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Dr. Raghavendra

Orthopedist, Hyderabad

350 at clinic
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Dr. Raghavendra Orthopedist, Hyderabad
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Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences....more
Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences.
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Dr. Raghavendra is a renowned Orthopedist in TKR'S Icon Hospital, Hyderabad. You can meet Dr. Raghavendra personally at Shalivahana Multi specialty Hospital in TKR'S Icon Hospital, Hyderabad. Save your time and book an appointment online with Dr. Raghavendra on Lybrate.com.

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Shalivahana Multi specialty Hospital

# 16 -11 - 511 / D / 16, Shalivahana Nagar,LM: opp to BHASYAM school, HyderabadHyderabad 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.

Sir. I am diagnosed with plantar fasciitis ten years ago. Treated with hot and cold compression. Got better. Now I am wearing supporting shoes. I walk 4 kms a day. The pain increases in the evening, when I walk more. Morning pain goes away. Please suggest more so that I get more relief.

MBBS, MD - Anaesthesiology, FIPM, Fellowship in palliative medicine, certificate in interventional pain management
Pain Management Specialist, Pune
Sir.
I am diagnosed with plantar fasciitis ten years ago. Treated with hot and cold compression. Got better. Now I am...
Plantar fascitis resolves by 1 year in most patients with conservative treatment. In your case it is persistent , you can try following treatment : 1)Decrease your walking/ running. take rest for 7 days and then start your walking gradually. 2) Reduce body weight if you are obese 3) Take pain killers and apply ice pack locally 4) change your shoe supports if they are very old. 5) Do not walk bare foot or exercise on hard surfaces 6) Use night splint in affected foot . 7) Injections into plantar fascia to decrease pain and improve mobility. This is a general outline about treatment strategies.
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I sleep always taking a pillow. Since 2 days I have head and back problem. Now what to do?

BPTh/BPT
Physiotherapist, Mumbai
I sleep always taking a pillow. Since 2 days I have head and back problem. Now what to do?
Hi I can understand your problem 1) avoid activities that make your symptoms worse 2) apply hot packs 3) start physiotherapy treatment as electrotherapy will reduce pain inflammation 4) exercise and manual therapy will help in pain free movement. Describe your problem in detail and do share related reports and prescription if you have. Best wishes.
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When she walks for even a long distance like 1 mile then she will be suffering with severe backpain. Give some advice please.

BPTh/BPT
Physiotherapist, Mumbai
When she walks for even a long  distance like 1 mile  then she will be suffering with severe backpain. Give some advi...
Hi I can understand your problem. # relax & stay positive. # take hot and cold foementation. # change sleeping position. # use lumber support. # take break every 20 minutes. # do strengthening exercise of back and core muscles not all back pains are same, you need specific treatment plan according to your symptoms.
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I am always having pain in my foot. What should I do to cure it? Please help me I am very curious about it.

DHMS (Hons.)
Homeopath, Patna
I am always having pain in my foot. What should I do to cure it? Please help me I am very curious about it.
Hi, tk, homoeo medicine: @ rhus tox 200-6 pills x 3 @ ledum pal 200-6 pills x 3. Tk, plenty of water, your diet b e aside digestible on time, go, for meditation. Tk, care.
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I feel lazy 24/7 no matter what. I dnt feel energy in my body. Honestly if I do some work mi legs n back pain alot. N just want to hit the bed every freaking time. What do I do to get rid of this?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
I feel lazy 24/7 no matter what. I dnt feel energy in my body. Honestly if I do some work mi legs n back pain alot. N...
Do Take balanced diet and hyderated Avoid stress anxiety and anticipating the things Do regular physical activity and breathing exercises for about 30 minutes regularly Best Wishes
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Hello Dr. I am 21 year old. In my heel is very pain in morning time. Please give any solution.

