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Dr. Pawan Nath

Orthopedist, Mumbai

600 at clinic
Dr. Pawan Nath Orthopedist, Mumbai
600 at clinic
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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. Pawan Nath is a renowned Orthopedist in Mumbai, Mumbai. He is currently practising at SevenHills Hospital in Mumbai, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. Pawan Nath on Lybrate.com.

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Marol Maroshi Road, Andheri - East. Landmark: Next to Marol - Maroshi Bus Depot, MumbaiMumbai 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.

I am 23 years old female, I have back ache and also back neck pain. What should I do? can I do exercises?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
With the pain don't do any exercises unless been clinically assessed and advised by neuro physiotherapist or orthopaedician or neuro physician for pain apply hot water and cold water fomentation thrice a day for 12 days of 15 minutes duration each time if still pain persists do consult neuro physiotherapist or orthopaedician or neuro physician asap regards
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I am 38 years old male I have pain in elbow for last week I have lifted some 30 kg weight now what to do?

B.P.T
Physiotherapist, Chandigarh
I am 38 years old male I have pain in elbow for last week I have lifted some 30 kg weight now what to do?
You might have a tennis elbow (tendinitis), try wearing a band around the elbow and avoid lifting any heavy weights till the pain subsides, also you will need to take physiotherapy treatment by visiting the nearest physio clinic.
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Hi. When I wake up in morning my legs below knees used to pain daily n specially the ankle joint n foot. Can you suggest me something..

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Hi.
When I wake up in morning my legs below knees used to pain daily n specially the ankle joint n foot. Can you sugg...
Calf muscle are stiff and do hot fermentation with warm water and do gentle massage ya tens therapy and ultrasonic therapy after relief do calf stretching exercise and should be equal balance on both legs. Avoid long standing.
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My Age - 48 years, Suffering from knee pain and stiffness at shoulder, stiffness neck since last 6 to 7 years. Please advice good Ayurved treatment without any side effect.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
My Age - 48 years, Suffering from knee pain and stiffness at shoulder, stiffness neck since last 6 to 7 years. Please...
With Ayurveda do physiotherapy treatment for few days and stretching exercise of neck and shoulder. And a X-Ray of cervical. Tk calcium supplements for knee with physiotherapy put a towel roll under knee and press for 10 second then release. And quadriceps exercise. Best for you and also a X-Ray of knee. Its arthritis changes in your joints.
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Hi, I am 27 year female, I have pain in lower back ,shoulder and I was having headache so much. So I test my result was Esr test is 35 mm and crp is 3.7 and hemoglobin is 11 .what further I have to check. My vitamin d is 13 .i do not have thyroid.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Hi, I am 27 year female, I have pain in lower back ,shoulder and I was having headache so much. So I test my result w...
Postural Correction- Sit Tall, Walk Tall. Extension Exercises x 15 times x twice daily. Apply Hot Fomentation twice daily. Avoid bending in front.
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I have lower back pain dizziness pain at back of testicles what problem do I have?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have lower back pain dizziness pain at back of testicles what problem do I have?
Bhujang Asana -- Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day.
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I am 43 years old, having backache since last 4 months. Thought it will be ok but its not let me sleep in night also. What is the solution for it.

BHMS
Homeopath, Faridabad
I am 43 years old, having backache since last 4 months. Thought it will be ok but its not let me sleep in night also....
Hello, first of all you should know what is backache and by which factors it caused and aggravated. The usual cause of low back pain is the sedentary lifestyle that we lead these days. There is hardly any movement. We remain seated most of the time and stand for very short periods of time. Unfortunately walking, running and cycling like activities are also not a part of our daily routine. To add to it, our diet consists more and more of junk food. Fresh fruits, vegetables and high fibre foods are consumed less and less. These daily practices lead to obesity. The increased body weight puts lot of pressure on the spine which has to bear all the extra unwanted weight. The back muscles which are already weak due to lack of exercise and wrong posture are unable to cope with this increased load. This causes pain in the back muscles. Management for Low Back Pain:-Along with medicines for relieving pain, one needs to identify the cause and correct it. This may require some medicines or some correction in your posture or reducing weight or improving your lifestyle. At the same time, there is a need to work on the local muscle strengthening. Back muscles need to be strengthened so that they can bear the weight of the upper body. For this exercises of the back muscles are very helpful. Regular walking is also very helpful as it is a wholesome exercise of the body, improves blood circulation and helps lose weight. Most importantly if you are overweight then losing weight is an important part of the whole treatment plan .Long term use of painkillers for low back pain is harmful Treatment for low back pain:- Homeopathic medicines are very helpful. They not only treat the acute stages but are also for the treatment of back pain but selection of the exact remedy depends upon the individual symptoms of the person.So choose the doctor of your choice, share the complete symptom picture and get the proper treament. In the mean time take Arnica 200, 3 drops in the morning and Rhus tox. 200, 3 drops at night for 7 days.Take care..
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Hello sir, I am 25 year old I have problem in my neck left side in the muscle and when I moving my neck it cause pain it about 1 year.

