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Pain when pressed on the back
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I have pain in my thigh
Back is tender when pressed
Tightness in the chest
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Muscle soreness is due to inflammation of muscle cells. Causes include intense exercise, viral illness, drugs, and autoimmune disease (body's immune system attacking itself).
Your doctor may ask these questions to check for this disease:
This condition usually improves on its own or after treating the cause. Physical therapy can help increase flexibility and relieve pain. Other simple treatments include warm compresses, stretching exercises, and avoiding intense exercises until the pain resolves. Medications like painkillers and muscle relaxants may also help.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Jan 14, 2025
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This questionnaire is customized to your situation and symptoms, including the following personal information:
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Q.
Heart Health After 65: A Senior's Guide to Safe Zone 2 Aerobic Training
A.
Zone 2 aerobic training after 65 means steady, conversational pace activity you can sustain, roughly 60 to 70 percent of estimated max heart rate, for 20 to 45 minutes on 3 to 5 days per week to support circulation, blood pressure, cholesterol, and long term heart health. There are several factors to consider, including safe activity choices, how to progress, and warning signs like chest pain, unusual shortness of breath, dizziness, or new palpitations that mean you should stop and speak to a doctor; see the complete guidance below for important details that could shape your next steps.
References:
* Siewierska, M. K., Siewierski, M. A., & Bąk, K. (2023). Effects of different exercise training intensities on functional capacity and cardiovascular outcomes in older adults: A systematic review and meta-analysis. *Geroscience*, *45*(6), 3327-3343.
* Stasiak, M., Siewierska, M. K., Siewierski, M. A., & Szczygiel, M. (2022). Aerobic Exercise Intensity for Older Adults with Cardiovascular Risk Factors: A Systematic Review and Meta-analysis. *Clinical Interventions in Aging*, *17*, 1785-1801.
* Arena, R., Mignogna, G., Arena, B., & Cahalin, L. P. (2020). Physical Activity and Exercise Training in Older Adults With Cardiovascular Disease. *The American Journal of Cardiology*, *125*(11), 1734-1743.
* Izawa, K. P., Maekawa, E., Takashima, R., & Omiya, K. (2020). Cardiovascular benefits of aerobic exercise in older adults: An updated review. *Journal of Physical Therapy Science*, *32*(12), 856-860.
* Guazzi, M., Vicenzi, M., Arena, R., & Arena, R. (2020). Exercise training in older patients with heart failure with preserved ejection fraction: a narrative review. *Journal of Geriatric Cardiology : JGC*, *17*(5), 282-290.
Q.
The "Slow" Secret: Why Running Slower Is Actually the Key to Living Longer
A.
Running slower at a steady Zone 2 pace is linked to a longer, healthier life by strengthening mitochondria, protecting the heart and blood vessels, lowering chronic inflammation, supporting brain function, and being sustainable enough to build consistency. Aim for conversational-effort sessions about 60 to 70 percent of max heart rate for 30 to 90 minutes, 3 to 5 times weekly, using high intensity sparingly, but there are several factors to consider, including recovery needs, pain signals, and when to talk to a doctor, so see the complete details below to guide your next steps.
References:
* Schnohr P, O'Keefe JH, Marott JM, Lange P, Jensen GB. Dose of jogging and long-term mortality: The Copenhagen City Heart Study. J Am Coll Cardiol. 2015 Feb 10;65(5):411-9. doi: 10.1016/j.jacc.2014.11.023. PMID: 25616847.
* Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014 Aug 5;64(2):118-29. doi: 10.1016/j.jacc.2014.04.058. PMID: 24819289.
* Mandsager K, Boddupalli D, Patel H, et al. Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing. JAMA Netw Open. 2018 Oct 5;1(6):e183605. doi: 10.1001/jamanetworkopen.2018.3605. PMID: 30646252.
* Siewert K, Gläser A, Schipke J, Laufs U. Physical activity and all-cause mortality: what is the dose-response relation? Dtsch Med Wochenschr. 2018 Sep;143(19):1396-1402. doi: 10.1055/a-0639-5095. PMID: 30257321.