Diploma in Acupuncture, Pranic Healing, MD - Acupuncture
Acupuncturist, Bangalore
Hello Dr. I am 21 year old. In my heel is very pain in morning time. Please give any solution.
Try this for joint pains try this. Identify the mid point between the ankle bone and tendons and give pressure with a blunt edge on either side of your foot for 2 minutes. Also give pressure in the web between 2nd and 3rd finger from your toe for 2 minutes. Finally give a good massage for both feet in hot water. This will relieve your problem. Consult after 10 days.
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I am 37 years old and having a problem with ass, It is not becoming strong and I don't have any bad habits like smoking drinking etc. If I sit for 10 mins continuously my legs are paining, Hope this not nerves issues or blood circulation issue. Please do the needful.

BPTh/BPT
Physiotherapist, Mumbai
Leg pain can be due to nerve compression at lumber spine, use small pillow or towel roll at low back while sitting. Take 8 sessions of S.W.D followed bu McKenzie exercise.
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What are the medications for osteoporosis. My doctor advises me not to sit on the floor.

BHMS
Homeopath,
What are the medications for osteoporosis. My doctor advises me not to sit on the floor.
Take food having calcium..expose ur joints in the sun for 30 min in the morning and after noon..with this u need proper homeopathic treatment..
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I'm 53 year old male, 5ft 5inch tall. On my right foot finger next to small finger has been swollen for 11 months (no injury), 3 months ago left foot small finger got swollen without injury, then whole toe swelled. Back of left foot also has been swollen for 14-16 months. It's the part behind foot, where heel connect to leg. Perhaps called tendinitis. Can not put on shoes anymore since last summer. I desperately need help.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
I'm 53 year old male, 5ft 5inch tall. On my right foot finger next to small finger has been swollen for 11 months (no...
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. Actually I would like to examine you to see whether there is any s/s of inflammation like skin redness, local warmth of skin, pain, swelling etc? also can you send me a clinical picture pointing towards the site of pain & inflammation? have you got any investigations like blood tests done to r/o out any inflammatory/infectious pathology especially if there is no h/o any injury. 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.
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I'm 19 year old indian boy. I'm having pain just below my neck around upper part of my shoulder. I want to know the reason, cause and what is best for it.?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
I'm 19 year old indian boy. I'm having pain just below my neck around upper part of my shoulder. I want to know the r...
Hi, thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. You are very young to actually have persistent neck pains. If you have localized neck pain with no other symptoms like radiating upper limb pain, neurological symptoms like numbness, weakness, paresthesias etc, then you can start with following recommendations for initial period of 2-3 weeks: - to maintain proper posture of your neck while working and sleeping and maintain principles of neck ergonomics especially during work. - if pain is more then you can take a short course of an anti-inflammatory medication like tab etoshine or paracetamol or one which suits you - physical therapy initially under supervision of a trained physiotherapist and then to continue at home - adequate calcium & vitamin d intake if levels are low in body - ice packs can applied if your pain is acute, then hot fomentation can be done at home - analgesic spray for local application can be used and is easily available. We will observe you for next 2-3 weeks how you respond to this conservative management protocol. If you are not feeling better, then we will have to get some investigations like, dynamic x rays of neck region and few blood tests for evaluation. 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.
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I feeling back pain and stomach pain. Normally it comes when I masturbate more and pain will continue for 3-4 days. Do I need to consult doctor. Is it a big problem?

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I feeling back pain and stomach pain. Normally it comes when I masturbate more and pain will continue for 3-4 days. D...
gastric problem and due to weakness of abdominal muscle. so do core strength exercise. and avoid strain.
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I have low back pain for last 5-6 years but I am not getting any treatment so what can I do ?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have low back pain for last 5-6 years but I am not getting any treatment so what can I do ?
Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day. Back Stretching- lie flat, pull one of the knee forward to chest, hold for 3 seconds, then bring the other knee forward to the chest and again hold for 3 seconds. Then pull both knees towards the chest and hold for 3 seconds. Repeat 10 times each exercise twice a day.
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Dis is Nithin. My father is an diabetic patient. As he suffered with foot cellulitis last year & infection level increased. In order to decrease infection level he had undergone skingrafting surgery. It was normal fr few months & again it started swelling in the near foot grafted region. May I know the best treatment for it at present situation.

