Delayed Onset Muscle Soreness and PTS/DVT?

Several types of pain are commonly described during the Post-thrombotic Syndrome and after DVTs, but little has been written about a particular type of pain called delayed onset muscle soreness (DOMS). Delayed onset muscle soreness characteristically occurs hours or days AFTER an unaccustomed increase in exercise activity, even though there was little or NO PAIN DURING the exercise. While often associated with running or walking downhill, it can occur after biking or other exercise activities (http://www.cptips.com/muspain.htm). This pain which is felt in the hours or days after the activity, is experienced as muscles contract – such as putting weight on a leg while running or walking – and the pain disappears as muscles relax - such as during rest. DOMS commonly occurs after unaccustomed increases in exercise, and in our lives before getting our DVTs, we all likely experienced DOMS many times.

The question is, are some people with the Post-thrombotic Syndrome more sensitive to developing delayed onset type muscle pain in their DVT-affected leg than in their unaffected leg?

I would like to ask you, have you found that your DVT-affected leg sometimes develops delayed onset muscle pain even though your unaffected leg does not, following increased exercise activities? What do you think?

Thanks for considering this.

Bob

Hi Bob,

I had a DVT in my right leg almost 2 years ago. I have been experiencing DOMS in both legs after strenuous activities that peak after 72 hours. The DVT leg though is usually 5 to 6 times more sore than the other, and pain will persist in the DVT leg for 4 to 5 days after the pain has stopped in the other leg. I suspect, after two years of favoring my other leg, and general inactivity out of fear and pain, my DVT leg should be pretty badly atrophied. I don't know that atrophy would entirely explain the huge difference in pain though. Anyone else notice this?

EricSt

Hi EricSt,

Thanks for raising this question again. Your description of DOMS-like pain sounds very much like what I continue to experience. With the symptoms being so consistent and reproducible, I’m surprised not more has been said about this. Hopefully we will learn more from others.

I pleased to say that I’ve had less DOMS-like pain since getting custom orthotics and taking gait training. I was apparently applying more weight to the lateral side of my leg than the medial, and this resulted in the lateral muscles carrying more weight than normal. Those therapeutic changes improved the distances and grades I can walk without getting the DOMS-like pain – that pain is predominantly lateral. Even so, as you wrote, my DVT leg continues to be more susceptible than my normal non-DVT leg.

Another interesting note is that 1 ½ yr ago I develop acute hip arthritis in my normal leg. With restricted weight-bearing on my normal leg before and after hip replacement surgery, my normal leg underwent marked atrophy. Yet, in the months after surgery as I began to gain strength and walk more, it was my DVT leg that was more prone to DOMS-like pain than my normal leg. So, I’m attributing the DOMS-like pain to post-thrombic problems and not to atrophy.

Bob

I was sure hoping the increased pain was just due to atrophy. I guess I'll keep working out and see if it improves. I'd really like to hear more feedback on this, too.

Muscle pain was becoming chronic for me along the line of my damaged vein.  It was getting to the point that I thought I may be developing another DVT.  Hamstring stretches daily before bed and recumbent biking have reduced my pain by, I'd say, 90%.  The stretches I learned from a physical therapist that I saw right after my dvt, but I only used them for the first few weeks.  Since I've started using them again, I feel so much better.  In fact this is the best I've felt in over 2.5 years.  If anyone is experiencing pain that seems to be extended DOMS in their dvt leg, I think I would recommend coordinating some physical therapy with your specialist.

I wanted to update this for anyone who may be interested, or for anyone who has experienced a dvt after an injury and is worried about their recovery. Things have really improved after 5 years. I'm still wearing compression on my bad leg, but I'm active now and not experiencing prolonged doms (unless I'm standing stationary for extended periods of time (4+ hours)). I run 3 to 5 km on a pretty regular basis and I am not experiencing any unusual pain. I gave up my recumbent for an upright bike and it is working out pretty well.

A big factor in getting to this point, I have to admit, was just getting over the fear that the pain was a sign of a recurring clot. Also, getting and staying active again really seems to have improved things. It just took a long time to work through the pain and fear. If I could go back, I think I would have worked with my doctor and physical therapist more to improve my rate of recovery, and not stress or injure myself worse (that is my only advise).

Dvts are aweful. I was 35 when this mess started for me. My dvt was caused when I hit my leg at my calf, and it filled my vien to 3 in. below my groin and down to my foot in 4 weeks. The vien was stretched to the point that it looked like it could have been filled with rolls of quarters. The warfirin was so horrible there is no way I could have made it longer than the year and a half I spent on it. 5 years later though, things have really improved. I hope anyone reading this can take some hope from that.