Exercise Tips

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Man and a Woman performing plank exercises at the gym
  1. The most common mistake that is made in most gyms is that people try to lift more weight than they are capable of and this usually results in poor mechanics when lifting, leading to injury. With any new exercise start with lighter weights then you think you should be lifting so that you can master the form first, and then slowly increase. Use mirrors to keep an eye on making sure your back is staying straight and you are using the right muscles to lift. When lifting with your arms your back should be saying straight and strong with your core engaged. When lifting with your legs you should not be rounding your lower back as this can result in disc herniation of the lumbar spine. If you are trying a new machine always read the instructions first to ensure you are using it properly. Finally, all strengthening should be done in a slow and controlled manner, a good guideline is you should be lifting for a 1-2 second interval and then returning to the start position in a 2-4 second interval. If you lift with good form and with slow and controlled mechanics you will not need heavy weights to get a good workout.
  2. When starting a new exercise program or trying to lose weight always remembers that it is a long process. One major reason why exercise programs fail so often is because people try and “lose all their weight at once” by going too hard for the first week. Frequently this results in injury, extreme soreness, or a feeling that it is impossible to keep with the routine because it is too demanding. Instead, start slow with exercise and work into bigger things. If you have never done an hour of cardio before, begin with 20 minutes of cycling instead of starting with a spin class. A good rule of thumb is that if muscle soreness last for longer than 2 days after an intense workout you are pushing too hard and should decrease the weight and or reps. Another good rule to follow is the 10% rule, meaning that you should not increase the amount of weight you are using by more than 10% at a time to prevent any injury. This rule also holds true with increasing the distance you are running, cycling or swimming and is the easiest way to drastically decrease your chances of being injured while trying to get back into shape. Moderation is the key early on in a workout program and rest is as important as working out when trying to get stronger, lose weight, or improve your fitness. A good workout plan should consist of 4-5 days a week of exercise and at least 2 rest days which are spread out intermittently throughout the week. This gives your body time to recover and your muscles time to grow so that you do not experience any overuse injuries from working out.
  3. Two of the most improperly performed exercises that people perform in the gym are squats and lunges. When performing a squat you should have your feet slightly wider than your hips width apart, and your knees should never go past your toes. Furthermore you should have your back straight and your weight should be firmly through your mid foot and not on your heels. When trying to squat, begin without weights and in front of a mirror to perfect your form. As you squat you should pretend like you are trying to sit into a chair that is about 1 foot away from where you are standing. Another easy trick is to stand with your toes touching a wall or a board and during each squat your knees should not come into contact with the wall. If you find yourself falling over backward or leaning on your heels as you squat, take a light weight and hold it out in front of you to help counter balance your body as you squat down. Finally, keep your back straight and your eyes looking directly in front of you with your chest up while you squat down. Squatting is foundational movement for any sport including running and having good form with squats can severely decrease your chances of suffering an injury such as an ACL tear or ankle sprain. The most common mistake seen with lunges is that the front knee is pushed forward out past the foot which can cause patella tendonitis, or patella-femoral pain syndrome due to the excessive stress being placed on the knee cap and patella tendon. To correct this, take a slightly larger step forward when lunging and focus on trying to touch your back knee to the ground rather than bending your front knee forward. By doing this you will keep your weight spread evenly on both legs instead of accidently driving too far forward and causing your front knee to go past your front toe.
  4. When trying to decide which cardio machines are best for you please consider the following; If you are experiencing arthritis in your knees, hips, back or ankles you should try to engage in cardio without any plyometric component including cycling, or an elliptical machine. These machines take the pressure and force off of your legs and help to strength without over taxing the joints. If you have osteoporosis you are looking for cardio that will stimulate bone growth and this will require light plyometric activity such as walking, step aerobics, jumping jacks or light jump rope. If you are experiencing joint pain and do not feel comfortable with cycling or an elliptical then swimming can be a great workout, or even walking in a pool to help build muscle while taking pressure off of the joints. Unless you have run before, it is not advised to begin with running on a treadmill or outside due to the amount of force it can place on your muscles and joints. A walking program that includes hills can be as beneficial as running can be and is a great way to ease into aerobic activity.