MBBS, MS - General Surgery, FIAGES(Fellowship in minimal access surgery), FMAS (Fellowship in Minimal Access Surgery)
General Surgeon, Ghaziabad
Dis is Nithin. My father is an diabetic patient. As he suffered with foot cellulitis last year & infection level incr...
Skin infection is quite common in diabetic patients. Control hyperglycemia. Prevent lower limb from any kind of injury. If cellulitis has occurred again start antibiotics after consulting.
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I have undergone tkr for both knees and also an operation where my ball in the hip joint was damaged in an accident 2 years ago. I am 60 years. Obese (95 kg). I cannot bend my knees less than 45 degrees and cannot climb steep staircases. Should I still do physio? I am walking for half an hour daily and also do pranayaama. Kindly advise.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I have undergone tkr for both knees and also an operation where my ball in the hip joint was damaged in an accident 2...
You must reduce weight. To loose weight: Step 1-stop taking sugar & fat e.g. Ghee/fried stuff. Step 2 take a plate of salad before meals Reduce no. of chapatti gradually. Continue with Yoga.
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I have back pain due to kidney stone? So what I should do to reduced the back pain and stone?

BHMS
Homeopath, Delhi
I have back pain due to kidney stone?
So what I should do to reduced the back pain and stone?
Hello,take homoeopathic medicines 1.Lycopodium 30 (4 drops in little water) twice a day for 15 days. 2.Berberis Vulgaris Q (10 drops in little water) thrice a day for 15 days and revert. Increase fluid intake, especially water. Recommended intake of water is 12-15 glasses per day
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I am 34 year old. 2 years back I played almost 4 month badminton then after I feel pain on my both the knees. Some times its goes tough sit. I always feel little heavy on my knees. I am also a diabetic since last 2 years. Pls suggest permanent remedy.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hello, thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. Knee pain in young age group is actually grouped loosely into chondromalacia if there is no injury or any other inflammatory/infective pathology for it. There are multiple causes for this type of pain, which could be muscular imbalance around knee region, malalignment of knee etc. Can you kindly tell me medications you generally take and what has been your treatment history till now for existing problem. I would like to know whether you have got your inflammatory profile done till now and whether calcium and vitamin d testing/supplementation has been done. Also please let me know what all exercises you are doing on a daily basis. Do not hesitate to contact me if you need any further assistance.
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Hello doctor. I am 18 years old. I am having a pain always in my legs. Please tell how to resolve so that it doesn't occur in future.?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Hello doctor. I am 18 years old. I am having a pain always in my legs.
Please tell how to resolve so that it doesn't ...
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 1 wk, contact me again. Do not ignore. It could be beginning of a serious problem.
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Hi. I am 27 year old male. To add to my workout routine every morning, I would like to perform squats, as squats strengthen legs and workout total body. But there are controversies that squats may injure knees over the long run. Can you please suggest whether I can add squats to my workout routine? To add, I am already doing them for two weeks and I am feeling very good. My metabolism seems to improve and feeling light for the complete day.

MD - Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Lucknow
Hi. I am 27 year old male. To add to my workout routine every morning, I would like to perform squats, as squats stre...
Hi if squats are performed with exact perfection and postures with moderate weight, its not going to injure your ligaments and soft tissues they are going to strengthen quadriceps femoris and as it is compound type of exercises it will surely raise the bmr you can do it with moderate weight under guidance and supervision of qualified trainer best of your luck.
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My father have Problem in bis knees. Whenever hi goes for sleep. He have Problem knee pain.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
My father have Problem in bis knees. Whenever hi goes for sleep. He have Problem knee pain.
Homoeopathic meedicine MANGANUM ACETICUM 3X ( Wilmar Schwabe India) Chew 1 tab twicedaily HYPAGOPHYTUM Q ( Wilmar Schwabe India) Drink 10drop in 20 ml fresh water 3 time daily. Report after 60 day
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