That you need to exercise to stay fit and healthy has always been what the doctor ordered. More and more people are hitting gyms, pounding pavements, practising yoga with the latest television cult guru, doing t’ai chi, pilates or aerobics, or setting up fancy exercise stations at home.
A positive trend, indeed, since regular exercise cuts the risks of obesity-related killer diseases such as diabetes, heart disease and strokes. However, the flip side of this enthusiasm for exercise is the rising number of gym or exercise-related injuries.
From slipped discs to hamstring pulls, shoulder injuries to ligament tears, doctors across the country are treating a new breed of patients—the overenthusiastic exercise freak. Age and gender are no bar as patients range from the 20s to the 60s, men and women alike.
Dr S.K.S. Marya, director and chief surgeon of Max Insitute of Orthopaedics and Joint Replacement, New Delhi, reports that on an average, he gets three-four exercise-related injury cases every week.
While, he says, rest, painkillers and physiotherapy are enough to treat most of these, at least two-three cases in a year require surgery. Dr Kaushal Malhan, knee and hip surgeon, Wockhardt Hospital, Mumbai, reports that he, too, is seeing a growing number of such cases.
Take the 28-year-old Mumbai-based executive, who was using weights to build the upper body and was incorrectly put on to a very aggressive and heavy weight-training programme. He ended up with a pectoralis major tendon rupture, seriously injuring the large powerful muscle in the front of the chest.
Or, take the case of Rina Talwar, a housewife in her mid-40s, who had kneecap problems, yet was put onto an aerobic workout schedule, with exercises that put undue stress on the knee. “I developed acute pain and had to stop all exercise till the problem was resolved,” she says.
Not all exercise-related injury cases are due to faulty methodology. The majority of cases, according to both doctors, are due to a lack of adequate warm-ups before exercising and setting overambitious weight-loss targets.
Fitness instructors such as Kiran Sawhney, who runs her own fitness boutique, Fitnesolution at Greater Kailash-2 in New Delhi, and Rahul Narang of Olympia Gym, also in Greater Kailash-2, say how a bit of common sense and some professional advice can help avoid such injuries. Here is a 10-point guide to an injury-free exercise regimen.
1. Get a qualified trainer
According to Kiran Sawhney, one of the biggest reasons for exercise-related injuries is that people work out under unqualified and inexperienced trainers. Often, the gym, too, is not up to the mark, with badly maintained equipment. Before signing up, always seek out a reference and insist on a complimentary session to check the place—and the trainer—out. Also, as Bangalore-based orthopaedic specialist Dr Deepak Sharan points out, an increasing number of people are exercising without personal supervision, relying on television programmes or books for guidance. This often leads to faulty routines, causing more harm than good.
2. Be realistic about yourself
A common cause for injuries is that people are trying to achieve too much too soon. Narang says that it is common to see people trying to lift 15kg when 10kg is what they could safely do. As Dr Marya points out, “A lot of people in their 40s think they can do the same routine they did 10 years ago, little realizing that their bodies have aged.” Echoes Dr Malhan, “The pace should be appropriate to age, weight and endurance capacity of the patient and the heart rate should never be more than 80% of the maximum achievable.” So, make sure you strike an optimum balance and don’t cross your limits.
3. Home gym
A home gymnasium is a convenient option for busy professionals who may not find time to exercise otherwise. However, Sawhney has her reservations: “It is just like buying medicines over the counter from a chemist without consulting the doctor.” It’s best to get a personal trainer home and do the routine under supervision for some time before trying to do things on your own.
4. Check with your doctor
Professional gyms will always insist that you get a medical certificate from your doctor before they take you on board. Many people tend to ignore existing medical conditions and start hitting the gyms without realizing the problems they could face later.
5.Choosing the right regime
Choosing the right regime is critical. Each person needs a well-designed workout plan customized to meet individual requirement keeping in mind medical history, age, fitness aspirations and targets. Often, heavily overweight people start jogging or walking briskly, not realizing the strain they could be putting on their knees and heels. Says Narang, “Prolonged running should be attempted only after some weight loss. Yoga might work better in such cases. Make sure you choose the right programme”.
