Because I’m a lifelong advocate of fitness walking and injury-free walking, I’m always trying to come up with the simplest way to get walkers to move along the ground in a way that produces the least amount of impact to the feet, knees, hips and lower back. The answer to this dilemma is different depending on whether you’re walking or running. I’ll begin with you walkers.
The coronavirus pandemic has had a major effect on all areas of people’s lives, and physical activity levels are no exception. Recent studies show that the pandemic and associated lockdowns prompted many people to go one of two ways with regard to their exercise program. They either decided to work out more in an attempt to get in the best shape of their lives, or chose to spend lockdowns sitting at the computer, watching TV and/or enjoying long phases of inactivity. Both of these choices, while seemingly unrelated, have led to an increased number of people experiencing musculoskeletal injuries.1,2,3
What is Causing the Increase in Injuries?
The COVID-19 situation prevented most people from utilizing in-person fitness and exercise services. Consequently, those individuals who decided to increase their physical activity levels often did so without the supervision of a qualified fitness or exercise professional. In addition to engaging in exercise endeavors unsupervised, research found that they tended to work out longer and harder than would have been appropriate, and tried more extreme forms of exercise. This has resulted in many of these people experiencing musculoskeletal overuse injuries.1
Alternatively, individuals who stopped exercising during the pandemic and instead spent more time watching TV, playing computer games, and generally sitting for longer periods of time became deconditioned. Once lockdowns and COVID-19 restrictions began to ease up, these people experienced musculoskeletal injuries as they tried to return to their pre-pandemic exercise levels in a deconditioned state. 1,2
Guiding Clients Back from Pain and Injury
Corrective exercise specialists and fitness professionals well-versed in corrective exercise methodologies are uniquely positioned to help people overcome pain, injuries and musculoskeletal issues that have arisen as a result of over- or under-exercising during the pandemic.
Clients who sustained overuse injuries in their pandemic pursuit of ultimate fitness will benefit most from incorporating activities into their exercise regime that actively promote rest, recovery and rejuvenation. Coach these people to take days off from strenuous activity to instead perform self-myofascial release and gentle stretching exercises appropriate for their musculoskeletal issue or condition. Areas of the body that were overly-strained, stressed and/or injured during high levels and intensities of exercise should now be prioritized with these corrective exercise techniques.4
A deconditioned client trying to resume their pre-pandemic physical activity levels without adequate reintroduction will benefit from the application of gradual progression. Coach them about the need to address musculoskeletal changes that have occurred as a result of prolonged static postures like sitting, and the importance of slowly reintroducing exercise stress to help safeguard their body from the pain and injury that can result if they overdo it upon returning to the gym.4
As the availability of in-person exercise and fitness services begins to resume, corrective exercise specialists are in a unique position to assist people that have sustained musculoskeletal injuries as a result of too much or too little exercise. Whether helping clients get over pain and injuries incurred during the pandemic, or reintroducing exercise safely to those who are unfit and out of shape as a result of long periods of inactivity, expertise in the area of corrective exercise is now more important than ever.
Justin Price is one of the world’s foremost experts in musculoskeletal assessment and corrective exercise and creator of The BioMechanics Method Corrective Exercise Specialist certification (TBMM-CES). The BioMechanics Method is the fitness industry’s highest-rated CES credential with trained professionals in over 70 countries. Justin is also the author of several books including The BioMechanics Method for Corrective Exercise academic textbook, a former IDEA Personal Trainer of the Year, and a subject matter expert for The American Council on Exercise, Human Kinetics, TRX, BOSU, MFN, Arthritis Today, BBC, Discovery Health, Los Angeles Times, Men’s Health, MSNBC, New York Times, Newsweek, Time, Wall Street Journal, WebMD and Tennis Magazine.
- Clarence Valley Independent. Nov 7, 2021. Increased exercise leads to unexpected injuries during lockdown. Retrieved from clarencevalleynews.com.au on Nov. 8, 2021.
