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A challenging workout can cause next-day muscle soreness and swelling.
A hard workout can be empowering, making you feel like you have taken charge of your health - until the pain sets in. Soreness and swelling that manifests within 24 to 48 hours post-workout is a normal part of the process of recovery leading to increased muscular fitness. But beware of excessive swelling accompanied by other telling symptoms that could signal a medical emergency.
Some muscle swelling after a workout is inevitable. However, persistent swelling accompanied by pain can be a sign of a medical emergency.
Pain That Leads to Gain
When you exercise in a way that exceeds your body's normal work capacity, a training principle called overload, you set in motion a series of reactions that leads to muscle growth, or hypertrophy. During exercises that cause your muscles to lengthen while force is applied - called eccentric muscle action - you cause microscopic damage to your muscle fibers, according to the American College of Sports Medicine. Eccentric action occurs during downhill walking or jogging, when landing from a jump, or during the lowering phase of a weight-training exercise. Damage to the muscle cells leads to delayed onset muscle soreness, or DOMS, marked by pain, stiffness and swelling.
Understand the Inflammation Response
When your muscle cells are damaged, your immune system responds with a series of immune reactions that cause inflammation, explains exercise scientist Len Kravitz of the University of New Mexico. The inflammation response helps contain the damage and creates an environment where repair can take place. It also serves to rid the injured area of waste products. This temporary post-exercise fluid retention can cause a three- to four-pound weight gain within a few days after a workout, according to Alan Titchenal and Joannie Dobbs, nutritionists with the Department of Human Nutrition at the University of Hawaii. As the muscle tissue heals, the swelling goes away, along with the extra weight.
Fuel Storage and Water Weight
While swelling associated with DOMS is temporary, one adaptation of regular ongoing exercise is an increase in your muscles' storage capacity for glycogen, a fuel source that you use in large amounts during exercise. Titchenal and Dobbs note that with each additional gram of glycogen stored in your muscles, you also store about 3 g of water, which could lead to a weight gain of as much as two to four pounds of body weight. As long as you continue to exercise, heightened glycogen stores will prevail, along with extra water weight.
When Swelling Isn't So Swell
If your muscles are swollen and painful for several days after a workout, you may have done serious damage that can be life-threatening. Overloading your muscles to the point where the cells break down can lead to a serious condition known as exertional rhabdomyolysis, or ER. ER is the result of the contents of muscle cells, particularly myoglobin, leaking into your bloodstream and then filtering into your urine. Exceedingly high myoglobin levels can damage your kidneys and lead to kidney failure. In addition to painful swelling and stiffness, dark brown urine is an indicator of ER. If you have symptoms of ER, seek immediate medical intervention.