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The gym seems to be the place to be every January, with fitness high on so many lists of New Years resolutions. That is the upside. The downside is that so many of those embracing exercise are setting themselves up for overuse injuries, placing more demand on their bodies than they can tolerate without beginning to break down. You can avoid being one of those who gets in trouble.
1. Recognize Pain & Listen To Your Body
If you feel something you shouldn’t (or never used to, or don’t on your other side), then your symptoms register on the scale of pain, however mild they may be. Listen to your body…it is talking to you. If it “doesn’t hurt much”, or you “think you can work through it”, you are admitting that it does hurt. Maybe it doesn’t hurt while you are exercising but you find yourself with pain the next day. If you are pushing yourself beyond a threshold of pain you probably are doing too much.
So why do many of us ignore the early signs and symptoms? Maybe we just can’t admit we are getting older and don’t have the capacity we used to. We may start a program with too much enthusiasm! Maybe the “no pain, no gain” adage many of us grew up hearing is rearing its ugly head. Let’s agree to bury that one.
There are only two “good hurts” with exercise. The first may be a bit of a burn; the result of fatiguing a muscle when strengthening – without eliciting or exacerbating pain in your joints or other areas. The second relates to physical therapy more than fitness, and comes into play if a joint lacks full range of motion and you must push past your comfort zone in order to restore mobility.
Don’t wait until pain becomes chronic before paying attention!
2. Watch Your Form
Many exercises lead to injury when performed incorrectly, such as lunges with your knees in front of your ankles or squats with them forward of your toes. A calf raise beginning with your heel hanging lower than your forefoot is another example. Form is key. Avoid momentum with strengthening, keep your shoulders from hiking up, maintain good posture with a stable core to protect your spine and limit your stronger muscles from coming into play to substitute for their weaker counterparts.
3. Avoid High-Risk Low-Reward Exercises
Behind-neck-pull-downs, deep dips, military presses and full-arc leg extensions, are only a few examples of exercises that pose excessive risk. There are many ways to strengthen targeted muscles more safely and with greater functional carryover. Even if you’ve gotten away with these exercises for years, they will likely catch up with you.
4. Remember That Quality of Effort Counts More Than the Number of Reps
Muscle fatigue is only good if not taken to an extreme. If your knee hurts during the last five reps of a set of squats, or your form suffers after the tenth rep but you insist on straining to a count of fifteen, you are setting yourself up for an overuse injury. Generally, the aftereffects of strengthening won’t be felt for about 24 hours. If your quadriceps fatigue is so great that you have trouble descending stairs the day after exercising, you have overdone it.
5. Rest Muscles After a Workout
Muscles need rest on alternate days to recover from strengthening. Strengthening to a point of fatigue (though not exhaustion) means that on a microscopic level you are causing some (desirable) breakdown of the muscle fibers. The healing of this disruption and subsequent building up of the fibers occurs on your “off” days. Pushing the limits of a muscle group on a daily basis can cause cumulative breakdown of a muscle; hence, an overuse injury.
6. Ramp Up Your Training Gradually, Not Radically
Challenge yourself by fine-tuning one variable at a time. For instance, if you increase your time or resistance on an elliptical, decrease your pace. Assess your response the following day before resuming the faster rate. If you add more resistance when strengthening, cut down your repetitions or sets. Ramp up the reps and sets only after you know you were able to handle the exercise with good form and without repercussions the following day.
7. Consider Cross Training
Rather than spend 40 minutes or an hour on the treadmill, split your time between various pieces of equipment so as not to create repetitive stresses to the same joints or muscles. You can still get in the desired amount of cardio yet lessen the likelihood of injury.
8. Know Your Limits & Address Predisposition to Injury
Each person’s limit is different. Each muscle’s limit is different. Each individual’s predisposition to injury is also different, and that should be considered when discussing overuse injuries. As a physical therapist, I look for balance between the right and left sides of the body; a balance of joint range of motion, muscle strength and flexibility. Research has shown that a deficit of greater than 10% from one side to the other is one factor that predisposes to injury in sports. Most of us have at least a slight imbalance due to dominance – we are right or left handed/footed.
Restricted joint mobility, ligamentous laxity (looseness), muscle weakness, or a lack of muscle flexibility can all predispose to injury. Poor posture, alignment issues, past injuries and their repercussions also make us more vulnerable to new injuries. Identifying and addressing these factors is crucial to our wellbeing; before we ramp up our level of activity.
9. Recognize theValue and Danger of Rest
If you already have musculoskeletal complaints, keep them from becoming chronic. Many of us are in denial and put off getting the proper care. Rest alone may enable us to feel better. Rest and anti-inflammatories may make us feel “even better,” but that is deceiving. In fact, weak muscles may get even weaker due to the de-conditioning that comes with disuse (better known as rest). This is called disuse atrophy. Restricted joints may lose more mobility from disuse – by not putting a joint through its normal ranges of motion, its lubrication is diminished. In addition, scarring down of the connective tissues (especially in the presence of swelling) may occur, further limiting motion. Tight muscles that are not exercised become tighter with inactivity (and with age).
Rest may give us a false sense that all is right in the world; that we are back to normal. Just get back in the game however, and you will soon see that is not the case. Rest alone may actually increase vulnerability and make us more prone to recurrence, or to more chronic complaints and further damage. The same is likely if we take an injection of cortisone and think that it is safe to go back to sports because the pain is gone. In each of these scenarios, nothing was done to address the causes of an injury.
10. Get Fit to Play Sports Rather Than Play Sports to Get Fit
Whether you are picking up a new sport, renewing your participation in one that you played in college, or are just a seasonal athlete, beware! For instance, if you’ve only played an hour of doubles once each week in recent years, you may not be ready for singles on consecutive days. That day of serving for three hours in tennis camp may also put you over the limit (particularly dangerous due to the repetitive overhead motion). Likewise, driving a few buckets at the range may be more demanding than playing a round, during which you would also chip and putt much of the time. Whatever the sport, get fit to play. Build your tolerance to avoid overuse. Stay fit, injury free, and use good mechanics. With all three, you will enjoy the benefits without the pain.