- Moses, S, and Robins, M. August 2, 2021. The COVID connection: Youth sports injuries on the rise. WKYC studios. Retrieved from WKYC.com on Nov. 8, 2021.
- Seshadri, D., Thom, M., Harlow, E., Drummond, C. and Voss, J. Case Report: Return to sport following the COVID-19 lockdown and its impact on injury rates in the German Soccer League. Frontiers in Sports and Active Living, Feb 18, 2021.
- Price, J. and Bratcher, M. 2019. The BioMechanics Method Corrective Exercise Specialist Education Program (2nd ed). San Diego, CA: The BioMechanics Press.
For many exercise professionals, the goal of training and educating clients is to improve health, increase strength and performance, and improve fitness parameters. The concept of reducing injuries may not be high on their radar screens.
Women have different biomechanics due to a slightly wider pelvis, which means their knees buckle more easily when landing from a jump. Women have looser joints, which is a risk factor for knee problems, and muscular, strength and hormonal issues also play a part.
The ACL provides the knee joint with stability and rotational control during movement. When an ACL tear happens, hearing or feeling a ‘pop’ at the time of injury is common. This is followed by localized swelling at the knee joint.
An ACL injury can occur in several ways:
- Rapid change of direction
- Sudden stop
- Sudden deceleration while running
- Landing incorrectly after a jump
- Hyperextension of the knee
- Direct contact or collision while playing a sport
If you experience any sharp or sudden pain at the knee, especially during sports or from a fall, follow the First Aid RICE protocol immediately — Rest, Ice, Compress, Elevate — and seek medical attention immediately.
There isn’t much you can do once the injury happens, but there are ways to minimize the chance of it happening in the first place. Prevention is better than cure so focus on strengthening the kinetic chain and muscles around the knee. If you do lots of sport with plyometric movements, ensure your technique and form is correct, and include agility drills for neuromuscular control.
Here are 5 essential exercises to help stabilize and strengthen your knees, hips and glutes, which in turn will help prevent an ACL injury.
Single Leg Deadlift
Ensure that your knee doesn’t buckle and aim to keep your hips level. Keep your spine neutral and braced throughout the entire movement while maintaining balance.
Elevated Hip Raise
This exercise targets the hamstrings and calves. Maintain a neutral spine throughout the range of movements.
Walking Leg Lunges with Torso Rotation
Maintain an upright torso with your hips squared. If you feel a sharp pain in your knee at any time during this exercise, stop and seek advice from a qualified trainer.
Begin by placing your feet wide apart, then shift your weight from left to right while placing most of your body weight on the heels of your feet. If you feel a sharp pain in your knee at any time during this exercise, stop and seek advice from a qualified trainer.
Reprinted with permission from www.purelyb.com
Ke Wynn Lee is an author and an international award-winning corrective exercise specialist who currently owns and operates a private Medical Fitness Center in Penang. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.
Athletes get injured. It’s part of the deal. Be it a torn ACL, Achilles tendonitis, or a pulled muscle, the questions arise: What can I eat to recover faster? Would more vitamins be helpful? What about collagen supplements? At this year’s virtual Food and Nutrition Conference and Expo (FNCE) of the Academy of Nutrition and Dietetics (AND, the nation’s largest group of nutrition professionals), several presentations offered updates on nutrition for injuries.
Around 20 million people in the US are pressing heels and down-dogging on their yoga mats, trying to gain as many health benefits as they can. Of course, yoga is a great physical activity to improve endurance, strength, and flexibility. This ancient practice helps reduce stress and anxiety.
Most people practice yoga to maintain heart rate, lower blood pressure, and boost metabolism and even fight obesity. But if not done correctly, yoga can be harmful.
The pulled shoulder is one of the most common problems associated with yoga. Since yoga focuses on improving balance, it includes various poses that involve shoulders. Shrugging, for instance, is all about how the shoulders are moved and compressed, which if not done correctly can cause muscle injury.
Finding Relief for Pulled Shoulder Muscle
A pulled shoulder muscle can be painful. The wrong postures can pull muscle fibers in the wrong direction or to the extent that’s beyond capacity. This causes small tears, which leads to pain.