  5. If you are trying to start running follow a program such as “Couch to 5k” that will lay out an easy week by week progression to get you to running the distance you would like. It can be dangerous to jump right in and try and run as far as you can without stopping your first time.  When beginning to run make sure that you start at a slow jogging pace.  If you were to rate how hard you are exerting yourself from 1-10 a 6 would be where you want to be. You should be able to jog and speak without difficulty when you first begin to ensure that you are not pushing yourself too hard too soon. One great tool for new runners is a heart rate monitor. These can be purchased at any sporting goods store or online and will give you immediate feedback on how high your heart rate is so that you can make sure you aren’t over exerting yourself. When using heart rate to monitor your exertion, simply subtract your age from 220 and then try to stay within a range of 60% – 80% of that number. This will ensure that you do not “crash” before you are finished with your run. It is also important to remember the FIT principle. This means that you should only increase either your frequency, intensity, or time but not all at once. If you begin with 10 minute runs 3 times a week at a light jog pace, you should not increase the next week to 20 minutes runs 5 times a week at a moderate pace. Following the FIT principle will go a long way in preventing any overuse injuries, tendonitis, and decreasing muscle soreness.
  6. One of the most important parts of physical therapy is transitioning to a home exercise program at the end of your treatment. Once you are finished with therapy it is important to keep up with the exercises prescribed to you by the physical therapist for the required amount of days a week. Many patients make the mistake of trying to exercise at home and frequently this will result in patients falling off of the wagon and re-injuring themselves because they become busy with other things. One easy way to combat this is use the time you would have spent at physical therapy and join a gym to go to during that time slot in your day. By doing this you will be more likely to stay with your program because you will be exercising in a place outside your home with less distraction. Also, it is important when transitioning out of physical therapy to not repeat the same bad habits that landed you in physical therapy in the first place. If you injured yourself working out previously then be sure to either avoid the exercise you were doing previously, decrease your weight/reps, or focus on proper form to ensure you do not get injured again. Finally, remember to apply the same philosophy that was used in therapy to your lifting at home. If you are feeling sore or discomfort then do not increase the amount of weight you are using, and try to slowly progress yourself into harder/heavier resistance exercises.  Ideally you will want to get your exercises done at home at least 3 times a week after therapy is over to make sure that your strength and ROM continue to improve and to decrease any risk of injury. Finally, do not be afraid to contact you therapist at any time if you have any questions or are unsure of anything. A simple e-mail can save you from a trip back to the therapist later because of an injury, just because you are discharged does not mean you are not allowed to contact your therapist with a question.
  7. A commonly overlooked area of strengthening in athletes and weekend warriors alike is the hips. Your hip muscles act to not only stabilize your pelvis and core, but also keep your knees stable and properly aligned beneath you. Lack of hip strength can lead to anything from a sports hernia, to an ACL tear, to a sprained ankle or patella femoral syndrome. The most common part of the hip that lacks strength is the gluteus medius followed closely by the hip rotators. The Gluteus medius controls abduction, or moving your leg out to the side, and is very important in keeping both the hip and knee joint stable. A simple way to test how much gluteus medius strength you have is to step off of a box or a step while looking in the mirror. If the knee of your weight bearing leg moves inward toward your other leg as you step down then you are weak in your gluteus medius. To strengthen this muscle you can do a variety of exercises including lying on your side and raising your leg upwards, lateral walks with a theraband which you stand in a slightly squatted position and slowly walk sideways in each direction, clamshells in which your lie on your side and rotate your knees apart while keeping your feet together, or lateral lunges. By strengthening the gluteus medius you will build a strong foundation for the rest of your legs and help to decrease your chances of injury greatly. Another great exercise for both your hips and your core are planks. Performing planks and side planks will greatly help to improve your stability during activity and strengthen all the muscles that stabilize your entire body which will make you stronger during athletics.
