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Dr. Suresh Suryawanshi

Physiotherapist, Pune

500 at clinic
Dr. Suresh Suryawanshi Physiotherapist, Pune
500 at clinic
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My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Suresh Suryawanshi
Dr. Suresh Suryawanshi is one of the best Physiotherapists in Fatima Nagar, Pune. You can visit him at Dr. Suresh Suryawanshi@Inamdar Multispeciality Hospital in Fatima Nagar, Pune. Book an appointment online with Dr. Suresh Suryawanshi and consult privately on Lybrate.com.

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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.

Hi doctor my husband is suffering with spinal cord disc problem. Some time he gets more anger for silly things is this related to spinal problem or else. please suggest me doctor how to control his anger.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Hi doctor my husband is suffering with spinal cord disc problem. Some time he gets more anger for silly things is thi...
Nothing to do with Spine Lesion do Take balanced diet and hyderated Avoid stress anxiety and anticipating the things Do focus one thing at a time and concentrate on that particular task till gets completed Best Wishes
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I am 56. Practice running for 45 years. Left knee pain when step up to stairs. Need recommendations re exercise.

CCP, MBA, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Karnal
I am 56. Practice running for 45 years.
Left knee pain when step up to stairs. 
Need recommendations re exercise.
You need to undergo janu vasti & start taking panchakatikta ghrit guggul orally. Calcium & vitamin d3 is not the solution. Please consult a panchakarma centre near you for janu vasti.
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I have always pain in my thighs when I climb any bikes and when I make my leg free its ok when I close my leg, then there is a severe pain in my things, whats the reason doctor? please help me?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
I have always pain in my thighs when I climb any bikes and when I make my leg free its ok when I close my leg, then t...
It might be of ls spine or of gluteus muscle strain of rupture do consult neuro physio and take appropriate therapy.
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I am 21 year old male and have backache for last 4 months. I have used pain relief ointment cream for couple of days but haven’t got any relief. What should I do now? And now a days am doing exercise for it so what I can do?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am 21 year old male and have backache for last 4 months. I have used pain relief ointment cream for couple of days ...
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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I am 21 year old and having pain in left knee. Pain started with an injury two years ago please suggest what I should do.

Fellowship in Shoulder and Knee Surgeries, DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Nagpur
I am 21 year old and having pain in left knee. Pain started with an injury two years ago please suggest what I should...
Post injury knee pain is mostly because of meniscus tear or ligament injury. Get MRI of knee at best centre with 3 tesla machine. That will be helpful to have diagnosis Then treatment can be advised
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My wife is 65 years old from past 5 /6 months had pain in her both knees ,doctors has suggested total knee replacement, doctors has told that she varicose vein disease also. She is not interested in her knee surgery. I, therefore, request you to kindly suggest some treatment for her knee problem and also for varicose vein problem.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Noida
My wife is 65 years old from past 5 /6 months had pain in her both knees ,doctors has suggested total knee replacemen...
Hello Lybrate user As you asked about your wife's problems related to knee joints pain. It is due to dryness of synovial fluid which create movement. Not need to replacement of knee. She may follow some Ayurveda medicines as given below. 1 / Lakshadi Guggul. .2tabs Singhnad Guggulu .2tabs Arogyavardhini vati .1 tab twice daily with warm water after meals. 2 / Dhanwantaram KUZUMPU oil massage over effected knee joints and janu basti every day for 10-20 days. She will be get rid of her problems related to joints. I would like to advise you to consult me privately for her Pulse Diagnosis and proper treatment.
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I am feeling very weakness and my backbone is paining so can you please tell me what should I so?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
I am feeling very weakness and my backbone is paining so can you please tell me what should I so?
Homoeopathic medicine SPONDYAID ( BAKSON) Drink 10 drops in 20 ml fresh water 3 times daily CALCAREA PHOS 6X ( Dr Reckeweg) Chew 4 tab 3 times daily Report after 15 days
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Hey I want to ask about my father who use to work usually sitting in a chair so his hip always use to get pain. He dosent take any medicine at all .he is not suffering with sugar .his age is 51so please help.

DHMS (Hons.)
Homeopath, Patna
Hey I want to ask about my father who use to work usually sitting in a chair so his hip always use to get pain.
He do...
Hello, Lybrate user, Tk, homoeo medicine:@ Hypericum 1000-5 drops, wkly. He, should go for walk in the morning. His diet be easily digestible as per anti-diebetic norms. He ,should go for meditation to reduce his stress. He, should avoid junkfood, alcohol, nicotine, cold intake. Report, wkly, your feedback matters for further follow-up, please. Tk, care.
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My legs are paining a lot in the night time while I am going to sleep. For that way should I do? Please help me.

BPTh/BPT
Physiotherapist, Mumbai
My legs are paining a lot in the night time while I am going to sleep. For that way should I do? Please help me.
Hi looks like you have restless legs syndrome (rls) kindly rule out iron deficiency, diabetes. It can also be due to peripheral neuropathy alcohol and sleep deprivation. Treatment * begin a regular exercise program, *establish a regular sleep patterns, and *eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. *leg massages *apply hot baths or heating pads or ice packs to the legs do reply for detail treatment plan. Wishing you a good health.
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I had a back pain. From 1 week. Even I can not sleep in nights. What can I do to get relief from this?

