May 17, 1997
Know your body to help prevent exercise accidents
By Dr. Robert P. Nirschl
Taking up a sport to get in shape is a common approach to health and fitness. Also common is joining a Health Spa after succumbing to those appealing ads of beautiful young people in bathing suits. On occasion these approaches can be helpful but often these concepts are ineffective and can be injury producing.
Why we exercise
Exercise is best understood by defining three categories. These categories include: rehabilitation, fitness, and performance. The goal of rehabilitation exercise is to transform abnormal, weakened, or injured tissue (e.g. tendons, muscles, joints, etc.) to as close to normal as possible. Fitness exercise presumes the tissue is normal and the goal is to enhance it to better or super normal. Finally performance exercise (e.g. sport, occupational, or performing arts) has as its goal the production of products, services, or winning. As such the abuse or injury potential from performance exercise is relatively high. As coaches often state "If the team stays healthy, we have a better chance of winning". The message is quite clear, performance activity, such as sport, can be injury producing.
Make realistic goals
Several other factors are critical to achieving exercise success. These include clear and realistic goals of what is to be achieved by exercise and the presence of any body weaknesses which increase the vulnerability to injury. What is the exercise goal? Examples might include: fat weight control, better heart fitness, improved strength, prevention of heart attack, control of diseases such as arthritis, diabetes, or high blood pressure, enhancement of sport performance, look good in a bathing suit, or just plain fun. Of equal importance is what deficiencies are present as a result of heredity, prior injury, or prior sickness. In many instances major strength and flexibility deficiencies are present of which the person is often unaware. This is especially true of prior injury has occurred even many years ago. Back and knee symptoms commonly resurface after many years of no apparent problems. As an example, an old high school football injury becomes painful when a 40 year old starts jogging or weight lifting. Common hereditary factors (e.g. you were born with it) such as rigid high arched feet, flat feet, knock knees, or bad posture also can increase injury risk.
What foot type are you?
When you look at your foot imprint in wet sand for instance you should find that you are close to one of three common foot types:
- The normal foot
- The flat foot
- The high-arched foot
Challenging the body
Finally the exercise itself can challenge and cause body changes which are not always healthy. Examples include weight lifting which can result in shoulder arthritis or aggravate high blood pressure, running which causes calf/Achilles tightness while weakening the front shin muscles, baseball throwing and swimming which weaken the shoulder blade and rotator cuff muscles with resultant rotator cuff tendon problems, or golf and tennis which often weaken forearm muscles with resulting tennis or golf elbow.
For the majority, exercise is highly beneficial. In my view, "It is better to wear out than to rust out". Certain concepts are however important to exercise success. First and foremost, choose exercises which are convenient and pleasant. In addition, your exercise goals must be clearly understood and programs chosen which can accomplish those goals. Ask a lot of questions to those who propose to help you. Many so called fitness experts are not experts at all. Finally you must understand your body. If there is any question about prior injury, weakness or hereditaril deficiencies, obtain a complete pre-participation exam. By complete I mean not only a routine physical but performance testing for strength, flexibility, and both cardiovascular (heart/lung) and musculoskeletal (muscle/joints) endurance. If your current physician only does routine physicals but not performance testing, ask to be referred for such testing to a quality sports medicine rehabilitation center well versed in pre-participation exams. This is especially important if prior musculoskeletal injury has occurred. Identified deficiencies can and should be corrected by rehabilitation before proceeding to fitness and sport exercise.
Overall "it is best to get in shape to take up a sport rather than take up a sport to get in shape." Most important enjoy what you choose. Happy exercise and best of luck.