative medicine, holistic medicine and so on. Now, there are so many different types of medicine that's warranted. So back in California, I know for instance, DOs were not recognized as physicians so they could actually buy their MD license for some fee like $500 or something. So they weren't even allowed to practice in the state of California. But today, most the time, they're looked at as equals. In other parts of the world, they are not recognized as fully licensed physicians in the UK, for example, DOs are viewed the equivalent of chiropractors, which you know, chiropractic medicine was developed separately from osteopathy. Our views and training compared to chiropractors are different as well as our approach to patient treatments. Sometimes I will use the term chiropractor just to make it easier for patients to understand what type of manipulation I'm going to be performing, since most people are more familiar with chiropractors versus osteopaths. So, that's kind of a brief rundown of the differences.

Unknown Speaker 9:42

Again, like I said, I'm sure you've seen both types of positions in their lifetime, you just may not have realized that so. So that is the medical component for today. Now I'm going to move on to the fitness component, which is somewhat sort of overlap with medicine as well. So I'm going to talk about this arms, which is delayed onset muscle soreness. So I have a few different reference guidelines that I use off the internet. The first one comes from medicine net. So basically, any exercise can cause delayed onset muscle soreness when you start a new routine, or increase the intensity. But exercises that require the eccentric muscle contraction in particular are more likely to cause Dom's. So I'm going to refer to it as Dom's throughout the rest of this discussion, since it's easier to say than delayed onset muscle soreness. Eccentric attraction of an exercise is basically the muscles slow load against gravity as the muscles being lengthened. So an example a few examples of eccentric muscle contraction would be bicep curl, which most people can understand the visual visualization of that. So the as you're bringing the bar from your hips up towards your shoulders, that is going to be the concentric or the shortening of the muscle, and then the eccentric portion is going to be lowering the weight slowly from the shoulders down back to the hips. A few other examples is going to be downhill running, because the quads are being forced to lengthen and brace against gravity, downward motion in squats, or the downward motion and push ups. Also, if you're looking at doing a pull up as you lower yourself back towards the floor, that is another example of eccentric. So like I said, concentric on the other hand, as when you're shortening the muscle. essentra contraction is actually more efficient way than concentric contraction to exercise a muscle because it uses less energy to work harder. Though beneficial eccentric contraction is also more likely to produce Dom's because it places more stress on the muscle. So what exactly is this that I'm talking about delayed onset muscle soreness, so basically, it is the muscle pain you feel after a workout. It does not occur during the workout but typically starts the day after maybe a few days later peaks after 24 to 72 hours and start seizing up after that it can last up to five days and anything longer is not normal. What is the main cause, you know, it's usually a combination of microscopic tears in the muscle fibers that result from a workout and the muscles response to repair the damage. So you get little tiny muscle tears when you stretch your muscles more than they're used to or in a newer different ways. So if you have been primarily a runner or did a lot of circuit training, and then you go to a bodybuilding style approach or even maybe CrossFit, your muscles are not used to reacting that way. The muscle tissue then releases enzymes to repair the tears in the tissue which results in inflammation and soreness. Contrary to belief. lactic acid buildup can cause pain during a workout, but this is not the source of Dom's. Lactic acid builds up when the muscle does not get enough oxygen to break it down, which causes cramping and muscle fatigue. The pain typically goes away within a few hours with rest and hydration unlike Dom's, which can last much longer. It can happen to anyone regardless of fitness levels. When the muscles are challenged in a way they are not accustomed to even elite athletes can develop Dom's when they start training after a break, or when they increase their training intensity. So I'll use myself in this example I was doing on my garage, gym athlete workout protocols. I was doing one that primarily focused on squats and running it was called BCT. And we basically squatted three days a week and ran three days a week and I was on this circuit for approximately six months. And then I decided to go a different route. So then I started going back to more of a concurrent training model which was well, the BCT was concurrent training also but it was focusing mainly on lower body. So then I went back to normal and so I started doing quite a bit of pull ups and I feel I got Dom's in my lat muscles because I've been doing pull ups for like six months and then when I got back into these, I was sore for probably five to six days and it just hurt to do everything so I'm sure some people can relate to what this feels like. Is Dom's a good sign. muscle soreness is commonly equated with a good workout but Dom's does not need to always be there to be a good sign soreness does indicate that the muscle has been worked, which encourages and motivates you to continue with the activity but it also is important to be aware that how much of soreness says beneficial if it makes you to sort of carry on through daily activities, it's