So how do you find relief if you get a pulled shoulder muscle during yoga?
Besides seeking professional help to master all poses, the following tips can help you get rid of the pain and treat your muscles in time.
Stop Right Away
As soon as you realize a muscle injury, stop what you are doing right away. Discontinue the pose and see a doctor before you resume yoga. Continuing exercise with an injured muscle can double the damage and make recovery more challenging and time-consuming.
The first step is to protect it by realizing the problem and finding a solution for it. Avoid doing anything stressful with that shoulder until you see a doctor.
The Icing Method
In case you cannot get an appointment right away, use the icing method to stop blood flow to the injured muscle. This helps with swelling and mitigating the pain. If you are outdoors, get home and grab an ice pack and apply to the affected area. You can even use a bag full of ice cubes to have the same effect.
Also, remember to always use a medium to apply ice to avoid direct contact with skin. Start with applying ice for twenty minutes every hour in a day. If the pain persists and the swelling doesn’t reduce, rush to the hospital immediately.
Compress the Shoulder
The next top is to wrap the affected area to control swelling and pain. A pulled muscle naturally weakens the joint and causes pain if pressure is applied. Using a wrap to compress your shoulder will provide support to the joint and make pain bearable.
Wrapping, in this case, will differ greatly from how you would’ve wrapped your ankle. In fact, to provide the right support, wrap it around the bicep to create the anchor effect. Use the bandage to cover the chest and the opposite arm.
Bring the bandage up again and cover the injured shoulder and around the same bicep once again. Do not make it too tight but make sure it compresses the affected shoulder to avoid swelling.
Take Maximum Rest
In case the injury is not severe, your shoulder should heal after you are done with icing and compressing. But if you allow your shoulder to come under any impact of pressure again, it could disrupt the healing process.
Continue with icing and keep the shoulder wrapped for at least three days. Avoid lifting weights or stretching your arm to grab something out of your reach. It is best if you keep your arm and shoulder elevated and close to your chest. Avoid sleeping on the side of the injured muscle.
Keeping the severity of your injury in mind, it could take up to eight weeks for your shoulder muscle to heal completely. Even when you don’t feel the pain anymore, avoid overstretching or pressurizing your muscles. Start with your regular, slow-paced activities and only indulge in gentle stretches if you continue with yoga.
During your yoga session, avoid pulling too hard on your shoulders and do not overstretch. When in the posture, keep your shoulders straight and held back from the ears. If you find a certain pose difficult to practice, do not hesitate in asking for help from a professional.
Even after you have completely healed, avoid doing intense shoulder stretches for a while. This could be the culprit for shoulder pain and injury. In fact, placing the neck incorrectly and applying pressure can also damage the cervical vertebrae, which leads to severe joint issues and can even cause loss of neck flexion.
If you need, use props to help elevate your shoulder and neck away from the floor to avoid extreme pressure.
It is best to see a doctor if you suspect severe injury. However, mild ones can be treated at home with a little help. Before you are back to your routine, it is best to check with a physician to get a green signal. Sometimes, you may need to briefly work with a shoulder surgeon or physical therapist to get you back to your normal shoulder movements.
Lately I can’t go to the gym without someone coming up to me looking for advice because in their efforts to remain fit and active they have hit a roadblock. Something hurts- a sore knee, achy shoulder or bad back that goes out more than they do. Ditto for my practice where I have seen a significant increase in exercise related ailments. I should give out orthopedic frequent flyer miles.
I’m an orthopedic surgeon specializing in sports medicine who has also had a life long interest and commitment to exercise. What I have learned over the years is that the far majority of exercise related ailments are preventable with some simple measures. That is why I wrote FrameWork- Your 7 Step Program for Healthy Muscles, Bones and Joints, as well as the FrameWork “Active for Life” series (Rodale Press).
