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Reducing the Risk of Injury #1 Rule for Injury Mitigation • Assumption – everyone has been cleared to start an exercise program by their primary care provider Warm-up Before Exercising • raises the body’s temperature • starts the blood flowing throughout the entire body • eases the muscles and joints into activity How to Warm-Up • 5 - 10 minutes at an intensity that does not tire you out • Generic: jumping rope, jogging, jumping jacks, goosestepping, walking knee lifts, walking butt kicks OR • Specific: do the activity of your exercise (e.g., walking, jogging, biking) slowly for awhile • Strength Training: move your joints and muscles in the same motion of what you will be doing with weights What About Stretching? • Static – bend the body in such a way that there is tension on a muscle and hold it for at least 30 seconds • Dynamic – swing, bounce or move body parts in their normal range of motion at a controlled speed • Ballistic – swing, bounce or move body parts outside their normal range of motion (NOT RECOMMENDED WITHOUT SKILLED SUPERVISION) • See http://www.bodybuilding.com/exercises/finder/lookup/ Do I Stretch or Warm-up First? • Do not perform static stretching without first warming up • Preferably do not perform static stretching until after exercising. • Dynamic stretching looks a lot like warming up Cool-Down • Cooling-Down looks a lot like Warming-Up. • For 5 to 10 minutes reduce the intensity level of your exercising before stopping. • Now stretch Do Not Overtrain Do Not Overtrain • Give your body rest between workouts • Do not do too much, too fast during workouts. • 10% rule: from one week to the next do not increase speed, intensity, duration, or weight more than 10% Good Nutrition Good Nutrition and Hydration • A tired or fatigued body and mind are more apt to have accidents or be distracted while exercising • Exercise converts bodily tissue into usable energy; both fuel and water are necessary for this process • A combination of protein, carbohydrates, and fat is best Good Nutrition and Hydration – cont’d • Eat about two hours before working out and (assuming you are already hydrated) drink 8 to 16 ounces of water about two hours before working out. • Exercise that lasts less than an hour typically will not require sports drinks to replenish electrolytes (salts). • Some studies indicate that it is beneficial to consume an even mix of carbohydrates and protein within two hours of completing strength training Listen To Your Body • Selecting Exercises and Activities – You know what injuries you’ve had in the past – You know what exercises to avoid • While Exercising – You know when you feel a pain that is different than your typical ache – You can recognize that you are light-headed or otherwise not 100% – Modify during a routine as needed Use Correct Gear • Running shoe manufacturers (who are not unbiased) suggest replacing running shoes every 300 miles • Cotton gets wet and stays wet with sweat. Chafing and skin irritations are more likely with cotton exercise clothes. • Safety – every time Nathan posts his sweaty mug while biking, it is apparent that he is wearing a helmet. Use Correct Form Use Correct Form • If you do not know how to use a particular machine at the gym, ask a trainer • If you do not know how to properly perform a particular exercise, ask a trainer (or do some careful Internet research) See http://www.bodybuilding.com/exercises/finder/lookup/ • This point is important for stretching, not just exercising Example of Proper Form: Walking The 8 Keys to Proper Fitness Walking 1) Stand tall, with your shoulders back, head and neck aligned with your spine, and abs pulled in. 2) Push off with the toes of your rear foot, and land squarely on the heel of your lead foot. 3) Roll through the entire foot, from heel strike to the ball of your foot to the final push off with your toes, allowing your ankle to move through its full range of motion. 4) Avoid over-striding. Increase the number of steps per minute to increase speed. 5) Bend elbows at a right angle, and swing your arms from the shoulder, keeping elbows close to your sides. 6) Avoid clenching hands or over-swinging your arms. 7) Minimize leaning on hills. 8) Don’t neglect stretching and strength training, especially if you experience burning or tightness in shins or calve muscles. Use Correct Form Muscle Imbalance We have opposing or complementary muscle groups to move our bodies in a desired way. When one muscle contracts (agonist) the other muscle lengthens (antagonist). The agonist bends a limb in a desired direction and the antagonist returns the limb to its original position Examples: biceps vs. triceps hamstrings vs. quadriceps abs vs. erector spinae delts vs. traps Muscle Imbalance – cont’d • Muscle “pairs” can be out of balance if one cannot lengthen enough in response to the other’s contraction or if one is significantly stronger relative to the other. The result is poor biomechanical movement at the joint that can stress tendons and ligaments or harm cartilage. • An example is that many runners have hamstrings that are relatively weak compared to the strength of their quadriceps and this is a common cause of knee pain. How to Reduce Muscle Imbalance • Variety