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Filed under: Injuries

DOMS: Post-workout delayed muscle soreness

A tough workout can leave you sore for days. Find out how to prevent and reduce delayed onset muscle soreness (DOMS).

Muscle pain a day or so after exercise—known as delayed onset muscle soreness (DOMS)—is common among athletes. Do you wonder why this happens—even when your workout went great—or what you can do about it?

DOMS results from damage to muscle fibers that occurred during exercise. You might experience DOMS after a hard workout, or even simple activities such as running and/or walking downhill or jumping. It also can occur when you’re starting a new workout routine or just getting back into shape after an illness or injury. The good news is DOMS can be treated at home—and sometimes prevented—with simple techniques, including stretching, protein/carbohydrate recovery drinks, and cold-water immersion. Sports massage and foam rolling can help reduce muscle soreness too.

Over-the-counter medications also can provide some relief. But use these at the lowest effective dose. Visit your doctor if the pain worsens or swelling occurs. In the meantime, read HPRC’s article, “Delayed Onset Muscle Soreness,” to learn about the difference between DOMS and other musculoskeletal pain.

How to avoid stress fractures

Painful stress fractures can hurt your workout routine too. Learn more about training safely.

An important thing to know about stress fractures is how to avoid them. A stress fracture is a tiny crack in a bone that happens when your muscles can’t absorb shock and transfer stresses to the bone. Most occur in the lower extremities, especially the lower leg and foot.

A stress fracture is usually an overuse injury that develops over a long period of time—from weeks to months. They’re especially common among military recruits, in about 3% of men and 9% of women. And since it can take several weeks to months for a stress fracture to heal, the best approach is to avoid getting one. Here are some tips for prevention:

  • Use the progression principle of training: Gradually increase your training intensity, usually by no more than 10% weekly if you exercise 3 or more days a week. Slowly incorporate higher-stress activities such as jumping and interval training into your workout. Set incremental goals to help you develop your training routine step-by-step.
  • Check your footwear and make sure it matches your training routine. Replace old or worn footwear.
  • Check your form. Are you moving properly when you exercise or does your form put you at risk of injury?
  • Pay attention to early signs of injury. Unusual muscle soreness and other aches and pains can be a sign of injury and/or imbalances that could worsen if they aren’t addressed early.
  • Monitor your diet, specifically calcium and vitamin D intake. To learn more, read the National Institute of Health’s Dietary Supplement Fact Sheet on calcium and HPRC’s article on vitamin D.

It’s important to recognize a stress fracture and get medical help early, as described by the American Academy of Orthopaedic Surgeons. The Mayo Clinic provides more information on symptoms. And check out HPRC’s Injury Prevention section for more on how to avoid injury.

Protective eyewear could prevent injuries

HPRC Fitness Arena: Environment, Total Force Fitness
Blast shockwaves can seriously damage eyes, but immediate treatment could aid healing. Learn more about protecting your eyesight.

Many service members exposed to bomb blasts in the field walk away unscathed—or so it would seem. However, there could be some damage they’re not “seeing.”

High-pressure shockwaves from explosive blasts can cause serious eye trauma. In fact, up to 10% of all blast survivors experience significant eye injuries from projectiles thrown into their eyes, eye perforations caused by the high-pressure blast waves, or effects on the eyes associated with traumatic brain injury (TBI). If you were exposed to a blast while in the field but weren’t otherwise injured, don’t wait to set up an appointment with your eye doctor. Prompt medical attention could prevent permanent injury.


Most eye injuries are preventable if you wear protective eyewear on-duty and off-duty. There are many options to choose from the Department of Defense’s (DoD) approved Authorized Protective Eyewear List (APEL). Your vision is extremely important! For more information on protecting your eyesight, visit the Vision Center of Excellence

You’ve got questions?

We’ve got answers. Learn more about staying physically fit in HPRC’s FAQ and Ask the Expert sections.

Looking for some answers to basic fitness questions? You’re not alone. We’ve created a FAQ section on topics we hear a lot about. Whether you want to know about flexibility, cardiovascular fitness, injury prevention, or workout routines—we have the answers. Still can’t find what you’re looking for? Submit your question using our Ask the Expert feature. We’ll provide an evidence-based answer to keep you informed and in shape.

Check back often to learn the latest and greatest information on exercising, optimizing performance, and staying resilient. 

Recovery Care Coordinators can help!

Learn how Recovery Care Coordinators help service members during their recovery, rehabilitation, and reintegration process after a serious or catastrophic wound, illness, or injury.

Recovery Care Coordinators (RCC) help wounded, ill, and injured service members, their caregivers, and their families navigate the recovery, rehabilitation, and reintegration process. They help ensure a smooth transition from a recovery and rehabilitation setting back into the civilian community or, in some instances, back to military duty. An RCC is the first point of contact within each of the military services’ wounded warrior programs. RCCs are located at military treatment facilities and installations throughout the country and overseas. Referral to RCCs can come from the service member, a caregiver, a family member, medical personnel, or a wounded warrior program. For more information on the referral process (and for contact numbers), read this factsheet.

How do RCCs help support service members, their caregivers, and their families during what is often a difficult and stressful period in their lives? The RCC develops a comprehensive recovery plan (CRP) with the service member, caregivers, family members, and the recovery team to identify goals and resources needed to achieve those goals, such as assistive technology, education, employment, or housing.

The DoD Office of Warrior Care Policy is responsible for oversight, policy of the Recovery Coordination Program, and standardized training for all RCCs, but each military service branch implements its own Recovery Coordination Program in accordance with DoD policy. The terminology may differ with service (for example, advocate, care coalition, recovery care), but the mission and the standards are the same. Check out the following links for service-specific information:

Spare your back when moving

Here’s a reminder about how to handle heavy objects properly and protect your back when loading your moving truck during PCS.