Exercise is essential for maintaining optimal health, and being sedentary is just not an option, yet many individuals run into difficulties in their quest to be fit. Just about anyone can get into trouble, from young, fit and seemingly indestructible, to older and somewhat “beat-up”. We all bring “weak links” to the gym or out on the field. I‘ve learned this from working not only with my sports medicine patients but also athletes at the highest levels, including professional and Olympic. I have also learned the harder way, personally. A high school football injury that came back to haunt me, and a more recent low back issue.
The key is to find those “weak links” before they find you!
The human body does, and will, breakdown, especially when often pushed to the break point. Some of us are more vulnerable than others. And many of our “weak links” are of our own making. Workouts, activities or sports that leave imbalances in your frame, overuse, inadequate recovery, and so much more, mostly preventable factors. Musculoskeletal ailments have surpassed the common cold as the #1 reason people seek medical care in this country. It is no wonder for many, that workouts can be a challenge. Also, as Arnold Schwarzenegger so wisely said in the FrameWork forward, “I have really come to appreciate how the body is a dynamic, ever-changing structure that is different at different times. At 30 you need a different approach to fitness than when you were a teenager”. His workouts have evolved with him and even the Terminator himself has had to visit the repair shop. So, how can you be more durable, with less risk of breakdown? FrameWork offers 7 easy steps that can benefit everyone, young and old.
In FrameWork, I outline a 7-Step comprehensive plan for optimal health and durability. In Step 1, a unique self- test (take the interactive on-line version of the self-test) asks the question “are you built to last?” and finds your individual “weak-links” (we all have them). These “weak-links” or points of vulnerability may be old injuries or ailments, suboptimal nutrition, genetics, lifestyle, workout design, mindset and more. They are like hidden land minds, just waiting to be found, waiting to rear their ugly heads and put you on the sidelines, rather than in the game.
Step 2 thru 7 allow you to customize a program for your unique frame (based on the self-test and your own history) focusing on balanced workouts, frame-friendly nutrition and the important role of recovery and mindset. The program combines healing and restorative methods from the worlds of rehabilitation, martial arts, and yoga in a way never presented before. A “troubleshooting” section teaches you how to prevent, treat and safely work (out) around the “Top 20” sports medicine ailments from tendinitis and knee problems to back pain and pinched nerves. I also offer an insiders view of safely navigating the healthcare system, including a look into the very promising future for those with stubborn musculoskeletal issues. Most importantly, I use stories, drawn from my experience treating many wonderful athletes, entertainers and my many patients to help you better understand, and listen to your body- so that you can extend the warranty on your frame and it will be there for you when you go the distance. Remember, longevity and durability, two sides of the same optimal health and aging coin, are very different. We are certainly living longer and better, but without durability, problems are certain as we age. Fortunately many are preventable!
Find your “weak-links” and get a body that’s “Built to Last”.
Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.
Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA
Have you ever felt like Tom? You try and try but seem to end up adrift? Your intelligent, well read a motivated, hard working athlete, you know a lot of things, you certainly know how to exercise and you do it well. You have probably asked for some advice over the years on how to train. Especially since that nagging injury occurred.
Maybe it’s shin splints that developed from training for a ½ marathon, maybe it’s the knee injury from playing basketball, tennis, pickleball or sliding into 3rd base. Maybe you rolled an ankle because you missed that bottom step while walking out the door and that ankle hasn’t been right since.
So what do we do? We medicate it, rest it, tape it and brace it. While we are resting we look at the latest exercise programs and plot our course to get back on track once we feel it’s better we hit the gym – wrap that injury and go…. HIIT training, Cross Fit, Boot Camp, running we are on a roll. After just a couple weeks that injury is back. Now we are back on the couch with our favorite bottle of motrin again, now your despondent. That nagging thought creeps into your head, I’m too old, gotta give up the game.
Not so fast my friend! We can do things a different way! The problem here is we took a few weeks or months off!
How about trying ACTIVE Rest?!
Active rest defined: “Involves performing light exercises that stimulate the recovery process without imposing undue stress on the injured body part.”
Taking an active rest day will hasten your recovery, making you feel stronger and faster when you’re back in workout-mode.
