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Dr. S.Rajesh

Orthopedist, Chennai

200 at clinic
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Dr. S.Rajesh Orthopedist, Chennai
200 at clinic
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To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. S.Rajesh
Dr. S.Rajesh is an experienced Orthopedist in Thirumangalam, Chennai. You can visit him/her at VeeCare Hospital - Anna Nagar in Thirumangalam, Chennai. Book an appointment online with Dr. S.Rajesh on Lybrate.com.

Lybrate.com has an excellent community of Orthopedists in India. You will find Orthopedists with more than 31 years of experience on Lybrate.com. You can find Orthopedists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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VeeCare Hospital - Anna Nagar

No.106, Jawaharlal Nehru Salai, Thirumangalam, Anna Nagar. Landmark: Near Koyambedu Junctions & Opp To Indian Bank, ChennaiChennai Get Directions
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Delayed Onset Muscle Soreness (DOMS)

Physiotherapy In Cerebral Palsy and Leprosy, MPT Neurology
Physiotherapist,
Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness (doms), also called muscle fever, is the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise.

The soreness is felt most strongly 24 to 72 hours after the exercise. It is thought to be caused by eccentric (lengthening) exercise, which causes microtrauma to the muscle fibers. After such exercise, the muscle adapts rapidly to prevent muscle damage, and thereby soreness, if the exercise is repeated.

Delayed onset muscle soreness is one symptom of exercise-induced muscle damage. The other is acute muscle soreness, which appears during and immediately after exercise.

Characteristics

The soreness is perceived as a dull, aching pain in the affected muscle, often combined with tenderness and stiffness. The pain is typically felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest. This tenderness, a characteristic symptom of doms, is also referred to as" muscular mechanical hyperalgesia.

Although there is variance among exercises and individuals, the soreness usually increases in intensity in the first 24 hours after exercise. It peaks from 24 to 72 hours, then subsides and disappears up to seven days after exercise.

Cause

The soreness is caused by eccentric exercise, that is, exercise consisting of eccentric (lengthening) contractions of the muscle. Isometric (static) exercise causes much less soreness, and concentric (shortening) exercise causes none.

Mechanism

The mechanism of delayed onset muscle soreness is not completely understood, but the pain is ultimately thought to be a result of microtrauma mechanical damage at a very small scale to the muscles being exercised.

Doms was first described in 1902 by theodore hough, who concluded that this kind of soreness is" fundamentally the result of ruptures within the muscle. According to this" muscle damage" theory of doms, these ruptures are microscopic lesions at the z-line of the muscle sarcomere. The soreness has been attributed to the increased tension force and muscle lengthening from eccentric exercise. This may cause the actin and myosin cross-bridges to separate prior to relaxation, ultimately causing greater tension on the remaining active motor units.[6] this increases the risk of broadening, smearing, and damage to the sarcomere. When micro-trauma occurs to these structures, nociceptors (pain receptors) within muscle connective tissues are stimulated and cause the sensation of pain.

Another explanation for the pain associated with doms is the" enzyme efflux" theory. Following microtrauma, calcium that is normally stored in the sarcoplasmic reticulum accumulates in the damaged muscles. Cellular respiration is inhibited and atp needed to actively transport calcium back into the sarcoplasmic reticulum is also slowed. This accumulation of calcium may activate proteases and phospholipases which in turn break down and degenerate muscle protein. This causes inflammation, and in turn pain due to the accumulation of histamines, prostaglandins, and potassium.[7][9]

An earlier theory posited that doms is connected to the build-up of lactic acid in the blood, which was thought to continue being produced following exercise. This build-up of lactic acid was thought to be a toxic metabolic waste product that caused the perception of pain at a delayed stage. This theory has been largely rejected, as concentric contractions which also produce lactic acid have been unable to cause doms. Additionally, lactic acid is known from multiple studies to return to normal levels within one hour of exercise, and therefore cannot cause the pain that occurs much later

Relation to other effects

Although delayed onset muscle soreness is a symptom associated with muscle damage, its magnitude does not necessarily reflect the magnitude of muscle damage.

Soreness is one of the temporary changes caused in muscles by unaccustomed eccentric exercise. Other such changes include decreased muscle strength, reduced range of motion, and muscle swelling. It has been shown, however, that these changes develop independently in time from one another and that the soreness is therefore not the cause of the reduction in muscle function.

Possible function as a warning sign

Soreness might conceivably serve as a warning to reduce muscle activity so as to prevent further injury. However, further activity temporarily alleviates the soreness, even though it causes more pain initially. Continued use of the sore muscle also has no adverse effect on recovery from soreness and does not exacerbate muscle damage. It is therefore unlikely that soreness is in fact a warning sign not to use the affected muscle.

Repeated-bout effect

After performing an unaccustomed eccentric exercise and exhibiting severe soreness, the muscle rapidly adapts to reduce further damage from the same exercise. This is called the" repeated-bout effect.

