One of the most common questions we hear at Caruso Physical Therapy & Nutrition is:
“I actually feel a little more sore after my last couple of visits. Is that normal?”
The short answer is: sometimes, yes.
While increased pain is never something we ignore, a temporary increase in muscle soreness or discomfort after beginning physical therapy can be a normal part of the healing process. Understanding the difference between “good soreness” and “something isn’t right” is an important part of recovery.
Your Body Is Learning to Move Again
Whether you’re recovering from surgery, healing an injury, or dealing with chronic pain, your body has often adapted by avoiding certain movements or relying on compensations.
As therapy progresses, we begin asking muscles, joints, and connective tissues to work in ways they may not have for weeks—or even months.
This can lead to:
- Mild muscle soreness
- Fatigue
- Temporary stiffness
- Awareness of muscles you haven’t used in a while
This type of soreness is very similar to what many people experience after starting a new exercise program, often referred to as delayed onset muscle soreness (DOMS). It typically develops 12–48 hours after activity and improves over the next few days.
Progress Doesn’t Always Feel Better Right Away
Healing isn’t always a straight line.
Sometimes patients feel better immediately after treatment. Other times, introducing new strengthening exercises, improving mobility, or correcting movement patterns can temporarily increase soreness before things improve.
That doesn’t necessarily mean the treatment was too aggressive.
Instead, it may mean your body is adapting to new demands.
At Caruso Physical Therapy & Nutrition, we constantly monitor how your body responds. If soreness is appropriate and short-lived, we often continue progressing your program. If pain is sharp, worsening, or lingering longer than expected, we modify your treatment accordingly.
Not All Pain Is “Good Pain”
While temporary muscle soreness can be expected, there are certain symptoms that should always be discussed with your therapist:
- Sharp or stabbing pain
- Increasing joint swelling
- Pain that continues to worsen each day
- Numbness or tingling
- Pain that prevents normal daily activities
- Pain that does not improve after several days
Communication is one of the most important parts of rehabilitation. The more we know about how you’re feeling between visits, the better we can tailor your treatment.
Where Nutrition Comes In
This is where recovery often gets overlooked.
Your body cannot rebuild tissue, repair muscle, or reduce inflammation efficiently without the proper nutrients.
Think of physical therapy as providing the stimulus for healing, while nutrition provides many of the building blocks your body needs to respond.
Protein Supports Tissue Repair
Strengthening exercises create small amounts of stress within muscles, which stimulates adaptation. Consuming adequate protein provides the amino acids needed for muscle repair and recovery. Research suggests that sufficient dietary protein may help improve recovery from exercise-induced muscle damage.
Hydration Matters More Than You Think
Even mild dehydration can contribute to fatigue, reduced exercise performance, and slower recovery. Staying well hydrated supports circulation, nutrient delivery, and overall recovery.
Anti-Inflammatory Foods Can Support Recovery
Foods rich in:
- Colorful fruits and vegetables
- Omega-3 fatty acids (salmon, walnuts, flaxseed)
- Whole grains
- Healthy fats
provide nutrients that help support the body’s normal inflammatory response and recovery after exercise. While nutrition isn’t a cure for soreness, evidence suggests certain nutritional strategies may help reduce exercise-related muscle soreness and improve recovery. Speak to the expert, a Registered Dietitian, to determine what is best for you!
Why Caruso Combines Physical Therapy and Nutrition
At Caruso Physical Therapy & Nutrition, we believe that movement and nutrition work best together.
Physical therapy helps restore strength, mobility, and confidence.
Nutrition helps provide your body with the resources it needs to recover, adapt, and perform at its best.
By addressing both movement and nutrition, we can help patients recover more efficiently while building healthy habits that last well beyond their final therapy visit.
The Bottom Line
Feeling a little more sore after your first few physical therapy sessions doesn’t automatically mean something is wrong. In many cases, it’s simply your body responding to new movement and rebuilding strength. The key is that this soreness should be temporary, manageable, and improve as your body adapts—not progressively worsen.
If you’re ever unsure whether what you’re experiencing is normal, don’t hesitate to ask your therapist. We’re here to guide you every step of the way and adjust your program based on how your body responds.
At Caruso Physical Therapy & Nutrition, our goal isn’t just to help you feel better today—it’s to help you move better, recover smarter, and stay healthier for the long term.
Written by Nicholas Layton, PTA
References
- Nahon RL, Lopes JSS, Neto AMM. Physical therapy interventions for the treatment of delayed onset muscle soreness: Systematic review and meta-analysis. Physical Therapy in Sport. 2021.
- Peake JM, Neubauer O, Della Gatta PA, Nosaka K. Muscle damage and inflammation during recovery from exercise. Journal of Applied Physiology. 2017.
- Pearson AG, Hind K, Macnaughton LS. The impact of dietary protein supplementation on recovery from resistance exercise-induced muscle damage: A systematic review with meta-analysis. European Journal of Clinical Nutrition. 2023.
- Kim J, Lee J. A review of nutritional intervention on delayed onset muscle soreness. Journal of Exercise Rehabilitation. 2014.