What are the benefits of active rest in a pool?
Biggest benefit – Reduce swelling. When you reduce swelling you reduce pain. A two-fer bonus! Also unload the joint – due to the gravity free environment, again – takes the pain away. With the reduction in swelling and pain we can keep the joint moving, stabilize and strengthen it, working up to full body workouts to spin you back out into your sport.
The pool is what I call a pass through. It’s not a destination for most of us. We use it for it’s amazing properties so we can continue our favorite activities and sports. Active rest in a pool will not only rehabilitate your injury getting you back to your sport and activities faster it will help you mentally and emotionally, because you can DO something! It keeps CAN’T out of our vocabulary! High Schools, Colleges, Professional Teams and even our Military are using pools for training. Athlete or not, we hate being sidelined. We do much better when we are active. So next time you are adrift…try something different.
Debbie Booth is an aquatic fitness educator and trainer; she grew up in MI, (a Lake Girl for life) where her love of water began. She teaches medically based aquatics and has yet to grow gills. If lost she will usually turn up at the end of a dock with her feet in the water. You can visit her website at wateristhenewgym.com
1. Drink sufficient amounts of water to stay not only hydrated, but flushed.
Suggested amount of water intake is… Take your body weight divide in half for normal daily consumption and add another half of that amount for medium to heavy exercise days. A 200 lb. man should drink 100 oz. of water in normal daily consumption and 150 oz. for days where there is medium to heavy exercise. Also note that for every glass of soda, coffee, or alcohol, 2 cups of water is necessary to counteract the dehydrating properties of those drinks.
Drinking Water you say? Yes, Drinking water helps to flush your muscles of lactic acid which can lead to cramping and tight muscles. When you exercise while dehydrated and full of lactic acid, you have a greater chance of tearing muscles and ligaments. Learn more about The Real Squeeze on Muscle Cramping
Picture this scenario – You are running on a treadmill and your calf muscle decides to seize; in the middle of that cramp, your leg extends and, as you continue your run and the muscle that is seizing is now stretched beyond the point of cramp, RIP goes the muscle and now you collapse on the ground, or twist your ankle from the pain, or any number of other possibilities. You are now injured. Pretty likely scenario.
“My Ankles Were Swelling After I Would Dance Or Walk Or Play Pickleball And I Would Come Home And Put Them Up, Thinking I Had Been On Them Too Long. Then I Remembered What Ari Said About Water. And I Read Something That Said Swollen Ankles Were The First Sign Of Dehydration…So, Now I Have Been Drinking More And Constantly As I Play/Dance, And No More Swollen Ankles…”
2. Stretch, stretch, and more stretching before, during, and after exercising.
What you really need to know though, is that stretching properly is one of the most important parts of Effective Injury Prevention. If you have flexibility and control in your Range of Motion, when unexpected events occur such as car accidents, sports injuries, trip and falls, and any other sudden traumatic possibilities, your body will be fully prepared to withstand those traumas with little to no damage. I cannot emphasize enough how important it is for your overall wellbeing to have a flexible, supple body.
3. Core Strength and creating a strong foundation
So many people move and exercise without paying attention to the foundation they are building. I give the metaphor of a builder building a house and starting with the appliances and cabinetry before pouring the foundation and building the structure. We are programmed by magazines and advertisements to want to create a sculpture with our bodies. Become Greek Gods of chiseled stone. Athletes today build their bodies to look like sculptures but they shatter like glass.
Building a strong core and foundation will help your body tremendously with injury prevention. A weak foundation leads to improper form and technique which leads directly down the line to injuries. If I could illustrate this for you with a picture, I would; but for now think of it this way. You are sitting in a 4 legged chair and 2 of the legs were not properly screwed in. You turn to talk with someone and put extra strain on one of those legs and, because of the stress on placed on that leg, the entire chair buckles. This scenario happens constantly with people going to work out. They do not do the foundation building exercises first, get right into the design and sculpture of the body, and, because of this and lax technique, injury occurs. Prevent injuries by starting off building a strong foundation first so you can avoid needless injury, pain, and having to start all over after being laid up due to the injury.