Unknown Speaker 14:15

probably a little bit too much. muscle strength grows with exercise even if you do not feel soreness so once you get accustomed to the work that you're doing, you may not be getting as sore as you used to before. Excessive or persistent soreness is detrimental to muscle recovery and can in fact be negative effects that you are looking for an exercise and may affect your athletic performance. If you ignore this persistent soreness can also damage the capacity of the muscle to repair and grow stronger. Is it okay to work out through Dom's? Yes it is some soreness from Dom's is temporary and it's perfectly fine to work out through these as long as the ache is moderate in nature. Keeping those muscles active in fact has been official because it improves blood supply and speeds up healing. You can do General exercises like walking or swimming until the soreness subsides or rest for a day or so if the activity increases the pain, one of the things I'll typically do is and all the dresses and different podcasts but some zone to running which is basically others five heart rate zones. Zone two is like, you know, you can keep a conversational pace that's, you know, fairly low intense in nature, but it does help with blood flow and can also you know, build your cardiovascular base, but that'll be a separate podcast topic for in the future. How can you prevent Dom's? It may or may not be possible to prevent those, but you can reduce the severity by gradually increasing the intensity when you start a new exercise routine. Warming up before and cooling down and stretching after an intensive workout can greatly help in relaxing the muscles and reduce soreness. So the biggest thing I you typically see is people go from being fairly sedentary nature, and all of a sudden, you know, they're on Instagram and they see, you know, Rich Froning, his new workout or some sort of superstar CrossFit athlete that has been doing this for a long time and you just get this kind of all in mentality. And you go from not doing much to doing a whole lot and then you can barely walk for a week and then you kind of go back to the way you work because you did not like how that made you feel. So this is one common Miss conception or mistake people make when they go into training. varying your daily routine by cross training with exercises that engage different groups of muscles may be another good way to handle Dom's. Again, it gives your muscles a chance to recover between workouts without really disrupting your training. A few other aspects that is super important for this is eating a very nutritious diet that includes all groups of foods that help muscles heal. Also adequate hydration with electrolytes before during and after workout may help minimize this as well. So now what happens if you get this so how do I treat this? Dom's usually does not require treatment it typically goes away on its own. Again the best thing for Dom's is to keep those muscles moving unless the pain is intolerable. Other things that can help reduce Dom's include gentle massage, which may help increase blood flow, you can use a foam roller they can help loosen up knotted muscles, wearing compression clothing, which many athletes say improves blood flow and reduces pain. Although there's really no conclusive evidence or studies for this that I've seen. Applying ice packs can numb the nerve endings to the muscle that may help a little bit alternating between hot and cold showers. topical application of pain really bombs like Icy Hot or Asper cream or some sort of thing like that may be beneficial. Current research suggest non steroidal anti inflammatory drugs or NSAIDs such as aleve or Motrin are not really effective for Dom's. Further preventing inflammation with NSAIDs is self defeating the purpose of the exercise because inflammation is the central process in which makes our muscles grow and get stronger. Now if you get to the point where the pain is super bad, you may need to see a physician. So a few key things you may see is if the pain is completely unbearable, if you're paying last longer than a week, you have swelling in your arms or legs and your urine becomes really, really dark despite adequate hydration, which may be a sign of a term called rhabdomyolysis, which is very, a very severe condition that needs immediate medical attention. So I'm going to kind of go through another there's this is off of pain science.com. This is a Paul Ingram is a gentleman that took a deep dive into Dom's. It's the biology and treatment of muscle fever quote unquote, which is another word for Dom's. The deep muscle soreness that suggests or I'm sorry, that surges 24 to 48 hours after an unfamiliar exercise. So he kind of goes through so this is termed muscle fever, which is a distinctive muscle pain that nearly everyone experiences after intense or unfamiliar exercise. It's often called Dom's, as you said before, the biology of it kind of remains unclear, we really don't know. And there's really no way to cure like I said before, this kind of goes through different reasons of why and I'm going to skip over a lot of this because a lot of...

