1. MAKING IT TO THE STARTING LINE: PREVENTING INJURIES Marcus Haemmerle, MD Orthopedic Surgeon

2. The Game Plan Benefits of exercise Common injuries and causes Tips to prevent injury The warm-up Proper stretching technique Importance of hydration Basic treatment of injury

3. Benefits of Exercise Increased energy, strength, endurance, balance, and coordination Decreased risk of chronic disease ▫Heart disease ▫Diabetes ▫Osteoporosis ▫Sleep disorders Lower stress Improved self-esteem Weight reduction

4. Common Injuries Tendonitis Bursitis Sprains Back Strain Muscle Tears Stress Fractures

5. Tendonitis “Inflammation of a tendon” Tendon attaches muscle to bone Very common when starting new activities Caused by overuse or overstrain Results in burning, aching-type pain that is worse after activity Can result in vicious cycle of pain if unresolved

6. Tendonitis Achilles Tendonitis ▫Located behind heel ▫Usually caused by running, jumping, climbing activities Patellar Tendonitis ▫Located below knee cap ▫Also caused by running, jumping, climbing Rotator Cuff Tendonitis ▫Pain felt on side of shoulder radiating to elbow ▫Caused by repetitive overhead/lifting activities

7. Tendonitis Plantar Fasciitis ▫Not true tendonitis ▫Located from heel to ball of foot ▫Sharp pain with weight bearing at base of heel ▫Worst in morning with first step ▫Caused by repetitive impact activities (running)  -those with tight calf muscles are more susceptible

8. Bursitis “inflammation of a bursa” Bursa is a sac containing lubricating fluid located near joints and tendons Can become painful and swollen Similar causes, symptoms, and treatments to tendonitis

9. Stress Fractures Result of repetitive low-level trauma Sudden increase in level of training Inadequate periods of rest Most common in feet and lower legs Progressive, localized pain in bone X-rays may be normal at first Treated with rest and sometimes casting and crutches

10. Causes of Injury Overuse Lack of flexibility Improper technique Faulty equipment/footwear

11. Tips to Prevent Injury 1. Slow and steady… ▫Be cautious ▫Start slowly, then build gradually ▫Low intensity activity early helps train muscles and improve coordination to better perform as intensity increases

12. Tips to Prevent Injury 2. Don’t follow no-pain, no-gain ▫Listen to your body ▫Stop activity if you have pain, difficulty breathing, dizziness, nausea, chest pain ▫Should be able to carry a conversation during work-out ▫Pushing through pain is quick way to develop injuries

13. Tips to Prevent Injury 3. Emphasize low-impact activities ▫Reduced stress on muscles, tendons, and joints ▫Examples  Bicycling  Elliptical trainer  Walking (level ground)  Swimming  Weight training

14. Tips to Prevent Injury 4. Warm-up, Cool-down ▫Take 5-10 minutes before each workout to gradually warm-up ▫Increases muscle temperature  Improves muscle efficiency  Improves elasticity  Improves transfer of Oxygen to muscle  Improves range of motion of joints ▫Mental preparation ▫5 min cool-down helps remove toxic substances that build up during exercise (lactic acid)

15. Tips to Prevent Injury 5. Make stretching part of regular routine ▫Improves range of motion and decreases strain on muscles and tendons ▫Best done after muscle has been warmed-up ▫Technique  Gradual, prolonged (20-30 sec), and pain-free  Avoid bouncing  Breathe

16. Tips to Prevent Injury 6. Mix it up ▫“cross-training” ▫Do variety of aerobic and resistive weight training activities on alternating days ▫Decreases overuse of the same muscle groups ▫Improves muscle balance ▫Decreases boredom and exercise burn-out

17. Tips to Prevent Injury 7. Hydrate ▫Before, during, and after activity ▫~1 cup (8 fl oz) before and every 10-15minutes during activity ▫Weigh self before and after activity  Drink 2-3 cups of water for every 1 pound lost ▫Water vs. Gatorade  Water usually better choice unless exercising for multiple hours  Water = zero calories

18. Tips to Prevent Injury 8. Rest and Recover ▫Allows body to repair, rebuild, and strengthen ▫Muscles require ≥48 hours to recover from stress ▫Get adequate sleep

19. Tips to Prevent Injury 9. Be safe ▫Inspect equipment and shoes ▫Know how to use equipment  If not, ask ▫Smooth, controlled movements  No jerking

20. Injury Treatment Minor injuries (RICE) ▫Rest -If it hurts, don’t do it ▫Ice -20-30 minutes every 1-2 hours -protect skin ▫Compression (ACE wrap) ▫Elevate

21. Injury Treatment When to seek medical attention ▫Severe pain, swelling, or deformity ▫Inability to bear weight through limb ▫Symptoms not improving with appropriate treatment (RICE)

22. THANK YOU