in Exercise – Can help ensure all muscles are being worked – Can help prevent injuries or soreness from repetitive motion – Can help make exercising less boring – Deliberately train both muscles of the “pair” • Stretching – Use static stretching to target muscles that always seem tight Should You Exercise When You are Sick • The “Neck Rule” (simple to apply but not fool proof) – If all your symptoms occur above the neck, then it is probably OK to exercise; but you can give your body the extra rest. – If any symptoms occur below the neck, then it is better not to exercise until you get better. Reduce Your Bodyweight • Risk of joint and muscle pain or injury is higher for exercisers that are obese • Risk of stress fractures is higher for exercisers that are obese What If You Do Get Injured or Hurt? ACUTE: • Acute injuries are sudden, sharp, traumatic injuries that occur immediately (or within hours) and cause pain (possibly severe pain). Most often acute injuries result from some sort of impact or trauma such as a fall, sprain, or collision and it's pretty obvious what caused the injury. • Acute injuries also cause common signs and symptoms of injury such as pain, tenderness, redness, skin that is warm to the touch, swelling and inflammation. If you have swelling, you have an acute injury. What If You Do Get Injured or Hurt? – cont’d CHRONIC: • Chronic injuries, on the other hand, can be subtle and slow to develop. They sometimes come and go, and may cause dull pain or soreness. They are often the result of overuse, but sometimes develop when an acute injury is not properly treated and doesn't heal. Most Likely Injury to Occur • Sprain – involves ligaments that connect bones together at joints • Strain – involves muscles or the tendons that connect the muscle to bones Most Likely Injury to Occur – cont’d • The signs of most sprains or strains are very similar: pain and inflammation, and sometimes bruising, at the injured area. Depending on the severity of the sprain or strain, the pain may be mild, moderate, or severe. • The more severe the sprain or strain, the more difficult it is to use the affected area. If the pain and swelling do not begin to subside within 24-72 hours, you cannot bear weight, or if your symptoms actually get worse, see a doctor promptly. Caring For Sprains and Strains The gold standard of care for sprains and strains is known as RICE therapy. • Rest: Don’t put weight on the injured area (this includes not lifting with an affected wrist or elbow) for 24-48 hours, to guard against aggravating the injury further. If you physically cannot put weight on an injured knee or ankle, see your doctor. • Ice: Put a bag of ice on the injured area for 10 minutes at a time, and then take it off for about 20-30 minutes over the course of the first 3 days. Ice should not be applied directly to the skin. The cold constricts blood vessels and slows down the inflammatory process, easing pain and swelling. Too much time can cause injury, however, so don’t leave the bag on too long. Caring For Sprains and Strains • Compression: You can either wrap an injured wrist, ankle, knee or elbow in an elastic bandage, or buy a compression sleeve at any drugstore. Like ice, compression helps to decrease swelling. • Elevation: By placing the injured area on a pillow and elevating it above the level of your heart, you keep fluid from collecting in the area and decrease swelling. • RICE therapy is particularly important during the first 24-72 hours after a sprain or strain occurs. When Do I Use Heat Therapy? • Do not use heat if there is inflammation! • Heat is for muscles — taking the edge off the pain of whole muscle spasms and trigger points (localized spasms, or muscle knots). Shin Splints • "Shinsplints" refers to medial tibial stress syndrome, an achy pain that results when small tears occur in the muscles around your tibia (shin bone). This makes up about 15 percent of running injuries; 10 percent of runnersworld.com respondents poll had shinsplints in the past year. • WHO'S AT RISK? Shinsplints are common among new runners and those returning after an extended layoff. They're a sign that you've done too much, too quickly. Shinsplints more likely strike runners wearing the wrong shoe or a pair with too many miles, and those with high arches or flat feet. • CAN YOU RUN THROUGH IT? When the first twinges of pain strike, back off your running to a comfortable level for a few days to a week, then slowly up your mileage using the 10 percent rule. Bike, pool run, and swim instead, if you can. What About Chronic Pain? • Icing is primarily an analgesic — a pain‐reliever — and not an actual treatment. That is, it doesn’t “fix” anything. Use it like you use ibuprofen. It may help to resolve chronic problems, but it’s mostly intended to simply numb painfully inflamed or other hurting tissues. • For some people, they perceive that heat relieves their chronic pain better than ice. • Heat or Ice?? It is a personal preference. The End • Any Questions? • Next Challenge ! – Choose one item from question #1 of your selfassessment and make a goal of not consuming that item for the next two weeks – Deliberately stretch for at least 10 minutes on at least three different days of each of the next two weeks (i.e., 6 days total)