6. Don’t blame the equipment
As more and more cases of falls from treadmills or injuries suffered on the bench press get reported, equipment is often held the culprit. Both doctors and personal trainers say that it’s not the equipment but the person using it who’s at fault 95% of the time.
Injuries are mainly a result of wrong technique, not poor equipment.
7. Weekend warriors
Many of us work hard through the week and keep exercise for the weekend, lifting weights or playing an energetic round of tennis. In the process, our bodies are subjected to a burst of unaccustomed stressful activity that will ultimately prove harmful. Exercise has to be regular or the body may not be able to cope.
8. The nutrition factor
Nutrition is a big factor. As Narang points out, “A lot of people, who set themselves impossible targets, eat less even as they set a punishing exercise regime for themselves. This will tell on their health.”
9. Keep varying the routine
Exercise fatigue can occur if excessive exercise is done and if there is no variation in the routine, says Dr Malhan. It’s important to rotate all the muscle groups. A combination of cardiovascular exercises with strength training works best.
10. What’s the best remedy?
For sports or gym-related injuries, doctors advise R.I.C.E. (rest, ice, compression, elevation).
Dr Marya expresses his disapproval of advertisements that promote pain-relieving gels and sprays as the best remedy. “That’s just not the answer and you should always visit the doctor before the condition gets aggravated,” he says.
• Know your equipment and m ake sure it is in good condition.
• Know your limits. Consult an expert to establish what is safe as well as what is not suited to you. Get a good, thorough physical assessment and train under expert supervision before you start exercising on your own.
• Stretching exercises are a must. However, these must be done correctly. Wrongly executed exercises can cause even more injury.
• Be sure to tell your doctor if you have any ailments before starting an exercise regime.
• Use proper shoes and clothing.
• Pace the programme gradually. Go for safe and achievable targets
• Get a nutritional assessment.
• Drink plenty of water during the day before your workout. Keep drinking water throughout and after your workout to replace water lost through sweat.
• Don’t try doing new routines without personal supervision, at least in the initial stages, such as exercising in front of the TV set or by following a video, or in a large group session (especially for yoga or aerobics).
• Don’t ignore signs of early injuries or discomfort. These are warning signs that what you are doing is perhaps not what you should be. A problem that is attended to early enough can ensure a trouble-free time ahead.
• Don’t ignore medical conditions like osteoarthritis, as certain routines may inflame the condition.
• Don’t forget to warm up before beginning any exercise and and cool down after completing the routine.
• Ensure that your blood pressure is at an optimum level before undertaking an exercise regimen.
(As told by Dr Deepak Sharan , Dr K. Malhan and Rahul Narang)
Areas of the body affected by faulty workouts
Back injuries commonly occur in the gym, especially affecting bodybuilders and those doing abdominal exercises the wrong way. In extreme cases, this can lead to a slipped disc, requiring surgery. Also a common injury for golfers, who often have to swing their spinehave to twist their torso for the swing action and often end up damaging their spine.
Common among those playing squash, tennis, badminton and lifting weights in the gym, using wrong form and techniques. The shoulder area is prone to muscle ruptures, biceps tendon rupture or even a constant nagging pain due to overuse injury.
Muscular strains or myofascial pain in the neck are caused by poor stretching routines after training. Overdoing it often causes tightening of muscles.
Elbow injuries affect those who play racket games and bodybuilders. Those who overdo weights or try to push something heavy could end up with inflammation and rupture of the triceps tendon (at the back of the upper arm).
The wrist is one of the most common areas where ligament injury occurs. Typically affects those who play racket sports or lift weights.
Joggers, treadmill users, squash and soccer players are affected by knee injuries. Patellofemoral pain syndrome, or runner’s knee, is when the cartilage deteriorates in the inner part of the kneecap.
Overenthusiastic treadmill users.
Ankle injuries usually strike long-distance runners and joggers.
Heel pain (plantar fasciitis) affects overweight walkers who suddenly spend too much time on their feet. Excessive hill running and improper shoes can also lead to Achilles tendonitis, which is the bane of many runners.
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