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

 

Jennifer, good luck!

Original Post by melkor:

 Do not under any circumstance ever static stretch before strength training. Static stretching reduces muscle strength by about 25-30% for 3-4 hours, so static stretching of a muscle prior to exercise is a good way to reduce the training effect and possibly injure yourself.

 Dynamic flexibility/mobility drills are okay, but no static stretching before working out, ever. Save it for after.

Thank you for the advise. I have been doing static before and after. Since I read this I looked up and found a new stretching routine to try before I run.

Injury prevention is very important for me. I'm 52 and have never had knee pain, something very common in females of all ages. My entire workout routine is designed around not only getting good results, but preventing injury. I use an elliptical machine several times a week and find it to be a great way to reduce stress on my knees, hip joints and lower back. I highly recommend it for women. Running is great, but it's not only very hard on the knees and many other joints, it's hard on the connective tissue in women's breasts, regardless of what sports bra is worn. Female knees are more susceptible to injury due to our femoral heads being much further apart then males', and the angle at which our femurs descend from the pelvis to our knees. I encourage all women to baby and take care of their knees. A knee injury can sabotage your health and weight loss efforts for months, years or even permanently.

Congrats to all who have had success and best wishes to everyone on reaching your goals.

Hi all.

 I have been on a diet regimen for some time and I got discouraged going to the gym seeing thin little  things in there and Friday I stepped on the scales and got... irritated to say the least and decided to er.. .I dunno  anyway I waited until dusk and put on my ipod and ran at the track. I ran and ran and ran...  laid on the track for three minutes looking at the stars and got up and ran some more. I ended up with shin splints. I was sore yesterday and still went power walking thinking if I warmed my muscles up they wouldn't be so stiff.... nuh-uh. Bad idea. Plus today I am wearing heels since they are kind of required, so I'm reaping the benefits of pushing myself so much.

Thanks for the advice Alevin, I was planning on going again today thinking it would loosen them up!!

~Liz

 Im glad that I got to read that I needed a reality check. I hurt my ankle a little while ago. Yesterday I chose to get on the treadmil because I thought I was healed up enough and it wasnt hurting when i walked around and now it hurts worse. I LOVE Love LOVE to run so this is a big hamper on my joy but like you said if I dont sit it out then the injury will get worse and it will extend down time.

A HUGE THANK YOU ;)

I've lost about 20 lbs. since I've begun my journey, and still need to drop another 40 lbs.  In my brain, I knew that I needed to lose another 20 lbs. before I began running again, but I caved in to my kids, friends and the stuck scale, that I could begin running again.  The first two weeks went well, running a 1/4 mile, walking a 1/4 mile, repeating that until a full mile was walked and ran. This was just a couple times per week.  But this past Monday, I increased my run to 1 and 1/4 miles and felt fine. The next day, had a little pain in the right knee, but didn't think too much of it. Went back to run (on rubber track) and within 1/2 lap, both knees were killing me!  Made it home, rubbed in some icy hot and took tylenol.  Today I didn't do any morning exercises (and it's killing me not too!), and I am supposed to walk this evening (no running, I promise). Right knee still hurts a little bit.   I am wearing a knee brace, but I actually think it's making it hurt more!  So my question is, how long should I wait to get back to running?  I was always below 130 (pre-op weight) and gained weight after surgery. Should I wait till I am at 130 again??  And do I give me knees a week off?  Not doing any walking is very HARD for me.

Original Post by melkor:

 Do not under any circumstance ever static stretch before strength training. Static stretching reduces muscle strength by about 25-30% for 3-4 hours, so static stretching of a muscle prior to exercise is a good way to reduce the training effect and possibly injure yourself.

 Dynamic flexibility/mobility drills are okay, but no static stretching before working out, ever. Save it for after.

 Do you have a reference for this?  A link possibly, or is this just your opinion?  I personally do a 3-4 minutes warm up (jumping jacks, arm circles etc) then mix about 50/50 static and ballistic stretching before and after every work out.  I will agree that overdoing a pre-workout static stretch will wear you out quicker.  As far as reducing results or injury, I'd have to have a little more proof before I bought into that.

Try this article for the layman's reference, and this one from Michael Boyle for a practicing strength coach's take on how to do it right - dynamic warmups and mobility drills before working out, static stretching afterwards.

 (For a more scholarly reference, start with this literature review from the Journal of sports medicine which should provide you with a few hours' worth of reading material ;)

 There's a few references in that paper that suggests that you can mitigate the negative impact from static stretching on performance by waiting 15-20 minutes post-stretching before tackling the workout, but then you'd have to warm up all over again which seems to me to be an odd way of doing it.