Some injuries can end in a happy mending
Thursday, April 06 2006, 11:19 PM EDT
Contributed by: R.J. Ignelzi
HAPPY MENDINGS
When orthopedists told Barbara Wayne that her persistent back and knee problems probably meant the end of her running days, she reacted "as if I was losing my best friend," she says. "I was devastated."
Over a 14-year period of logging 30 to 50 miles a week, running had not only become a way to relieve stress, but also helped her to lower her blood pressure and cholesterol and lose 12 pounds.
"I thought as soon as I stopped running, I'd get fat and lazy," says the 52-year-old. "I thought I'd gain 10 pounds the first month."
DON’T LET AN INJURY GET YOU DOWN
However, today, two years after her doctors' recommendation to curtail her favorite sport, she's as fit and trim as in her high-mileage days.
Although she only runs once or twice a week and just on soft surfaces, she supplements her fitness program with low-impact activities including cycling, walking, yoga and strength training. She's learned that injuries and chronic conditions don't always have to sideline your fitness regimen.
By modifying movements, alternating exercises and paying close attention to the body's response, physical setbacks may end up elevating your workout to a new and exhilarating phase.
"Maintaining some kind of a modified exercise program while you're injured has both physical and mental benefits, and might ultimately enhance workout routines," says Dr. Paul Stricker, sports medicine specialist at Scripps Clinic in San Diego.
Besides burning calories and revving up the endorphins, keeping active while on the injured list may also speed healing.
"Any kind of safe exercise improves circulation and blood flow, flushes out any by circulation and blood flow, flushes out any byproducts of inflammation, and increases the oxygen and nutrients to the injured tissue area," says Gail Kuwatani, physical therapist with Shiley Sports and Health Center at Scripps Clinic. "It can all help with healing."
Health and fitness experts offer some tips for a successful rehab, along with ways to help you maintain your fitness when pain and injury strike:
- Take a break.
Professional football players get paid to play through the pain. You don't. When something hurts, cut back on your activity or take a few days off.
"Taking it easy during the inflammation phase of an injury is probably the best advice," says Fabio Comana, exercise physiologist with the San Diego-based American Council on Exercise, who recommends allowing all swelling and inflammation to ease before resuming activity.
- Identify the problem.
Just because you have knee (or hip, foot, etc.) pain, doesn't mean that's where the problem is.
"It's important to identify the problem since it's not always at the point of pain," Comana says. "The injury may not be localized because the body is a continuous chain. A hip problem, for example, can show up in the knees or shoulder."
Have the pain checked out by a health-care professional if there's no improvement after some rest and exercise modification, to make sure you're on the right rehab track.
- Modify your activity.
Before giving up on your favorite form of exercise, first try making some simple changes.
"Try to keep doing the things you like to do, but with some modifications," Kuwatani says.
If you're a runner with chronic knee problems, for example, try changing the frequency of your running. Instead of pounding the pavement four or five times a week for an hour, limit it to one or two days for just 30 minutes. Change your running surface from asphalt streets to sand, dirt trails or a rubberized track. Try inserts in your shoes to absorb more shock.
- Cross-training is not a four-letter word.
But pain is. One way to avoid and counter pain, especially pain resulting from an overuse injury, is to practice a variety of activities.
Although runners usually like to beat the streets and cyclists would rather pump the pedals, it's important to incorporate several forms of exercise into your workout schedule.
Who knows, you may be like long-distance runner Michael Bell and discover you like one of your new sports as much as the one it replaced.
When the 41-year-old fitness buff suffered a torn anterior cruciate ligament (a stabilizing ligament in the knee that connects the thigh bone to the shin bone), he was forced to give up not only his beloved running, but also all pivoting sports, including tennis, basketball and soccer. And because of a previous shoulder injury, swimming wasn't an option. That left cycling.
"I never would have looked into spinning (indoor group cycling classes) if I hadn't been injured, but it turned out to be a really good thing," says the airline pilot from Coronado, Calif., who plans on continuing with indoor cycling even if he's able to resume running. "Injuries can be an opportunity to learn about other forms of exercising."
- Seek a balancing act.
When exercising with or rehabbing an injury, it's crucial that balance training be part of the program.
"Especially when you have a lower-extremity injury, your proprioceptors (nerve endings that sense a change in body position and are needed for balance) lose sharpness and sensitivity," Comana says. "Get on balance equipment with both feet, or just stand on one leg and resensitize those receptors."
- Stretch and flex.
Even in the first days after injury or pain onset, light stretching is possible and usually recommended.
