The right gear, techniques to help sidestep injuries

Posted: Sunday, May 09, 2010

There's nothing like an injury to hinder your fitness progress -- or stop it in its tracks. As everyone embraces the warmer weather and new activity, it's important to couple enthusiasm for whatever activities you choose with safe execution.

First and foremost, don't neglect stretching, particularly as you get older. When I was skating, we had two or three workouts a day, and we spent 15 minutes stretching before and after every workout. That adds up to a lot of stretching, but that's how necessary it is.

Stretching does not impart the normal muscle soreness people associate with exercise so they don't believe it's accomplishing anything. For this reason, it's the first thing people delete from their exercise routine. However, stretching is central to avoiding injuries. It increases blood flow to your tendons and muscles, which helps avoid strains. It also lubricates your joints. Even an activity with a small range of motion, such as cycling, requires stretching. If you fall, you won't pull muscles if you're limber.

Good shoes are also key to avoiding many activity-related injuries, according to Mayo Clinic-trained orthopedic surgeon Paul R. Lipscomb Jr., M.D. "It all starts with getting your foot and ankle in alignment," says Lipscomb. "You do that with good shoes and, if need be, orthotics."

Shoes you'll be putting through the rigors of exercise should have well-cushioned heels, good arch supports and some medial support at mid-stance (the phase between heel-strike and toe-off in any sport that requires running and walking) "so your foot doesn't flatten out and pronate," Lipscomb says. "That can not only cause ankle and foot injuries, but it can also cause knee injuries."

Mechanics are important with activities requiring overhead motion, such as swimming, golf and racquet sports, and even some weights. To avoid shoulder injuries in racquet sports, work on overhead and ground strokes and your serve. Have a coach assess and advise you on your form.

If you experience shoulder pain, stay in the "safe zone" when you exercise: Keep your hands shoulder level and below. This avoids putting stress on the rotator cuff, which can lead to significant injuries. When lifting weights, lie on your back on a reclining bench, with your feet higher than your head, and do bench presses toward your feet. When swimming, do the breaststroke or crawl or use a kickboard, and vary your stroke.

To guard against wrist and elbow injuries, concentrate on good technique; make sure that you use a racquet with the string tension, weight and grip size fitted to your ability and size. Also, be aware that the Western grip puts more stress on your wrist than do other grips.

In golf, use clubs with the correct shaft stiffness, grip size and club-head weight. Proper technique in golf is also very important; have a pro assess yours. Practicing on grass rather than a mat will be easier on your wrists and elbows.

If you run, the injuries you are most likely to encounter are due to overuse. Many of these can be avoided by staying away from hard running surfaces, varying the route you run, and getting shoes that fit your running style. If you develop localized pain that is persistent with exercise, it might be wise to seek medical advice to rule out problems such as stress fractures.

If you're a cyclist, ensure that your bike fits your body correctly. Many bike shops are set up to do bike fits using standard bike-fit parameters, but there are also small adjustments that can be made to address individual issues.

And, of course, if during exercise you ever experience shortness of breath, chest pressure, chest pain or light-headedness, or if you are a woman and experience shortness of breath or the sensation of fatigue, stop immediately and seek medical attention.

Next week, I'll go into detail about how to deal with muscle soreness and troubleshoot aches and pains before they lead to chronic overuse injuries.

Editor's note: "Focus on Fitness" is a new feature with healthy lifestyle advice from local and national health and fitness experts. Check here weekly great information and tips on maintaining a healthy lifestyle.

Eric Heiden, M.D., a five-time Olympic gold medalist speed skater, is now an orthopedic surgeon in Utah. He co-authored "Faster, Better, Stronger: Your Fitness Bible" (HarperCollins) with exercise performance physician Max Testa, M.D., and DeAnne Musolf. Visit www.fasterbetterstronger.com .



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