Cert.MDT (Mckenzie spine Therapist), CMP, MPTh/MPT, CDNT
Physiotherapist, Gurgaon
I had a back pain. From 1 week. Even I can not sleep in nights. What can I do to get relief from this?
Do hot fomentation twice daily. Postural correction- always sit with a small pillow at your low back. Sit tall, walk tall. Extension exercises like bridging and bhujang asana x twice daily. Sleep on your back with a pillow under your knees or on your sides with a pillow between your knees. And get vit d levels checked. Go for regular walks follow 30-30 rule when at work. After every 30 min of work. Do 30 sec of stretching or stand and walk a bit.
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Having pain in left shoulder. Specially in morning, feels like crazy and sometime reduces with time.

BHMS
Homeopath, Agra
Having pain in left shoulder. Specially in morning, feels like crazy and sometime reduces with time.
Hello, you can take homoeopathic medicine bryo 30, 2 drops twice a day for 7 days and update. If you want permanent homoeopathic cure, then consult me.
3 people found this helpful
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My mother has knee pain 2 years back, treated at orthopaedic center. Now little pain is der at just above the knee joint.

D.A.M.S( A. M.), D.AC/B.E.M.S
Acupressurist, Mumbai
My mother has knee pain 2 years back, treated at orthopaedic center. Now little pain is der at just above the knee jo...
You should take acupressure treatment and take biochemic calc flour 200x 4 tab thrice a day with warm water and take it 5 days and inform me private online.
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In April I had been for endoscopy every thing is normal, in July there is slightly pain in left chest, I had been for ECG it's normal, now a days I am getting pain in liver side last 2 months, I had been for ultrasonic scan reports are normal, but little bit pain is there in liver side do the needful doctor.

M.S. (proctology)
Proctologist, Navi Mumbai
In April I had been for endoscopy every thing is normal, in July there is slightly pain in left chest, I had been for...
I think you are having symptoms related acid peptic diseases like hyperacidity if every thing is normal then not to worry because liltebit stress also causes above symptoms increase Water intake specially after 1_1/2 after good it helpful proper digestion.
3 people found this helpful
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For past two months I am having pain in my heels when I wake up in the morning for around 5 minutes and after that it lessens but when I sit and stand the heel starts to pain again. Please give some tips and help me out.

BPTh/BPT
Physiotherapist, Mumbai
For past two months I am having pain in my heels when I wake up in the morning for around 5 minutes and after that it...
Hi self-management may include using ice, stretching, wearing proper footwear and altering training (exercise) methods. Ice should be applied prior to and following activity for approximately 20 minutes. Try using a frozen bottle of water and gently rolling it under the arch and heel.
1 person found this helpful
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I have a knee problem some time basically in winter it gives electric shok pain. What can do?

BHMS
Homeopath, Faridabad
I have a knee problem some time basically in winter it gives electric shok pain. What can do?
Hello, Is there any history of injury or hurt to the area? Any underlying medical condition? Medication: Meantime, take homoeopathic medicines - Arnica 200 and Rhus Tox. 200 - take both of them thrice daily for 1 week. Also, apply Schwabe's Topi-Arnica and Topi MP Gel on the affected area in circular motions gently thrice a day. And wrap crepe bandage over it. Get back to me thereafter.
1 person found this helpful
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I am suffering from shoulder pain from last five years I was take treatment and it works but when I stop the treatment its again start.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am suffering from shoulder pain from last five years I was take treatment and it works but when I stop the treatmen...
It requires detailed investigation and examination. Preliminary investigations suggested: hb, tlc, dlc, esr, blood sugar fasting & pp, uric acid vit d urine r/e x-ray of the affected part. Anyway it may be tried sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress 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. Do not ignore it. Let it not become beginning of a bigger problem. Make sure that patient is not allergic to any of the medicines that he/she is going to take. If it does not give relief in 4-5days, inform.
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I am 29 years old male having muscular problem from my neck to whole back. feeling tired everytime. Please help me.

BHMS
Homeopath, Sindhudurg
I am 29 years old male having muscular problem from my neck to whole back. feeling tired everytime. Please help me.
Homeopathy is one of the most important and effective therapy for back pain. Homeopathy produces excellent results in backache treatment without producing any side effect and is extensively used in all over the world. Homeopathy is a nature system of healing and that is why it can heal whole symptoms of illnesses and it also cure the illness from its root. Back pain is one of the people?s most frequent complaints. Eight out of 10 people are suffering from back pain. It is a third leading cause for surgery. Surgery is considered to be the most common or ultimate solution to this problem. Unfortunately, significant number of people still doesn?t get a complete relief from this problem even after the complicated surgery. Do not get frustrated Homeopathy can change your life? Tips for backache: Heavy objects should be pushed rather than pulled. The weight of the objects should be taken in your bent legs and arms and not in your back. During an acute attack sleep with a pillow under the knees. Choose shoes that offer good support in the arch and have low, but not flat, heels. Prop up one foot on a box or low stool when you're standing for a long time. Use a chair that provides support for your back, or tuck a little pillow behind your lower back
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