Injury prevention principles

Shin splints. Knee pain.  There are many forum threads posted by cc'ers who are starting to get into shape, and getting injured in the process. 

This post includes tips for avoiding overuse injuries as you get into shape.  Please bear in mind that I'm not a medical or fitness professional. Just someone who is vulnerable to overuse injuries and has learned to how to avoid them through trial, error, and learning.

I was a runner in high school and college, and was constantly getting overuse injuries.  I get overuse and joint injuries from all kinds of physical activity -- running, cycling, swimming, weights, yoga. You name it, I get injured doing it. Shin splints, shoulders, knees, ankles, hips, whenever I try a new activity, I feel it in the joints or get some other overuse strain. (This may be genetic, there are relatives on both sides of the family who have had hip replacements or hip surgery.)  It wasn't until my early 30s that I learned how to exercise without chronic pain.

Here are the principles that I've learned: 

Build up slowly.

Many people getting into shape try to exercise intensely, as much and as soon as they can. This is a mistake, and often leads to injuries that set them back.

* Start with short duration, low intensity activity.  Walk or go easy on an elliptical trainer. 
* Build slowly. When you build up, don't increase your mileage by more than 10% per week.
* Build endurance before intensity. You should feel comfortable with at least 30 minutes of your chosen activity before adding intervals.

Get good gear.

If you are running or using an elliptical trainer, make sure you have good shoes.  Go to a specialized store, if you can, not a large chain superstore or mall outlet -- a place where people know how to fit shoes. 

If you are cycling, make sure your bike is a good fit for you, and is adjusted for your body. Go to a good bike shop where people know how to fit bikes. It is definitely worth the money you will spend to not have to take weeks off and require medical care. If you are cycling, you do *not* need an ultra-fancy bike to get into good shape, but you do need a bike that is a good fit for you.

Don't work through pain.

If you have joint pain, or acute muscle pain, then stop.  Either do activities that don't aggravate your injury (if you have a hurt wrist, walking is ok but tennis is not). Or take the day off.   Rest until the injury is better. Don't try and work through the pain.  Many people who are eager to get into shape are fearful of taking time off and being set back. The setback will be worse if you get more seriously injured.  If it hurts a lot, or hurts for more than a few days and doesn't get better, go see a doctor. 

Body alignment is critical.


If you are doing the same physical motions over and over again, it is critically important to have good body alignment and form, or you will get injured again and again.  Yoga with a good teacher is excellent body alignment training.  Other good resources include the Egoscue method (see link below), and Pilates (I can't speak about Pilates from personal experience.)  In addition to general body alignment training, get specialized coaching in your sport or gear (cycling, running, swimming, etc.). If you are a gym member, ask for an instructor to review your form. 

Rest.


You may want to start with 3 days of exercise per week, and build up to 4-6. After an intense workout, take the day off, or exercise very lightly. 

Summary.

By following these principles, you are less likely to get injured. And if you do get injured, you will be more likely to quickly recover and pick up your exercise routine.

Following these principles is *not* the most efficient way to burn fat and calories right off the bat.  If you are already basically fit, have good body alignment, and good gear, then dive right in, and start to do interval training and lift heavy weights. 

But if you are getting back into shape after being sedentary, then following these principles can keep you from a serious setback that makes your progress much slower overall.

Resources:

Runners World 10 Laws of Injury Prevention
http://www.runnersworld.com/article/0,7120,s6-241-285--7638-0,00.ht ml

Egoscue Method:
http://www.amazon.com/Egoscue-Method-Health-T hrough-Motion/dp/0060924306/ref=pd_bbs_sr_1?i e=UTF8&s=books&qid=1200890719&sr= 8-1

 

Thanks, alevin!

I needed to hear this today, lol!!!

I just got a wonderful Polar f11 Heart rate monitor...and used it hard...and now I'm REALLY sore, but wanting badly to over-do! I really appreciate you taking the trouble to share this. I'll try to be careful, thanks to you! 

Have fun! I think I'll be getting one of those HRMs pretty soon.

If it's just garden-variety, post-hard-workout muscle soreness, then you're ok to go again today if you really must, but if so exercise lightly and try and do something different. For example if you were doing elliptical intervals than take an easy walk. If you did a hard run, take an easy bike ride.

Thanks!

I worked rather hard, lol!  

Heavy weight lifting...Nordic track, (hrm steady fussed that my heart rate was over range, lol! I KNEW it was trying to kill me! ), and rebounding 100 minutes...

According to the hrm, I burned an EXTRA 1300+ calories... in 3 hours of effort...!!! It was 1638 total, but 1300+ with regular calorie use taken back out...lol!

No weights today, I fear! And I did that Saturday- not yesterday! I guess I must stick to walking and rebounding for today... I hope!!!

wow i was about to post about a pulled muscle in my leg and wondering if I should exercise anyway.

DUH!!!! 

(BTW I injured myself jumping rope with 10 year olds. I way out jumped them but my calves and knees are not used to jumping on sidewalks anymore. 

2be, NordicTrack is fun.  I haven't belonged to a gym that has them since I lived in Boston (wonder if there are more of them in places that know what x-c skiing is?).  I thought that the cc calculators did the right thing in terms of pre-subtracting your resting burn, but I don't know for sure.

tribegirl, just regular jumping, or fancy tricks. I grew up in Philadelphia, and just did regular jumprope but there were some girls who could do some pretty complicated and athletic routines.

Best all with rest and recovery :-)

I took yesterday off after a long bikeride on Saturday, and am about to go to the gym for some weights+intervals.

 

Original Post by tribegirl:

wow i was about to post about a pulled muscle in my leg and wondering if I should exercise anyway.

DUH!!!! 

