January 14, 2003
Overuse injuries often result of Unrealistic Resolution Syndrome
By Susan Christensen
Health and Research News Service
JACKSON, Miss.—It’s as much a part of January as Christmas trees in the trash pile and credit card bills in the mail. Soon after the New Year, people start suffering the symptoms of what might be called Unrealistic Resolution Syndrome.
It’s what happens when a couch potato turns over a new leaf, then turns an ankle. Or when a veteran runner ramps up his mileage and strains a hamstring.
Typically, it’s a case of doing too much, too soon, said Mark Ware, manager of orthopedic physical therapy at Methodist Rehabilitation Center and a certified sports therapist.
“At the first of the year, the most common problems are overuse injuries – tendinitis, stress fractures and plantar fasciitis, an inflammation of the connective tissues under the foot,” he said.
So if you hope to make it into February with your new fitness routine, Ware warns against going gung-ho. “To risk overdoing is far worse than under-doing. Stress fractures can take you out for six to eight weeks. Tendinitis can be a problem for months. You need to set your goals realistically.”
Take it from registered dietitian Sandy Davis of Brandon, a runner who now knows the value of moderation, thanks to a hobbling case of plantar fasciitis. “I went from 1½ to 4 miles, which wasn’t too smart,” she said.
Now, Davis is more sensible about her mileage, and more committed to stretching and getting properly fitted footwear.
That’s a good strategy, Ware said. But the best hedge against injury is to learn your limitations before you launch a fitness program, he said.
“It’s never good to start an aerobics or aggressive cardiovascular program without appropriate screening,” Ware said.
A thorough flexibility screening can uncover potential problem areas, such as too tight hamstrings or structural problems with the feet, Ware said. Armed with such knowledge, you can avoid injury by choosing an exercise that fits your physique or use adaptive equipment, such as orthotics in your shoes.
“I would also recommend a complete physical, especially if you are over age 30 or 35,” Ware said. Otherwise, you might overlook something that could be life-threatening – such as heart abnormalities.
“People who have undetected cardiac problems and begin rigorous exercise can kill themselves,” Ware said.
Once you get your physician’s OK to exercise, it’s time for another consultation, said Scot E. Long, an exercise physiologist and director of Corporate Wellness for the Jackson Metro YMCA.
“I think you need to ask someone with a college degree in a fitness-related field to help you set up a program,” Long said. “If you don’t get proper advice these days, you can put your life in your hands.”
A case in point is relying on the conventional gym wisdom that says if you don’t work out at your target heart rate, you’re wasting your time. “A lot of people these days are on blood pressure medication that lowers their heart rate,” Long said. “Say your target heart rate is 140. If you’re on a beta blocker, your heart rate isn’t going to get up to that even if a pack of pit bulls is after you. Yet I’ve had people say: ‘Mr. Jones has been on the treadmill for 20 minutes at 11 degrees incline and his heart rate hasn’t gone up.’ I say: Did you look at his medical history? You’re going to kill him!’ ”
A qualified fitness expert also can share proper exercise techniques to help you avoid another major cause of injury – incorrect form. “Even if you are very fit and very strong, you’re going to hurt yourself if you do something incorrectly,” Long said. “There is a science to exercise, and if you violate it you’re going to pay for it.”
Nanette Sullivan, a registered nurse at Methodist Rehab, learned that lesson when she tried to keep up with some gym regulars 20 years her junior.
“A friend and I worked out at the same time as the male members of a ballet troupe,” she said. “They had these incredible glutes and quads, so we decided to get our glutes and quads looking like their’s. We did squats with too much weight, and way too deep. Since then, my left knee has never been the same.”
Once you learn to do your exercises properly, Long and Ware said the next step is to establish a routine.
“I would recommend doing aerobic exercise three to five times a week for 20 to 60 minutes at a time,” Long said. For strength training, he suggests starting with eight exercises that cover all the major muscle groups. “You should strength train two to three times per week, doing two sets of 15 repetitions.”
Once your body gets used to that routine, you can increase your exercise by about 5 percent, Long said. “If you are at a plateau, change things up,” he said. “If you’ve been walking or biking, swim and do the stairstepper.”
But don’t assume you can do your new activity at the same intensity. “If you’ve been running five years, that’s great. But that doesn’t mean you can swim laps without getting out of breath,” Long said. “Any time you change activities, you need to ease into that activity to keep from hurting yourself.’
For many people, a simple walking program is a good introduction to an exercise regimen, Ware said.
“In the beginning, what you are trying to establish is habit and regimen,” Ware said. “Don’t worry about heart rate. Your first goal is to do something on the schedule you’ve set. It’s like the commercial says, just do it. Just don’t overdo it.”
Got questions about exercise and sports injuries? Then ask Sports Therapist Mark Ware. Log on to www.methodistonline.org and click on Ask the Sports Therapist.
For more information:
Stretch: Take precautions to avoid injuries when starting a new workout | The Clarion-Ledger