4. Proper form and technique
What is the first thing you do when you set up to do an exercise? Let’s say you are doing a traditional bench press. I have been in enough gyms and watched enough people to know that most people who sit to do a bench press put on the weights (usually more than they should), sit in the chair (wherever the last person had it placed rather than setting it for their own height and weight), place hands on the bar (not making sure their hands are equidistant from either side of the ends), and push up, release, down, up, down, up, down, with no control of the sides (left usually weaker than right so the left side dips down with less control than that of the right). The result is wrist injury, chest muscle pull, shoulders give way, and the body becomes tense and tight in shoulders neck etc. causing even more pain and discomfort. Take the time to situate yourself in the proper position.
Be cognitive of the position of your body and the technique. If you cannot do an exercise with proper technique, either lower the weight of the apparatus or do a different exercise that can strengthen and stretch the weaker areas of your body first. Then, when you have built that foundation, come back to the exercise and try again. You will be sure to get the results you desire without the pain and agony of injury when taking this approach.
5. Take your time
First of all BREATHE. Take your time and be patient with yourself. It is more important long term to go slowly and build up to where you want to be rather than push yourself too hard at first. Intensity is great, but what is truly great is the long term effects of working for your body’s health. Injuries, because we try and push too hard and go too fast, are common. They cause a person to give up or at the very least they cut into the workout consistency because rather than being able to work out you are nursing your injuries. So, take your time and breathe through your workouts. Remember the end goal and that progress is measured more significantly in months not days.
6. Warm up and cool down periods
Many of us go to a gym or to a track to run or just get on a bike to ride and get straight to the business of pushing ourselves. I know I have been guilty of this too at times. I am on a time budget and have somewhere to be so I just want to get in and get out. The problem with this is that you are not allowing your body the preparation for working out properly, and then at the end you can seize up because you did not take the time to cool down in a way that eases your muscles out of the fire and burn you just put them under.
Light stretching and warming up muscles with brisk massage and medium speed walking are great ways to get muscles ready for the load of heavy exercising. Slow walking, light stretching, and keeping our bodies moving at a relaxed pace is a great way to cool down. Also, at the end of a workout, some light muscle squeezing and pushing up your limbs will help to flush some of the lactic acid out while giving the muscles a relaxing feel so they do not tighten up when you get in the car to go to your next appointment. Remember that this is about the long term health of your body. Injuries happen when we skip steps and do not take the time to prepare for the workout we are about to do.
“Ari, I Have Started Doing A Warm Up And Cool Down Exercise Even For My Line Dancing Group – It Puts Fluid In The Joints To Help Them Move Easier…I Even Am Starting My Day With The Warm Up And Whenever I Feel Stiff, I Repeat It”
7. PAY ATTENTION
Most of us, IF PAYING ATTENTION, have some sign before a rip or a tear or acute injury that what we are about to do is going to cause us pain. If we are diligent about paying attention to our bodies, we can avoid a great deal of undue anguish by listening to what our body is telling us. This is the same for working out as walking down the street and twisting an ankle because you were on your phone and not paying attention to the crack in the sidewalk or slipping and falling because you walked on a slick surface not paying attention to where you were going. Scenario after scenario of accidents can occur when we stop paying attention to our bodies and the world around us. We all do it. We CAN avoid it.
The majority of injuries we get are easily avoidable. Follow these World Class Athletes’ Secrets to Injury Prevention and you will have the BEST chance at leading a long, healthy life that is pain and injury free.
Ari Gronich is highly trained and certified in many disciplines within the fields of bodywork, emotional release, energy work, nutrition, sports hypnotherapy, health, and kinesiology and sports therapy. For the last 17 years, he has helped transform his clients’ bodies and lives through increased performance, thus enhancing physical, mental, and emotional health. To work with Ari, or for a Consultation Appointment you can email PerformanceTherapist@gmail.com or call 310-363-0FIT (0348). Visit his website, PerformanceTherapist.com