Deep Muscle Soreness after Prolonged, Intense Exercise

You should stop exercising for several days when you feel deep muscle soreness after very long exhaustive exercise such as running a marathon (26 miles), cycling a century (100 miles), going on a very long hike or lifting heavy weights repeatedly for a long time. Prolonged deep muscle soreness after running a long distance very fast is characterized by severe damage to the muscle fibers themselves. The muscle fibers are torn, the cell membranes are ruptured and the internal content of cells leak outside into the surrounding tissue (J Neuro Sci 1983;59:185-203). Of course, you do not need to stop exercising for the mild muscle soreness that you feel after a normal hard workout.

The deep muscle soreness that follows hard running is far less likely to occur in cyclists, swimmers or athletes in other sports because running causes eccentric contractions, while swimming and cycling usually do not. Muscles move your body by pulling on bones when they shorten. However if your sport forces muscles to lengthen when they contract, the severe force on the muscles caused by eccentric contractions (stretching during contraction) tears the fibers and ruptures the membranes. When you run fast, particularly down hills, your thigh muscles try to keep the knee and hip from bending excessively when your heel hits the ground, and they are stretched and torn.

The severe soreness from muscle damage is virtually always reversible, will almost always heal completely without treatment, and is part of the training process. Mild casual exercise does not help you to heal faster, so you might just as well curtail your running for a few days until the soreness lessens. You should not resume intense exercise until the soreness disappears completely.

Highly trained, competitive athletes will recover faster by eating a diet rich in protein and carbohydrates. However, less-conditioned people with muscle soreness will only gain weight if they increase food consumption.

Although many athletes believe that massage, stretching, or cross training help to relieve deep muscle soreness, scientific research has failed to prove that they actually hasten the recovery process.

HPV and Cancer

How do you get HPV? You acquire Human Papilloma Virus (HPV) through direct skin to skin contact with an infected person, through vaginal, penile, oral, or anal sexual contact, even if a person has no warts. The more sexual partners you have, the more likely you are to be infected and develop cancers from it. These viruses cause virtually all cases of cervical cancer and many cancers of the skin, vagina, penis, anus, mouth, nose, head and neck. Using condoms helps reduce your chances of becoming infected, but does not offer complete protection. Six million North Americans are newly infected each year, Twenty million are infected now with HPV, and more than 80 percent of sexually-active men and women have been infected.

Types of HPV: More than 150 different HPV viruses have been found, and the ones most likely to cause cancers are types 16, 18, 52 and 59. They are also the ones that persist the longest, and are most likely to cause cancers and abnormal PAP smears.

Can I ever get rid of HPV? Doctors cannot cure HPV, they can only destroy the warts caused by these viruses with chemicals or remove them with surgery. Most infections appear to clear themselves without any treatment (Am J of Ob and Gyn, 2000;183(3): 561-567). DNA tests of HPV show that 70 percent of women clear HPV infections within one year, and only nine percent continue to be infected after two years (NEJM, 1998;338(7):423-428). A summary of several studies shows that 90 percent of HPV tests become negative in about two years. The current theory is that you become infected with HPV through sexual contact and it can disappear without treatment, as cultures fail to find it. We do not know if the virus really goes away, but we often cannot find it. However some people never clear the high-risk HPV types and it is the persistent infections that can lead to cancers (Trends in Microbiology, 2011(Jan);19(1):33-39). Each additional sexual exposure increases your chances of acquiring additional HPV viruses and the specific viruses that cause cancer. You can have several different HPV virus types at the same time. Infected people who continue to have the most sexual contacts are the ones most likely to continue to be infected with HPV, as each new exposure carries risk for a new infection.

How long does it take for the virus to become undetectable? The average time for a person who has acquired HPV to have the virus unavailable for culture is six months. However, those with high risk HPV 16 and 18 took an average of almost eight months for the virus to become non-detectable. Again, we do not know if it really goes away.

Does having the virus cause abnormal pap smears? Most women who are infected with HPV will not develop a positive PAP test.

Immunization: Immunization protects you from infection with the viruses in that vaccine. It does not protect you from the many viruses not in the vaccine. High risk HPV subtypes are associated with almost all cervical cancers. Available HPV vaccines contain high risk HPVs 16 and 18.