As a result of this effect, not only is the soreness reduced, but other indicators of muscle damage, such as swelling, reduced strength and reduced range of motion, are also more quickly recovered from. The effect is mostly, but not wholly, specific to the exercised muscle: experiments have shown that some of the protective effect is also conferred on other muscles.

The magnitude of the effect is subject to many variations, depending for instance on the time between bouts, the number and length of eccentric contractions and the exercise mode. It also varies between people and between indicators of muscle damage. Generally, though, the protective effect lasts for at least several weeks. It seems to gradually decrease as time between bouts increases, and is undetectable after about one year.

The first bout does not need to be as intense as the subsequent bouts in order to confer at least some protection against soreness. For instance, eccentric exercise performed at 40% of maximal strength has been shown to confer a protection of 20 to 60% from muscle damage incurred by a 100% strength exercise two to three weeks later. Also, the repeated-bout effect appears even after a relatively small number of contractions, possibly as few as two. In one study, a first bout of 10, 20 or 50 contractions provided equal protection for a second bout of 50 contractions three weeks later.

The reason for the protective effect is not yet understood. A number of possible mechanisms, which may complement one another, have been proposed. These include neural adaptations (improved use and control of the muscle by the nervous system), mechanical adaptations (increased muscle stiffness or muscle support tissue), and cellular adaptations (adaptation to inflammatory response and increased protein synthesis, among others).

Prevention

Delayed onset muscle soreness can be reduced or prevented by gradually increasing the intensity of a new exercise program, thereby taking advantage of the repeated-bout effect.

Soreness can theoretically be avoided by limiting exercise to concentric and isometric contractions. But eccentric contractions in some muscles are normally unavoidable during exercise, especially when muscles are fatigued. Limiting the length of eccentric muscle extensions during exercise may afford some protection against soreness, but this may also not be practical depending on the mode of exercise. A study comparing arm muscle training at different starting lengths found that training at the short length reduced muscle damage indicators by about 50% compared to the long length, but this effect was not found in leg muscles.

Static stretching or warming up the muscles does not prevent soreness.[12][13][needs update] overstretching can by itself cause soreness.

The use of correctly fitted, medical-grade, graduated compression garments such as socks and calf sleeves during the workout can reduce muscle oscillation and thus some of the micro-tears that contribute to doms, proper nutrition to manage electrolytes and glycogen before and after exertion has also been proposed as a way to ease soreness.[15][16] consuming more vitamin c may not prevent soreness, but oral curcumin (2.5 gram, twice daily) likely reduces it.

Treatment

The soreness usually disappears within about 72 hours after appearing. If treatment is desired, any measure that increases blood flow to the muscle, such as low-intensity activity, massage, hot baths, or a sauna visit may help somewhat.

Immersion in cool or icy water, an occasionally recommended remedy, was found to be ineffective in alleviating doms in one 2011 study, but effective in another. There is also insufficient evidence to determine whether whole-body cryotherapy compared with passive rest or no whole-body cryotherapy reduces doms, or improves subjective recovery, after exercise.

Counterintuitively, continued exercise may temporarily suppress the soreness. Exercise increases pain thresholds and pain tolerance. This effect, called exercise-induced analgesia, is known to occur in endurance training (running, cycling, swimming), but little is known about whether it also occurs in resistance training. There are claims in the literature that exercising sore muscles appears to be the best way to reduce or eliminate the soreness, but this has not yet been systematically investigated.

For e. G I am 25yr old male and have backache for last 2 months. What should I do? for e. G I am 25yr old male and have backache for last 2 months. What should I do? for e. G I am 25yr old male and have backache for last 2 months. What should I do?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
For e. G I am 25yr old male and have backache for last 2 months. What should I do? for e. G I am 25yr old male and ha...
Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. If it does not give relief in 4-5days, contact me again.
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I am 56 years old. I am getting right leg pain from down the back till the foot. I had diabetic and b.p .what should I do?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Delhi
I am 56 years old. I am getting right leg pain from down the back till the foot. I had diabetic and b.p .what should ...
Diabetes is a metabolic disorder which results in increased blood sugar level due to relative or absolute deficiency of insulin. It is more common in those individuals who have a family history of diabetes. In case of Diabetes, there is an increased risk of various musculoskeletal complaints. Pain in legs could be associated with diabetes or may be a separate entity. Kindly provide us your blood sugar levels so that we can guide you further. You can start with Bakson’s Diab Aid Drops. Take 10-15 drops in one fourth cup of water before meals, 3 times a day.
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I am 75 years old. I am asked to take Diacerein and Glucosamine tablets twice daily for my Knee arthritis. Is it OK?

MD(EH)/AM/Accupressure
Homeopath, Chandigarh
I am 75 years old. I am asked to take Diacerein and Glucosamine tablets twice daily for my Knee arthritis. Is it OK?
You may take it for some days. F you are feeling better then it's okay. Take it only for ten days and see the results.
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I had done treatment of my headache and it cures too. But now my exams are coming soon and I am reading for 7 to 8 hours a day. Problem is that there is sudden pain in my head whenever I looked down in book. Pain goes away when my neck is in neutral position but sudden headache when I flexed or extend my neck. What would I do?