BHMS
Homeopath, Sindhudurg
Homoeopathic treatment- calc fluor 6x -4 pills 3 times calcivita syrup 1 spoonful 3 times bio combination no 19 rheumatism- 4 pills 3 times for 8 days and revert back.
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I am 23 years old male. I have a addiction to masturbation (frequent - once or sometimes even twice a day) since I was 14. I am facing problems such as premature greying of hair (since last 2 years), lower back pain, reduced memory and stamina, blurred vision and sometimes premature ejaculation as well. I am very thin (weight 50kg). I want to quit this addiction and become a healthy person. Need your advice. Thanking you in advance.

BHMS
Homeopath,
I am 23 years old male. I have a addiction to masturbation (frequent - once or sometimes even twice a day) since I wa...
Dear Kaustubh....Frequent masturbation indicates that you are always indulged in sexual thoughts.....Keep yourself busy....Do some physical activities daily....Also take Homoeopathic Mother Tincture ORIGANUM Q, 10 drops in a cup of water, thrice daily after meals
4 people found this helpful
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I have pain in my right leg it has swelling from last 4 days I fell from stairs what do I do ?

BPTh/BPT
Podiatrist, Mumbai
I have pain in my right leg it has swelling
 from last 4 days I fell from stairs what do I do ?
Hi, you might have sprained your ankle, to be on a safer side take a xray to see any hairline fracture, or consider a mri to detect soft tissue injury. For the time being, apply cold pack, every 4-5 hours for 15-20 min, observe if it reduces pain or swelling. Applying compression bandage and ankle support can help. Keep the leg elevated by 2-3 pillow. I would suggest that you should see the doctor personally as soon as possible, don't try to self medicate or ignore the injury. Please get back to me, if you need any further assistance.
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I am 25 years old. I have an habit of masturbation since 4th class. I am very weak, lean legs and no stability, constipation,bloating , irritating, anxious. How to recover from this bad habit.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I am 25 years old. I have an habit of masturbation since 4th class. I am very weak, lean legs and no stability, const...
change ur life style and keep busy ur self tk healthy diet and supplements and do stretching and strength exercise in gentle process
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I am a 79 year old man, with reasonable health. I practice yoga asanas on alternate days and walk in the morning on other days. From one year I feel I am loosing balance and I stoop forward unconciously while walking. My knees do not seem to be strong enough and wobble a little early in the morning. I dont have sugar or high b. P. From a few months I feel I get tired very quickly. Any remidy for this?

MD - Diabetology, Membership of the Royal College of Surgeons (MRCS), MBBS
Endocrinologist, Kochi
For a 79 year old, your health is not just" reasonable. It is remarkable! keep going. Sleep well, continue to exercise & you will be fine.
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My name is shekarachna I am 29 years old male and have hand pain coming this is my first time what I do .

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
My name is shekarachna I am 29 years old male and have hand pain coming this is my first time what I do .
Advice hot fomentation. Gentle stretching of hand muscles. Ball exercises. Wrist exerciser. Use cervical pillow.
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I am a 24 year old male and I have a strange pain around my tailbone, please suggest.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
I am a 24 year old male and I have a strange pain around my tailbone, please suggest.
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. Tail bone pain is referred to as coccydynia for which anti inflammatory medication, sitz bath, cushioned surfaces for sitting etc is recommended. You will have to specify the intensity of pain, whether there is any fever, swelling, h/o any injury to the tail bone area etc? 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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weight loss everyday,my legs get pain and numbness feeling both hands and feet and feeling lightheaded sometime.help me

M. sc Psychology, BHMS
Homeopath, Hyderabad
weight loss everyday,my legs get pain and numbness feeling both hands and feet and feeling lightheaded sometime.help me
First we should to know the reason for your wt loss& weakness, here I could nt get your age details, but it migt be due to less intake or improper intake of diet, or mal assimilation, any vitamin deficiency, anaemia, improper circulation of blood, mental or physical exertion, or any other c/os, first to be uled out. Then, you can get t/t accordingly. Based on symptoms, & diagnosis, you can get better relief in homeo.
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I have tell the about arm and legs pain and this problem increasing day by day but not relief. I have taken medicine .and please give me solution of this problem.

BHMS, MD HOM.
Homeopath, Mumbai
I have tell the about arm and legs pain and this problem increasing day by day but not relief. I have taken medicine ...
What medicine are you on. Start with homeopathic medicine:-- Rhus tox 30 Mag phos 30 4 pills each medicine x 3 times daily x 30 days.
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I am 20 years old and I am suffering from bach pain. I took certain medicines but didn't get rid of this. What should I do now?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
I am 20 years old and I am suffering from bach pain. I took certain medicines but didn't get rid of this. What should...
Do apply hot and cold water fomentation for thrice a day for 10 days followed by strengthening exercise from neuro physiotherapist use firm hard and even mattress for sleep.
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I had backache and stomach pain since last month what medication should I take up and what are the method for quit smoking as my younger brother smoke very much around 5 to 6 in a day what should I do now?

MBBS
General Physician, Mumbai
I had backache and stomach pain since last month what medication should I take up and what are the method for quit sm...
For stomach pain take tablet Meftalspas-Ds with rantac and for your brother ask him to take tablet librium to quit his smoking habit for two weeks
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