"No matter what injury is sidelining you, try to do some simple stretches," says Stricker, noting that stretches should be gentle at first and under the watchful eye of a therapist or trainer. "If you were active and then stopped because of an injury, you'll lose flexibility. If you can't do anything else, at least keep up your stretching."
- Keep the muscles (including your heart) strong.
It's important to keep your muscles and cardiovascular system conditioned, even when you're injured. But joint pain, particularly in the upper body, can make weight training difficult. And lower body injuries can make it tough to get the heart pumping. There are ways to work out around the injury, however.
By improving the strength of the muscles around the injured or sore joint, especially if the pain is caused by joint deterioration or arthritis, the joint problem may actually ease a bit. For example, someone who has suffered a knee injury will benefit from exercises to strengthen the muscles that support the knee - the quadriceps (front thigh muscle) and the hamstring (back thigh muscle).
To rev up the heart when you have lower body injuries, try working with an ergometer or a stationary bicycle for your arms.
Budding soccer star Matthew Malik, 17, is using the equipment to help keep him in tip-top shape as he rehabs a knee injury.
"I'm really trying to keep up my cardio and get back as quickly as possible," says the high school junior, who underwent knee surgery in February. "I don't have that much time to impress college coaches. If I can keep up my cardio and strength, it would really help."
- Don't do too much too soon.
"If you rush the healing and rehab, the body won't heal correctly and you will end up with more problems than you started with," says Comana, noting that everyone progresses and heals at different rates. "Coming back too quickly, you could retrain your brain to move in an unnatural way compensating for weak muscles (such as a limp or favoring a leg)."
Kuwatani recommends returning to activity slowly, at "about 50 percent or less of what you were used to and gradually build up."
- Keep smiling.
When your head says "go" and your body says "no," it can be very frustrating and depressing. The psychological effects of being inactive, especially for an individual who is accustomed to living an active lifestyle, may be more severe than the physiological ones, Comana says.
- The answer is to get moving.
"You can offset depression by (performing) alternative activities. Although it may not give you 100 percent gratification because it's not what you're used to doing and may not be your favorite activity, you can still get some of the benefits of being physically active without aggravating injury," he says.
SIDEBAR
Tips to get back on the road to fitness
By R.J. Ignelzi
Copley News Service
"When you're hurting, the natural tendency is to stop all activity or immobilize the sore or injured area," says Fabio Comana, exercise physiologist with the San Diego-based American Council on Exercise. "However, the body is designed to move."
Certain movements and exercise modifications not only can speed healing, but also let you maintain your fitness while on the mend.
Health and fitness experts recommend the following exercises while nursing commonly injured body parts. Be sure to consult your health-care professional before engaging in any rehabilitative exercise program.
SHOULDER INJURY:
- Practice range of motion with gentle shoulder rolls, graduating to stretch bands and light weights.
- To gently stretch the shoulder joint, try walking your fingers up the wall, using the wall contact for support.
- Keep arm movements below shoulder level.
- To help maintain shoulder mobility, lean forward from the hips, letting the arms dangle, and move them in a back-and-forth pendulum motion.
- While swimming may not be possible, you can still kick your legs in the water for a cardio workout.
- Cycle on a recumbent bike.
- Running is probably too jarring. Try walking or an elliptical trainer.
- Strength train lower body and core. Keep the weights light, especially at first.
- Use strength-training machines that allow you to work the arms independently.
BACK INJURY:
- Work on hamstring and hip flexibility.
- Perform gentle abdominal exercises.
- Practice core-strengthening exercises on a stability ball or Bosu trainer.
- Swim and/or do water aerobics.
- Walk or work out on the elliptical trainer.
- Cycle on a recumbent bike.
- When doing weights on a bench, lie back with knees up to take any pressure off the back.
- Perform strength training in a seated or reclined position using light weights.
KNEE INJURY:
- Try cycling with just the uninjured leg on a recumbent bike. Gradually build up to pedaling with both legs.
- An ergometer, an arm-cycling machine, offers a great cardio workout.
- Swim or do water exercises.
- Walk or work out on the elliptical trainer, if not too painful.
- Practice balance training.
- Strength train upper body, core and thigh muscles that support knee.
- Stretch back, hips and upper body.
FOOT / ANKLE INJURY:
- Practice flexibility by writing the alphabet in the air with your foot, using your big toe as the pointer.
- Strength train upper body, core and legs in a seated position.
- Perform balance exercises.
- Try cycling with just the uninjured leg on a recumbent bike. Gradually build up to pedaling with both legs.
- Use an ergometer for a great cardio workout.
- Swim and do water exercises.
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