* Lavie CJ, Sallis R, Kokkinos P, et al. Mortality in joggers: magnitude of risk and biological age. Prog Cardiovasc Dis. 2013 May-Jun;55(6):483-8. doi: 10.1016/j.pcad.2013.04.001. PMID: 23642493.
Q.
The Over-Training Warning: How High-Intensity Workouts Might Be Aging Your Heart
A.
High-intensity workouts done too often may age your heart by overloading it, raising the risk of atrial fibrillation, coronary artery calcium, inflammation, and other stress effects, especially with inadequate recovery. There are several factors to consider, including using Zone 2 training as your base, limiting hard days, and knowing when to seek care. See the complete guidance below for heart rate targets, the 70 to 80 percent Zone 2 and 20 to 30 percent high-intensity split, recovery strategies, and red flag symptoms that should prompt a doctor visit.
References:
* D'Andrea, I., Biffi, A., Pelliccia, A., Vianello, L., Furlanello, F., & Sarto, P. (2018). Cardiac remodelling in endurance athletes: A physiological adaptation or a pathological process? Journal of Cardiovascular Medicine, 19(5), 231-237.
* Peake, J. M., Tan, S. J., Frith, E., & Pyne, D. B. (2020). Oxidative stress, inflammation and immunity in overtraining. Exercise Immunology Review, 26, 84-118.
* La Gerche, B. (2019). Endurance exercise and cardiac fibrosis: A review of the literature. Heart, Lung and Circulation, 28(6), 879-887.
* te Riele, T. J. W. M., James, C. A., Bhonsale, A., Groeneweg, J. A., Murray, B., Tavares, T., ... & Calkins, H. (2018). Arrhythmogenic right ventricular cardiomyopathy and exercise: A new look at an old problem. European Heart Journal, 39(4), 289-299.
* Hautala, A. J., Kiviniemi, A. M., Kähkönen, E., & Tikkanen, H. O. (2023). Excessive endurance exercise: A health hazard?. Current Opinion in Cardiology, 38(5), 452-458.
Q.
Zone 2 Cardiovascular Exercise: Mitochondrial Health and Longevity Protocols
A.
Zone 2 training is steady, conversational aerobic work at roughly 60 to 70 percent of your max heart rate that boosts fat oxidation, expands and strengthens mitochondria, and improves cardiovascular, metabolic, brain, and inflammation markers tied to healthy longevity. There are several factors to consider, including how to find your zone, session length and frequency, activity choices, common mistakes, special populations, and safety red flags; see below for complete guidance that can shape your next steps and when to speak with a clinician.
References:
* Daussin FN, et al. Exercise and mitochondrial health: A path to longevity. Oxid Med Cell Longev. 2017;2017:6340263. doi: 10.1155/2017/6340263. Epub 2017 Mar 29.
* Lanza IR, Nair KS. Exercise training and mitochondrial function in aging: the importance of exercise intensity. J Appl Physiol (1985). 2010 Jun;108(6):1614-22. doi: 10.1152/japplphysiol.00194.2010. Epub 2010 Mar 11.
* Safdar A, et al. Mitochondrial biogenesis, function, and dynamics in response to exercise: a focus on aging. Antioxid Redox Signal. 2011 May 1;14(9):1647-59. doi: 10.1089/ars.2010.3792. Epub 2011 Jan 14.
* Piccirillo R, et al. Impact of exercise on mitochondrial health and redox homeostasis: current evidence and future directions. Redox Biol. 2021 May;41:101889. doi: 10.1016/j.redox.2021.101889. Epub 2021 Mar 18.
* MacInnis MJ, Gibala MJ. The physiological role of exercise intensity on mitochondrial biogenesis. Med Sci Sports Exerc. 2006 Jan;38(1):154-61. doi: 10.1249/01.mss.0000180492.36507.03.
Q.
