Crank Up Exercise Routine Slowly
Article Date: Apr 30, 2010

Sean Mullendore, M.D.

Finally – it’s spring, and we’re raring to go.

Before you rev up your engines, though, remember this: a Formula One race car can go from zero to 60 in less than 3 seconds, but it takes our bodies a bit longer to accelerate from couch potato to marathon runner.

Many people tend to start an exercise program with high expectations, maybe running two miles on their first day and ending up with sore muscles, says Sean Mullendore, M.D., family practice and sports medicine physician at Alegent Health Clinic in Bellevue.

“I frequently see folks who do that,” says Dr. Mullendore, who began his medical career in the Air Force. “The first thing I do is applaud them for making the effort to change their lifestyle in a healthy way. The problem is, they often ramp up their activity level too quickly. As a result, they can run into any number of problems.”

Increase slowly

Anyone who begins to exercise after a period of being inactive should gradually increase his or her activity level over a period of two to four weeks.

Much of your plan should depend on age and underlying medical conditions. While some pain is to be expected, pushing too hard and too fast can cause serious consequences, said Dr. Mullendore.

“Almost everybody will run into some degree of muscle soreness,” explained Dr. Mullendore. “When folks go from a sedentary to a more active state, we expect them to get ‘delayed-onset muscle soreness.’ ”

This soreness, which usually occurs the next day, is felt in the main muscle groups of the arms, legs, chest and back. It tends to have some stiffness associated with it, too.

Walk it off


“You can usually walk it off to some degree within a matter of minutes, definitely in less than an hour or two,” said Dr. Mullendore. “The treatment is to continue your exercise routine, but at a less - intense level. With delayed-onset muscle soreness – the pain gets gradually better over a couple days. Usually it’s gone within a week or two.”
The Alegent Health Podcast Episode #26
Zero to Sixty



There is a second type of muscle soreness – one from extensive muscle damage - even muscle death. If you stop doing the exercise, but the pain isn’t better, and actually gets worse within hours or even a day, you’ve got more going on than just delayed-onset muscle soreness, and it’s time to see a physician, he noted.

Likewise, if you start exercising and your muscles cramp up, you should not necessarily push through that soreness.

Ease the Pain


“The saying ‘no pain, no gain’ is not always true,” he said. “If you exert yourself beyond what your body can handle, your muscles are being asked to do more than they’ve done in quite awhile. They can actually get worked so hard that the muscle cells die and, as a result, you have significant soreness. Even touching the area, or passive movements of the joints with the muscles, will cause pain.”

That situation can actually cause fairly significant medical complications, specifically, kidney damage. In severe cases, as the muscle cells die, by-products of this death get metabolized and that can cause kidney failure.

To ease some of the weekend warrior aches and pains, Dr. Mullendore suggests finding time to work out on the week days, too.

“That way you won’t feel the need to cram a whole lot of exercise or activity into a short time frame,” he said. “You will be less likely to push your body beyond that threshold where you can’t handle it, and you’re going to be able to adapt better as a result.”

Adolescents and young adults may be less likely to suffer an overuse injury (tendinitis, muscle strain, etc.), but they can still have significant delayed-onset muscle soreness if they ramp up their activity level too quickly, notes Dr. Mullendore.

He commonly sees young athletes with pulled muscles, tendinitis, and joint sprains in the ankles, knees and backs. These can often be prevented by remaining active during the off-season, he said.

Dr. Mullendore, who is on the sidelines at Bellevue East and Bellevue West football games in the fall, sees athletes of all ages throughout the year. Here are his tips for staying active year round:

  • Cross train. Doing different activities on different days makes it less monotonous and decreases the likelihood of overuse injuries.
  • Work out with a partner. When you don't feel like exercising, a partner can keep you honest and get you to the gym.
  • Exercising and being active doesn't take that much effort. A brisk walk for 30 consecutive minutes on most days per week could be accomplished by giving up 1/2 hour of a TV show Monday through Friday.
  • Evaluate the shoes you wear to work out. Believe it or not, it does make a difference. Choose a shoe with good support, shock absorption, and balance.
  • Remember, shoes wear out, too. You need to replace them every six to 12 months, depending on how active you are.


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