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Вміст надано Christopher A Morrissey, DO FACOS, Christopher A Morrissey, and DO FACOS. Весь вміст подкастів, включаючи епізоди, графіку та описи подкастів, завантажується та надається безпосередньо компанією Christopher A Morrissey, DO FACOS, Christopher A Morrissey, and DO FACOS або його партнером по платформі подкастів. Якщо ви вважаєте, що хтось використовує ваш захищений авторським правом твір без вашого дозволу, ви можете виконати процедуру, описану тут https://uk.player.fm/legal.

Unknown Speaker 0:04

Ladies and gentlemen, welcome to the Morrissey Movement, the purpose of this podcast to discuss and share one aspect of fitness and one aspect of medicine. Being a general surgeon and a garage gym athlete, I have a strong passion for both of these aspects of life. So sit back and enjoy the show. This podcast is for entertainment purposes only. I am in no way forming a patient doctor relationship. All the aspects discussed in this podcast are medically accurate. You should always discuss with your doctor any questions that you may have about the content, you should always discuss with your doctor before starting any new exercise or dietary changes. Hey, what's going on everybody? This is Dr. Chris Morrissey here with another episode of The Morrissey movement. For those of you that listen, thank you so much feel free to leave any type of feedback that you feel is necessary. So this is episode two. So today I decided to discuss a few different topics. The medical topic for the day is actually going to be the differences in physicians meaning MD versus DO me being an osteopathic physician or a do I've been asked that throughout my career as far as what are the main differences? So I thought I'd spend some time kind of discussing this and maybe giving some light on the subject for people that don't know. And then the fitness aspect I'm going to talk about is what's called Dom's or delayed onset muscle soreness, because there's a lot of controversy of what this actually is. So I felt I would talk about these two things today. All right, so let's get started. So as far as talking about MD versus DO so an MD or a doctor of medicine or an allopathic physician versus a DO which is a doctor of osteopathy or osteopathic physician. So as far as an allopathic physician goes the, the word allopathic comes from the Greek aulos, meaning opposite and Pathos, meaning to suffer. So the phrase of allopathic was coined by the German physician Samuel Hahnemann, which I may have not said that correctly back in the 1800s is roughly refers to treating a symptom with its opposite. So an example would be if you're constipated, you would give someone the laxative, so you're kind of doing the opposite of what it would be. So if you have hypertension or high blood pressure, you're going to give a medicine that will make your blood pressure go down or an anti hypertensive. So that is the kind of the rough definition of allopathic osteopathic actually is a branch of medical practice that emphasizes the treatment of medical disorders through the manipulation of massage of bones, joints and muscles. So, in general terms allopathic physicians are thought to have focused on treatment of disease whereas osteopathy traditionally refers to treating the patient and not the disease. So where did osteopathic medicine come from? There was a Dr. Andrew Taylor still, who actually was an MD. Back in the late 1800s. He was the very first osteopathic physician in the United States. He had lost a few of his children to disease, one with pneumonia and one from like cholera, dysentery or something like that. And he just felt that modern medicine was failing. So we actually took about eight to 10 years sabbatical from medicine and studied the human body more intensively on an Indian reservation. So throughout his studies, he discovered that the spinal cord was more intimately related to the organs than previously thought. So he came up with the idea of manipulating the spine in order to alleviate pain and some diseases. Thus, osteopathy was born. The first osteopathic medical school was actually opened in Kirksville, Missouri, which is actually a fairly small town. I think today, they may have a Walmart and a few other things and then a medical school. So he actually migrated there from Baldwin, Kansas, so you can actually stay that osteopathic medicine was created in Kansas. As far as schooling go, there are approximately 155 accredited MD schools in the United States currently versus 37 accredited Do schools across the country both do an MD is you have to have an undergraduate degree. For the most part, there's a few early decision programs but for the most part, you have to have some sort of undergrad degree. And actually this can be in anything. It's a common misconception that all physicians have to be biology or chemistry majors. You know, what I recommend to people is do something you love. So if your loved music and you want to get a music major, you just have to take the prerequisite courses to get into medical school but you do not have to be a science bachelor's to get into medical school. So then once you go through medical school, you do typically four years of that and then you move on to residency anywhere between three to eight years depending on your area of focus.