Zone 2 for Women: How Low-Intensity Cardio Supports Hormonal Balance
A.
Zone 2 low intensity cardio at about 60–70% of max heart rate supports women’s hormonal balance by keeping cortisol lower, improving insulin sensitivity and fat metabolism, and supporting thyroid, adrenal, and mitochondrial function across reproductive years, perimenopause, and after menopause, with most benefits seen from 150–300 minutes per week in 30–60 minute sessions. There are several factors to consider, including how to find your zone, how to pair with strength and occasional intensity, signs you are pacing correctly, and important safety symptoms that mean you should speak to a doctor; see below to understand more.
References:
* Hagstromer M, Oja P, Sjostrom L, et al. Physical activity and reproductive hormones in women: a systematic review. *Int J Behav Nutr Phys Act*. 2011;8:132. Published 2011 Nov 21. doi:10.1186/1479-5868-8-132
* Li Z, Zhao J, Gao J, et al. Effect of aerobic exercise on insulin sensitivity in healthy women: a meta-analysis. *Exp Ther Med*. 2019;17(6):4853-4859. doi:10.3892/etm.2019.7490
* Thau L, Scherer R, Wopereis S, et al. Influence of moderate-intensity exercise on diurnal cortisol secretion in overweight and obese women. *Horm Metab Res*. 2011;43(9):653-657. doi:10.1055/s-0031-1279768
* Lundgren K, Zierath JR, Krook A. Effects of exercise training on mitochondrial function and lipid metabolism in women. *Exerc Sport Sci Rev*. 2014;42(1):37-43. doi:10.1249/JES.0000000000000003
* Sale C, Elliott-Sale KJ, Fraser WD. Exercise and the female endocrine system: implications for bone, muscle, and metabolic health. *Eur J Sport Sci*. 2015;15(4):301-313. doi:10.1080/17461391.2014.945084
Q.
What causes body aches when you have a cold?
A.
Body aches are a common symptom experienced during a cold, and they can be attributed to several physiological responses to the viral infection. Understanding these causes can help in managing discomfort during illness.
References:
Eccles R. Understanding the symptoms of the common cold and influenza. Lancet Infect Dis. 2005 Nov;5(11):718-25. doi: 10.1016/S1473-3099(05)70270-X. PMID: 16253889; PMCID: PMC7185637.
Q.
How many days does it take for muscle soreness after exercise to heal and how can you deal with it?
A.
Muscle soreness after exercise, known as delayed onset muscle soreness (DOMS), typically takes about 3 to 7 days to heal, depending on the intensity and type of exercise performed. There are several effective strategies to manage and alleviate the discomfort associated with muscle soreness.
References:
Vickers AJ. Time course of muscle soreness following different types of exercise. BMC Musculoskelet Disord. 2001;2:5. doi: 10.1186/1471-2474-2-5. Epub 2001 Oct 23. PMID: 11701094; PMCID: PMC59671.
Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc. 1984 Dec;16(6):529-38. PMID: 6392811.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Glaubitz S, Schmidt K, Zschüntzsch J, Schmidt J. Myalgia in myositis and myopathies. Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101433. doi: 10.1016/j.berh.2019.101433. Epub 2019 Oct 4. PMID: 31590993.
https://www.sciencedirect.com/science/article/abs/pii/S1521694219301093?via%3DihubToth PP. That Myalgia of Yours Is Not From Statin Intolerance. J Am Coll Cardiol. 2021 Sep 21;78(12):1223-1226. doi: 10.1016/j.jacc.2021.07.025. PMID: 34531022.
https://www.sciencedirect.com/science/article/abs/pii/S0735109721057053?via%3DihubKennedy C, Köller Y, Surkova E. Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis. Atherosclerosis. 2020 Apr;299:1-8. doi: 10.1016/j.atherosclerosis.2020.03.006. Epub 2020 Mar 7. PMID: 32179207.
https://www.atherosclerosis-journal.com/article/S0021-9150(20)30138-6/fulltext