  8. Instead of following a traditional stretching program before running or activity try using a dynamic stretching routine. Traditional “static” stretching has been shown in recent research to be an ineffective way to properly warm up and stretching a “cold” muscle can actually result in a higher chance of injury. On the contrary, dynamic stretching routines have been proven to reduce the chances of sprains and strains as well as improve efficiency during sport specific activity. The principle behind a dynamic stretching routine is to activate the muscles that will be used during the activity, as well as lengthen the muscle tissue to its optimal length for sport specific activity. Even better, a dynamic stretching routine takes much less time to complete and is much easier to fit in before playing or running. So next time you head out on the field try this routine instead of your usual stretching routine:LEG LIFTS
    Swing one leg out to the side and then swing it back across your body in front of your other leg. Repeat 10 times on each side. Feel wobbly? Hold onto a steady object.BUTT-KICKS
    While standing tall, walk forward with an exaggerated backswing so that your heels come up to your glutes. When this is easy, try it while jogging. Do 10 reps on each side.HACKY-SACK
    Lift your left leg up, bending the knee so it points out. Try to tap the inside of your left foot with your right hand without bending forward. Repeat 10 times on each side.TOY SOLDIER
    Keep your back and knees straight, walk forward, lifting your legs straight out in front and flexing your toes. Do 10 reps on each side.

    Step forward using a long stride, keeping the front knee over or just behind your toes. Lower your body by dropping your back knee toward the ground. Maintain an upright posture and keep your abdominal muscles tight. Do 5 reps on each side.

  9. When talking about managing injuries or acute pain the golden rule is RICE. This stands for Rest, Ice, Compression, and Elevation. If you suffer an injury whether it be during a sport, work, an accident or any other manner these 4 principles should be applied immediately. If you injure yourself during a sport try to get ice on the injured area immediately. When icing you should have 1 small layer (such as a paper towel) between the site of the injury and the ice and you should not ice for any longer than 15 minutes at a time with at least a 15-30 minute break in between ice sessions. Next, you should attempt to apply compression, especially if there is swelling present in the area. An ace wrap or compression garment works great, but be careful that they aren’t wrapped too tight. When wrapping an ace wrap you should apply slightly more compression at the bottom part of the wrap than the top so that swelling does not pool further away from the injury site. If you see any discoloration or feel tingling or numbness in the area further away from the ace wrap then immediately remove it as it may be cutting of circulation or causing further damage. Finally, elevating the area of injury is extremely important and will help to improve drainage of swelling from the area. When elevating, always make sure the injury site is elevated ABOVE the level of the heart for maximum benefit. This means that when elevating your leg you should be laying down for the maximum benefit. Last but not least it is very important to rest when injured. If you are having pain you should rest the area for at least 1-2 days prior to trying to return to activity, and when you do return remember to START SLOWLY so that you do not immediately re-injure the area. A short amount of rest immediately following the injury will usually prevent you from being side lined for weeks after the injury. Finally, if the pain, swelling and lack of mobility persist for longer than 2-3 days without seeing any improvement; be sure to consult your physician for further examination of the area.
  10. When training for a long distance race such as a half marathon, marathon or a triathlon it is important to make sure that you do not suffer any injury leading up to the race. To prevent this from happening make sure you are following a well laid out program that does not increase your distance too much too soon. Another great way to prepare for a race is to join a local running club or a training group. Not only will this help to decrease your chances of injury, but it will also help you stay with your training program as well. Remember when training that your rest days are as important as your running days, and that you will need this recovery as your mileage increases throughout the program to avoid over use injury. Secondly, make sure that you are fueling your body properly during long runs. Energy gels/bars are great for replenishing carbohydrates while on a run, and water or a sport drink is a must while training for distances longer than 6-7 miles to prevent dehydration and serious injury. When training for a distance such as a marathon it is important to note any pain or discomfort you are feeling while running. If you are experiencing any pain other than general muscle soreness it is important to take into account when the pain begins during your run, where it is, and if it goes away or gets worse during the run. All of these things will help to lead you to a better conclusion about what is wrong. If you are experiencing pain that worsens while running or after running and alters your running form in any way, you should stop your training program and consult an orthopedic doctor to make sure that it is treated as you can cause further injury or discomfort. It is important to try and take care of these injuries when they first start because they will go away much quicker than if you let them linger.  By taking care of them quickly you will not lose a lot of training time, and will not be sidelined come race day.