Service members and their families relocate a lot, and moving to a new home is hard enough without adding injury. Here are some tips on how to properly handle heavy objects such as moving boxes and furniture, and how to take care of yourself if you do sustain an injury:

  • Wear less-restrictive clothing such as looser-fitting pants or workout clothes.
  • Wear closed-toe shoes.
  • Take breaks when necessary. Stretching and reassessing your mechanics can help you maintain proper posture when lifting. HPRC has tips on how to maintain flexibility and remove tension in your body.
  • The U.S. Army has fact sheets on Lifting Techniques for handling heavy objects and How to Safely Perform Pushing and Pulling Tasks.
  • Remember to keep your core tight, and use your leg muscles rather than your back to lift heavy objects.

The best way to prevent back injury is to strengthen your back and core muscles. The National Institutes of Health (NIH) has suggestions and exercises to help build your back.

If you’re sore from all the lifting or think you may have pulled something, you can treat the pain with ice and rest—and perhaps an over-the-counter pain reliever—for the first 48 hours. Follow NIH guidelines on how to further treat your back pain if it’s acute. However, if the pain persists, consult your doctor to rule out a more serious back problem or injury before you do any more heavy lifting. If all seems well, consider core-strengthening exercises to support your back. Another option is a yoga class to relieve your pain, build your muscles, and return your back to normal function.

For more about how to protect your back, please visit HPRC’s Injury Prevention Series. Good luck with your PCS!

Is your Achilles tendon an uphill battle?

The Achilles tendon is stronger than you think, even when running hills.

The Achilles tendon (on the back of your ankle) is a common site for injury, especially for runners. And many people think running hills increases the likelihood of injuring their Achilles. Hill running provides many health benefits (cardiovascular endurance, strength, performance, etc.), but do the benefits outweigh the risk to your ankles? For the most part, the answer is, yes! The effects on your Achilles tendon while running on a flat surface, uphill, and downhill are all similar, meaning the risk of injury is no greater when running uphill or downhill than on the flat. Achilles injuries usually happen because of a combination of internal (ankle misalignment, muscle weakness, decreased flexibility) and external factors (footwear, over training, humidity, altitude). With movement, however, the Achilles tendon becomes more flexible, so a proper warm-up before exercise will help prevent injury.

What this suggests is that running hills isn’t necessarily a cause of injury to the Achilles tendon. More likely causes include progressing too quickly as a new athlete or not properly recovering from an injury. If you’re recovering from a previous injury to your Achilles tendon, talk to your doctor or therapist about when it’s safe to run again and how much hill running you are able to do. Be gradual in your return to running, especially hills. Don’t try to sprint up or down anything too steep too soon. But as long as you’re healthy, at your next hill encounter, be confident and take it on; your body is more likely to benefit than not.

National Veterans Summer Sports Clinic

Calling injured veterans to sign up for the National Summer Sports Clinic in San Diego, CA, September 13–18, 2015.

Spring is just around the corner, so it’s time to start thinking about sports and outdoor recreation. In keeping with the Mission ReDefined campaign (a joint effort of the U.S. Department of Veterans Affairs and the U.S. Paralympics), VA encourages eligible veterans (those injured within the last six years) to apply for the 2015 National Veterans Summer Sports Clinic.

The purpose of the Clinic program is “early intervention for Veterans battling back from injury, not only strengthening their bodies but improving overall well-being and self-worth.”

Spend a week in San Diego learning about adaptive sport and recreational activities such as sailing, surfing, track and field events, kayaking, and cycling (hand and tandem). This is a national event open to Veterans from all across the country with combat injuries ranging from TBI and polytrauma to spinal cord injuries and loss of limbs.

The clinic will be held in San Diego, CA, from Sept 13–18. 2015. The deadline to sign up is May 1, 2015; visit the Registration tab at the Clinic link above for details and forms.

Stay injury free with our new strategies!

Filed under: Injuries, Prevention
HPRC continues to expand its valuable strategies for injury prevention.

HPRC previously ran an Injury Prevention series with some general information to help keep you off profile. A new addition to the series is Injury Prevention Strategies, which will include information for the knees (specifically the anterior cruciate ligament or ACL), ankles, shoulders, and back. Check back often for the next in the series, and keep your body functioning at the top of its game!

Safe return to duty after a head injury

Filed under: Concussion, Injuries, TBI
Mild traumatic brain injuries (concussions) are very common in the military. Learn how you and your doctor can get you safely back to duty.

Returning to duty after a mild traumatic brain injury (mTBI; also referred to as acute concussion) requires a special recovery process. Until now, procedures used by military healthcare professionals were largely based on sports-related mTBI practices, which are not always appropriate for returning Warfighters to military activities and demands. Medical and military experts worked together to develop new recommendations for returning service members to military activity after mild traumatic brain injury. The six-step process includes progressing from rest through light to moderate activity and exercise and eventually to unrestricted activity. Patients cannot progress until they are symptom free at any given stage in the process. Almost 84% of military brain injuries in 2014 were from mTBI/concussions. Some of the most common causes of concussions occur in non-deployed setting. While not all mTBI/concussions are preventable, there are things that you can do to reduce your risk in your day-to-day life:

  • Always wear a seat belt when driving or riding in a vehicle.
  • Wear a helmet when suitable (for example, on a bicycle or motorcycle).
  • Create safe living spaces to reduce falls. Remove or secure potentially hazardous items from floors and overhead.
  • Be aware of your surroundings. Try these Mind Tactics Performance Strategies to improve your ability to control your attention.
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