Unknown Speaker 4:50

So during medical school do is actually learn OMM or osteopathic manipulative medicine or OMT, which is osteopathic manipulative therapy. You learn it for the first two years of medical school. So we typically begin by focusing on physical assessment, learning how to assess the spine searching for any type of dysfunctions or differences in the tissue. As we fill in our hands. We then learn how to attempt to correct any of these dysfunctions through a variety of ways, including myofascial release, which is basically firm pressure on different areas to try to get the tissues to relax. There's triggerpoint type therapy, there's a therapy called muscle energy, which is actually like a resistive type treatment. And there's also the ever popular hvla Or you know, the cracking backs and necks, which you kind of, most people have at least heard of, or seen that before. So anyway, after the first two years of classroom work, then we all go to rotations for third and fourth year, going through different areas of specialties. So typically, most of the time, you have two months of Internal Medicine, two months of Family Medicine, two months of surgery, two months of arms are one month of OBGYN one month of Pediatrics, one month of Psych and then some sort of elective, and then the fourth year is focused on your desired specialty. So about half of the fourth year is going to be in different programs trying to make a good impression on places where you would like to train at a particular facility. This is somewhat of a working job interview so to speak. Once you have to decide what kind of field of medicine you go into, which can very be very difficult to sometimes then once you get this figured out, then you go through a process called the match. This is where you basically decide what program you want to train in, you know in what certain city or state or hospital system. And then you basically make a list going from favorite to least favorite. And then the programs that you are choosing also do the exact same thing with his applicants. And then it goes through some sort of random computer algorithm. And then hopefully you get what you wanting to do. So this is a fairly stressful process because it's a lot of unknowns. And you feel like you have really no control over where you're going to end up. When you're looking at MDS versus DOs. They can be any type of physician. Traditionally, back in the day, osteopathy was primarily focused on family practice. However, there are deals in every single specialty in medicine, me myself and I, you know, I'm a general surgeon. So this is obviously an issue or, I mean a a specialty selection. But there's family medicine, there's gi radiology, emergency room, ENT, cardiothoracic surgeons, etc. I'm sure a lot of you have actually seen it do in your lifetime. And maybe you didn't realize this is what you had me growing up personally, up in Northwest Kansas, all of our hometown positions were DOs. And I had no idea there was even a difference until I started really looking at applying to medical school. If I had to venture a guess only about 10% or so of do is actually performed the manipulation. You some people just don't feel comfortable doing it. I actually utilize this in my practice, I would say around eight to 10% of my patients that I see is only for manipulation. So I thoroughly enjoyed doing it. And I've helped a lot of people with it. There are so many forms and uses of manipulation. So if you're having certain ailments that aren't being addressed or improving, seeking out someone that does manual therapy may be a benefit from you. However, you know, it has its specific place in medicine. Can it cure cancer? Absolutely not. It's just simply one tool in your bag that you can use to try to alleviate symptoms. There were times in history that deals were actually viewed as inferior to MDS. This was kind of true mid 1900s or so. Sometimes, osteopaths are lumped into alternative medicine, holistic medicine and so on. Now, there are so many different types of medicine that's warranted. So back in California, I know for instance, DOs were not recognized as physicians so they could actually buy their MD license for some fee like $500 or something. So they weren't even allowed to practice in the state of California. But today, most the time, they're looked at as equals. In other parts of the world, they are not recognized as fully licensed physicians in the UK, for example, DOs are viewed the equivalent of chiropractors, which you know, chiropractic medicine was developed separately from osteopathy. Our views and training compared to chiropractors are different as well as our approach to patient treatments. Sometimes I will use the term chiropractor just to make it easier for patients to understand what type of manipulation I'm going to be performing, since most people are more familiar with chiropractors versus osteopaths. So, that's kind of a brief rundown of the differences.