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
I had done treatment of my headache and it cures too. But now my exams are coming soon and I am reading for 7 to 8 ho...
Dear Lybrate user, Welcome to Lybrate. Could be due to stress. Stress is simply a reaction to a stimulus that disturbs our physical or mental equilibrium. In other words, it's an omnipresent part of life. A stressful event can trigger the “fight-or-flight” response, causing hormones such as adrenaline and cortisol to surge through the body. A little bit of stress, known as “acute stress,” can be exciting—it keeps us active and alert. But long-term, or “chronic stress,” can have detrimental effects on health. You may not be able to control the stressors in your world, but you can alter your reaction to them. Physical exercise, creative activities, deep breathing, being away from the situation for sometime etc can help you tackle the stress. I need to know, what are the causes with which you are stressed? Once you know the reason, you will be able to adjust with it with some psycho therapy methods. Please let me know the details. Take care.
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Hello I am 21 Years old, there is a pain in my legs about 3-4 Months so prefer me what can I do to remove the pain?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hello I am 21 Years old, there is a pain in my legs about 3-4 Months so prefer me what can I do to remove the pain?
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. Actually pain at calf/leg region can be due to many reasons, commonly it is muscular in nature but it can also be due to tendons, nerves, blood vessels etc. My advise to you for initial 2-3 weeks will be: - ice packs application intensively with elevation of your limbs at night - take a short course of anti-inflammatory medication as per your body's suitability - stop your physical activity till pain completely subsides - intensive physical therapy, training and proper muscle conditioning once pain has subsided - slow resumption of physical activities with proper pre activity warm up and stretching of muscles and short increments in duration of physical activity each day as per pain tolerance. - we will get some blood tests for you - serum vitamin d and serum potassium levels, esr and crp once you have all these reports then you can contact me as I can advise you for proper supplementation do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation. Thanks & regards
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Hello sir, I am 22 years old male i am suffering from legs and hands numblling so please tell me know which food for good health for nerves. And some of the doubt join 1 week daily sex causes nervous weak or not? And late night sleep please natural tips`

MBBS, MD - General Medicine, DM - Neurology
Neurologist, Hyderabad
Hello sir, I am 22 years old male i am suffering from legs and hands numblling so please tell me know which food for ...
Daily sex is not harmful and there is no need to worry about that. Numbness of hands and feet means that there could be a disease of nerves (peripheral neuropathy), which can be confirmed by doing nerve conduction studies.
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I'm feeling sleepy and tired all day even after a good 7-8 hours sleep. It's happening from past 7-10 days. I can't concentrate on work. I feel pain in Lower back and My Back feels stiff. I can't crack my back completely.

Bachelor of Physiotherapy, Advanced Dry Needling Therapist
Physiotherapist, Noida
I'm feeling sleepy and tired all day even after a good 7-8 hours sleep. It's happening from past 7-10 days.
I can't c...
Back stiffness can be because of long sitting hours. You can go for bhujang asana and extension exercises only twice a day. 10 repetition each time.
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Hello I am 25 years male virgin .i have one day constipation problem last month. On that day I got multiple bowel moments with difficulty. From that day I got constipation for two days sometimes. From that day the erection of penis slowly decreased when masturbate and before 6 days also my penis erection hardness is low when I masturbate watching porn. Before 3 days I ejaculate while sleeping and yesterday if want to check my erection through seeing porn the penis do not erect little much also. I do not smoke and I do not drink. My weight is 85 kg with 5'9 height. I consulted to some doctor online and he wrote nano leo capsules morning and evening for 15 days and syrup cremaffin for constipation. I want to know is it a common problem and by using the above medicines is there any side effects and why this occurs. With in 1 year I have to marry. So whats your solution for this and any remedies.

BHMS
Homeopath, Sindhudurg
Hello I am 25 years male virgin .i have one day constipation problem last month. On that day I got multiple bowel mom...
Keeping the digestive system healthy is the best  remedy for erectile dysfunction.  Here are few tips to keep the digestive system healthy. Watch what you eat and how much you eat. Keep processed food, sweets, sugar at bay. . Include much more natural foods in your diet. Start eating more fruits and vegetables, and stay away from foods cooked in a lot of oil. Healthy eating helps to flush out accumulated toxins. When toxins are expelled, our body rejuvenates fast with help of added antioxidants which are supplied through natural foods.Most of all, eating right can help get rid of erectile problems caused by poor digestion and constipation.
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Hi doc, my age is 17. From last two years I am facing back problem my back is bent I means shoulders are bent forward like an old man when I walk. So is their any treatment for this problem?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Gandhinagar
Hi doc, my age is 17. From last two years I am facing back problem my back is bent I means shoulders are bent forward...
Is there any injury? Pull out R you sport man R you not taking proper nutrition It may be due to weakness Calcium d3 deficiency Take two glass of milk.
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