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The Long Game

Photo by Franck Camhi/istock

Staying in prime shape, sans injury, is a lifestyle choice.

Those who have spent 30 years taking jarring bike runs down the face of a mountain or running road races might be as at risk for injury as a sedentary 50-year-old who wants to start walking for better heart health or the golfer who wants to take up tennis. Both starting a new athletic pursuit and repeating a pattern of impact over many years can lead to overuse injuries, especially if lifestyle changes do not accompany activity. 

Repetitive motions stress the musculoskeletal system, causing painful microtrauma that is difficult to treat, says orthopedic surgeon Elizabeth Matzkin, MD, of Brigham and Women’s Hospital. Allowing time for rest and recovery between workouts is crucial for injury prevention and something many put off, trying to tough it out. 

Thankfully, overuse injuries are 100 percent avoidable, she says. Begin and end workouts with a warm-up and cooldown. Train with the correct form and seek counsel from a trainer or coach to check proper form when you are starting out or even later on to adjust technique if you are experiencing pain. Use appropriate gear that is in good condition and sized accordingly. And vary workouts to strengthen the entire body, which can help prevent stronger muscle groups, such as quadriceps, from overcompensating for weaker ones such as glutes. 

In a world of instant gratification, beginning athletes and those training for an event need to have patience. Nothing suggests you need to run a mile (or 26) on your first day or max out on weights. Ask yourself: What do I want? What do I love to do? Training is sport specific, so setting clear goals and finding out what you enjoy will determine where and how you begin. Be realistic about your fitness level and follow Dr. Matzkin’s 10 percent rule: Don’t increase mileage, workout duration, or reps by more than 10 percent each week so that the body can adapt and recover. Tissues naturally break down and rebuild in the cycle of exercise and rest. 

Enough rest to be physically active may mean sleeping seven to eight hours each night. More important than the duration of sleep, however, is the consistency of sleep’s timing, says Charles Czeisler, MD, the director of the division of sleep medicine at Harvard Medical School. The brain uses the first half of the night to process the day’s events and the second half to file them among existing memories. When it cannot count on a set amount of time to fit in those two cycles, brain fog rolls in. Sleeping in on the weekends, especially for weekend warriors, or going to bed late a couple of nights a week confuses the process and opens athletes up to being groggy and accident prone.

When injuries do occur, begin the healing process with rest, ice, and anti-inflammatory medications, says Dr. Matzkin. If pain lingers after recovering from an acute event, seek the professional opinion of a specialist who can identify the cause of the pain and suggest a treatment plan to keep you moving. “There is a 95 percent chance that strengthening exercises can cure pain without surgery,” she says. Injuries can be caused by stressing a specific muscle group, tendon, ligament, bone, or joint. Resting the injured site while strengthening core and proximal muscles and increasing flexibility will help you not fall behind in your training. Even stress fractures benefit from strengthening the muscles surrounding the injury, says Dr. Matzkin. For knee pain, she says, weight management is crucial. For every pound of weight, the knee feels five times that. Losing just five pounds can relieve your knees of a 25-pound burden. 

Eating well will not only help keep weight in check, but it will also ensure that new or experienced athletes have the necessary energy available to them for endurance as well as muscle repair, says Dr. Matzkin. Nutrition, sleep, weight management, and cross-training should guide the fitness routines of weekend warriors and serious athletes alike.