Unknown Speaker 9:42

Again, like I said, I'm sure you've seen both types of positions in their lifetime, you just may not have realized that so. So that is the medical component for today. Now I'm going to move on to the fitness component, which is somewhat sort of overlap with medicine as well. So I'm going to talk about this arms, which is delayed onset muscle soreness. So I have a few different reference guidelines that I use off the internet. The first one comes from medicine net. So basically, any exercise can cause delayed onset muscle soreness when you start a new routine, or increase the intensity. But exercises that require the eccentric muscle contraction in particular are more likely to cause Dom's. So I'm going to refer to it as Dom's throughout the rest of this discussion, since it's easier to say than delayed onset muscle soreness. Eccentric attraction of an exercise is basically the muscles slow load against gravity as the muscles being lengthened. So an example a few examples of eccentric muscle contraction would be bicep curl, which most people can understand the visual visualization of that. So the as you're bringing the bar from your hips up towards your shoulders, that is going to be the concentric or the shortening of the muscle, and then the eccentric portion is going to be lowering the weight slowly from the shoulders down back to the hips. A few other examples is going to be downhill running, because the quads are being forced to lengthen and brace against gravity, downward motion in squats, or the downward motion and push ups. Also, if you're looking at doing a pull up as you lower yourself back towards the floor, that is another example of eccentric. So like I said, concentric on the other hand, as when you're shortening the muscle. essentra contraction is actually more efficient way than concentric contraction to exercise a muscle because it uses less energy to work harder. Though beneficial eccentric contraction is also more likely to produce Dom's because it places more stress on the muscle. So what exactly is this that I'm talking about delayed onset muscle soreness, so basically, it is the muscle pain you feel after a workout. It does not occur during the workout but typically starts the day after maybe a few days later peaks after 24 to 72 hours and start seizing up after that it can last up to five days and anything longer is not normal. What is the main cause, you know, it's usually a combination of microscopic tears in the muscle fibers that result from a workout and the muscles response to repair the damage. So you get little tiny muscle tears when you stretch your muscles more than they're used to or in a newer different ways. So if you have been primarily a runner or did a lot of circuit training, and then you go to a bodybuilding style approach or even maybe CrossFit, your muscles are not used to reacting that way. The muscle tissue then releases enzymes to repair the tears in the tissue which results in inflammation and soreness. Contrary to belief. lactic acid buildup can cause pain during a workout, but this is not the source of Dom's. Lactic acid builds up when the muscle does not get enough oxygen to break it down, which causes cramping and muscle fatigue. The pain typically goes away within a few hours with rest and hydration unlike Dom's, which can last much longer. It can happen to anyone regardless of fitness levels. When the muscles are challenged in a way they are not accustomed to even elite athletes can develop Dom's when they start training after a break, or when they increase their training intensity. So I'll use myself in this example I was doing on my garage, gym athlete workout protocols. I was doing one that primarily focused on squats and running it was called BCT. And we basically squatted three days a week and ran three days a week and I was on this circuit for approximately six months. And then I decided to go a different route. So then I started going back to more of a concurrent training model which was well, the BCT was concurrent training also but it was focusing mainly on lower body. So then I went back to normal and so I started doing quite a bit of pull ups and I feel I got Dom's in my lat muscles because I've been doing pull ups for like six months and then when I got back into these, I was sore for probably five to six days and it just hurt to do everything so I'm sure some people can relate to what this feels like. Is Dom's a good sign. muscle soreness is commonly equated with a good workout but Dom's does not need to always be there to be a good sign soreness does indicate that the muscle has been worked, which encourages and motivates you to continue with the activity but it also is important to be aware that how much of soreness says beneficial if it makes you to sort of carry on through daily activities, it's

