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July 10, 2019

Injury Versus Normal Soreness: How to Differentiate Between the Two

Has your child or kids you coach ever experienced soreness following a workout, practice, or a game? Sometimes it can be difficult to distinguish between harmless muscle soreness, the onset of a new injury, or exacerbation of an old one. Here are seven tips to help you, as a coach or parent, differentiate between the two.

1. The soreness is felt on both sides of the body versus on one side

Unless for some reason the child trained just one side of their body (such as working on single leg strength in a rehabilitation setting following ACL reconstruction to the right knee), soreness from a workout, practice, or game is typically experienced on both sides of the body. If, however, he/she complains of pain/discomfort in one knee, shoulder, or ankle, consider this as a possible warning sign of an injury to that area.

2. The soreness is felt in the center of the muscle versus a joint

The “good” soreness that is experienced following activity is the result of a small degree of fiber damage to muscle tissue as well as the build-up of metabolic waste (and no this isn’t “lactic acid,” which is an antiquated and debunked theory). Therefore, the muscle belly should be the area of tenderness or soreness. To the contrary, if the child is complaining of discomfort/pain located at a joint (e.g. knee, ankle, hip, shoulder, elbow), there is cause for concern, as joints should not feel sore following a training session.

3. Soreness appears after a change in workout intensity, duration, or modality versus appearing daily

When the body is challenged with a new stimulus, such as a different lift in the gym, an increased number of hill sprints at practice, or a tough game that went extra innings, it’s expected to feel soreness in the muscles which were challenged. But, if the soreness is experienced daily, especially when there has been no change in intensity, duration, or the modality of exercise, the possibility of an injury is greater.

4. Soreness improves after a warm-up versus worsens during the workout

Often a well-structured warm-up (stay tuned for my next article regarding what constitutes a good warm-up), will give insight as to whether the soreness experienced by the child is “good” soreness, or the onset of an injury. The goal of the warm-up is to increase core temperature, increase range of motion, increase the brain-body connection through movement, initiate muscle coordination/co-activation, integrate foundational movement patterns, and incorporate sport and activity-specific movements. Clearly a jog down and back on a field does not accomplish all of these objectives hence my comment of a “well-structured warm-up,” but I digress. Often by accomplishing each of these tasks, the child will sense they are moving better, with less soreness, and feel ready to train/practice/play. On the other hand, if after completing the warm-up, he/she continues to experience discomfort, it’s time to shut things down and reevaluate, as an injury may be the culprit.

5. Soreness improves daily versus worsening or remaining daily

As mentioned above, both muscle fiber damage and metabolic waste contribute to the soreness experienced by the child. As a result, soreness should decrease with each passing day as the body goes through the recovery process (and can be sped up with certain recovery techniques/modalities – stay tuned for an article on this topic as well).  If the soreness persists beyond several days or worsens, this may be a warning sign of an underlying injury.

6. Soreness doesn’t affect your form versus affecting your form

When the child is participating in a workout/practice/game, the soreness they experience should not affect their form with regard to lifting or the movements required for their activity/sport. As previously stated, the warm-up often mitigates the soreness by enhancing vascularity to the area, increasing range of motion, and improving overall movement. At this point, the movements required for that workout/practice/game should be performed without any compromise. As a parent or coach, if you observe the child favoring one side or not moving as well as they normally do, check in with him/her. This may be an indication of an injury.

7. Soreness is generalized versus localized

Again, with muscle soreness, the discomfort is typically diffuse throughout the area. If the child specifically points to one confined spot, this should raise concern that further evaluation is needed.

In the medical community when we evaluate patients, we don’t “hang our diagnostic hats” on one specific finding, test, or complaint. It’s a cluster of findings that lead us to the correct diagnosis. These seven tips are no different in that the presence of just one doesn’t mean the child has an injury. Evaluate each tip and then take inventory. If you find the majority of these “warning signs” are present, it is time for a proper evaluation by a medical professional (e.g. medical doctor, chiropractor, physical therapist, athletic trainer). The more knowledge you have as a coach or parent, the better off our youth athletes will be with regard to career longevity and success.


Roundtree, Sage. (2011) The Athletes Guide to Recovery. VeloPress

Written by Dr. Jenn Reiner-Marcello

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