(BTW I injured myself jumping rope with 10 year olds. I way out jumped them but my calves and knees are not used to jumping on sidewalks anymore. 

LMAO.  I have been on a BAD sprained ankle for 4 weeks from what...jumping rope!  For the last time-grown people should NOT jump rope.  LOL.  I have been on crutches, 3 doctor's visits and a few more WEEKS of healing.  My doc, friends, chiropractor all call me retarded and laugh till they cry because my 150 pound self decided to skip rope!  NEVER again (at least until i get the hang of it again).

On a side note-I will have the last laugh when i lose all this weight! 

YAY for finding your inner 10 yr. old! 

I know it's not good that you guys injured yourselves but I think it is kind of cool that you did so skipping rope :)

Thank you to *alevin* for putting this up! 

So you're talking about injury prevention, but what if you already have an injury? Any suggestions for something to do when you won't be able to walk for about the next month? (Though I must admit, my arms are looking quite nice from the crutches...)

Can you do upper body exercises?  Can you check with your doctor about what kinds of exercises would be safe given your injury?

Yeah, I've been lifting weights as much as I can, but I'm having a very VERY hard time with the whole not being able to walk thing.  Mostly because I'm normally very physically active and don't know how much I have to compensate with my eating habits or if it's even possible.  I would normally be eating 1800 calories a day to lose weight, but now that I can't do anything active really I'm afraid how much weight I'll gain.  Do you think I'd be able to kind of "make up" for it once I'm able to walk again?  That'll be in about a month.

Kristen, you'll need to eat somewhat less when you are exercising less. You can use the tools on this site to calculate how many calories to eat. It would be much better to maintain if you can than to gain.   Getting back into running shape when you can walk will be un-fun enough without even more weight to lose.

If the amount of calories to eat at your current activity level feels really small, maybe you can pause weight loss and eat maintenance until you are more active again. It might not be so bad to not run a deficit while you are healing.

And do check with your doctor, perhaps there are exercises you can do in water, or light cycling, that can help you maintain some level of cardiovascular fitness while your knee heals.  

Yeah, I think you may be right with the maintaining my weight for now. I would have to eat an absurd amount less to keep losing.  Thanks.

Kristen,

first good luck with your injury.

When I broke my leg, I thought the world ended, but it didn't. You will surprise yourself with what you can still do with floor exercises.  Give it a try. Lie down and start doing your any routine you can think of. ( I know it sounds wacko). I also discovery the world of yoga.

Whatver you do is better than nothing.

 

What exactly did you do when you broke your leg?  I get operated on next week and then I got told I should be able to walk about two weeks later, although it'll be really restricted.  I need stuff to keep me busy until then and I'm not really creative, so anything you did when your leg was broken I should be able to do and would be infinitely helpful.

Hey hey, first time poster, long time... something.

I'm no fitness expert either, however, I do know a few things and my way around the gym. I feel like people take running too lightly. People typically run to get into shape, but competitive runners get into shape to run. The main difference is that they train for balance, as mentioned by the original poster. One thing not mentioned is the need for localized balance in the legs. Running trains the gastrocnemius and soleus (back of the leg) and that leaves the anterior tibialis (front of the leg) dangerously weak. You need to train toe raises with a band or a dumbell or something if you want to start adding distance and not knee braces.

 As for exercises to do while on a bum leg, I'd definately stick to weight training for the upper body. I had to wear a moon boot for 4 weeks after an intense ankle sprain last August and increased my chin-up numbers from 7 to 12 per set.

Running trains the gastrocnemius and soleus (back of the leg) and that leaves the anterior tibialis (front of the leg) dangerously weak. You need to train toe raises with a band or a dumbell or something if you want to start adding distance and not knee braces.

Guitarmanzero-

For the toe raises, do you mean standingwhile pushing yourself up on toes, or laying on your back and flaxing toes with the use of an exercise band?  Or would both work?  Where would the dumbell come in?

I've been trying to train for a 5k and find that while I am running I have no pain in my knees, but when I bend down at the knees while standing, I have pain right above the kneecap.  Was wondering if anyone thought it could be the running leading up to an injury?  Like I said, it does not hurt while running or directly after, just when I kneel down.

Lapgirl, I don't know about the details of your issue, but it doesn't sound good.  Other might have insight, or ask a doctor. Meanwhile, it would be good to cut back on the running and do some crosstraining that allows whatever it is to heal.  (swimming, cycling).

Personally, I do yoga for body alignment. It does a good job of preventing injuries due to alignment and imbalance.

You may want to try this, but please first focus on healing. It's not good to continue to train in a state of chronic pain, whether that pain is when you are exercising or after in a different position.  Whatever it is you've got will get worse unless you rest it and heal. 

I'm new here :) But I have also heard that stretching before and after exercise also helps to prevent injuries. I had a knee injury (from over using it) last year and this is what the doctor recommended to me. Has anyone else heard that?

I'm happy to see this thread - I am dealing with an injured right leg that I have been working through - finally decided today to take a couple of days off but it has been hard because I feel like I am just "getting into the groove" and am worried about lapsing if I slow down. I have been running 6 days a week for the past 9 weeks as part of a training program and am I think it is just too much,... 45 minute runs, approx 4.5miles/day. Although it is part of a program I think I am going to substitute a different cardio workout every other day. I also have to really improve my stretching. From this thread I have learned I should also add in some flexion exercises for anterior compartment of my leg as lots of pain in gastroc/soleus.

Here, here on stretching. I get in a hurry alot after a workout and don't allow myself enough time to stretch.  Then wonder, "Why does my knee/ankle/ etc. etc. ache?".

I just ran 3 half marathons over the last 3 months. My knees are wrecked. I've switched to elliptical and biking while I give my joints time to mend.