Unknown Speaker 14:15

probably a little bit too much. muscle strength grows with exercise even if you do not feel soreness so once you get accustomed to the work that you're doing, you may not be getting as sore as you used to before. Excessive or persistent soreness is detrimental to muscle recovery and can in fact be negative effects that you are looking for an exercise and may affect your athletic performance. If you ignore this persistent soreness can also damage the capacity of the muscle to repair and grow stronger. Is it okay to work out through Dom's? Yes it is some soreness from Dom's is temporary and it's perfectly fine to work out through these as long as the ache is moderate in nature. Keeping those muscles active in fact has been official because it improves blood supply and speeds up healing. You can do General exercises like walking or swimming until the soreness subsides or rest for a day or so if the activity increases the pain, one of the things I'll typically do is and all the dresses and different podcasts but some zone to running which is basically others five heart rate zones. Zone two is like, you know, you can keep a conversational pace that's, you know, fairly low intense in nature, but it does help with blood flow and can also you know, build your cardiovascular base, but that'll be a separate podcast topic for in the future. How can you prevent Dom's? It may or may not be possible to prevent those, but you can reduce the severity by gradually increasing the intensity when you start a new exercise routine. Warming up before and cooling down and stretching after an intensive workout can greatly help in relaxing the muscles and reduce soreness. So the biggest thing I you typically see is people go from being fairly sedentary nature, and all of a sudden, you know, they're on Instagram and they see, you know, Rich Froning, his new workout or some sort of superstar CrossFit athlete that has been doing this for a long time and you just get this kind of all in mentality. And you go from not doing much to doing a whole lot and then you can barely walk for a week and then you kind of go back to the way you work because you did not like how that made you feel. So this is one common Miss conception or mistake people make when they go into training. varying your daily routine by cross training with exercises that engage different groups of muscles may be another good way to handle Dom's. Again, it gives your muscles a chance to recover between workouts without really disrupting your training. A few other aspects that is super important for this is eating a very nutritious diet that includes all groups of foods that help muscles heal. Also adequate hydration with electrolytes before during and after workout may help minimize this as well. So now what happens if you get this so how do I treat this? Dom's usually does not require treatment it typically goes away on its own. Again the best thing for Dom's is to keep those muscles moving unless the pain is intolerable. Other things that can help reduce Dom's include gentle massage, which may help increase blood flow, you can use a foam roller they can help loosen up knotted muscles, wearing compression clothing, which many athletes say improves blood flow and reduces pain. Although there's really no conclusive evidence or studies for this that I've seen. Applying ice packs can numb the nerve endings to the muscle that may help a little bit alternating between hot and cold showers. topical application of pain really bombs like Icy Hot or Asper cream or some sort of thing like that may be beneficial. Current research suggest non steroidal anti inflammatory drugs or NSAIDs such as aleve or Motrin are not really effective for Dom's. Further preventing inflammation with NSAIDs is self defeating the purpose of the exercise because inflammation is the central process in which makes our muscles grow and get stronger. Now if you get to the point where the pain is super bad, you may need to see a physician. So a few key things you may see is if the pain is completely unbearable, if you're paying last longer than a week, you have swelling in your arms or legs and your urine becomes really, really dark despite adequate hydration, which may be a sign of a term called rhabdomyolysis, which is very, a very severe condition that needs immediate medical attention. So I'm going to kind of go through another there's this is off of pain science.com. This is a Paul Ingram is a gentleman that took a deep dive into Dom's. It's the biology and treatment of muscle fever quote unquote, which is another word for Dom's. The deep muscle soreness that suggests or I'm sorry, that surges 24 to 48 hours after an unfamiliar exercise. So he kind of goes through so this is termed muscle fever, which is a distinctive muscle pain that nearly everyone experiences after intense or unfamiliar exercise. It's often called Dom's, as you said before, the biology of it kind of remains unclear, we really don't know. And there's really no way to cure like I said before, this kind of goes through different reasons of why and I'm going to skip over a lot of this because a lot of...

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