Injuries, Part I: Just Say No

By Steve Edwards

One of the most frustrating scenarios we face is when we finally make that commitment to our health, begin to work out, and then find ourselves sidelined by an injury. In this first of a two-part series, we'll take a look at some simple ways to avoid getting injured in the first place.

We'll all face an injury of some kind during our lifetimes. Accidents are unavoidable. But physical setbacks are even more frustrating when you're exercising in an effort to improve your health. Although looking at the big picture—that not exercising makes your body age faster, break down more quickly, and die younger—motivates you to Push Play, nothing can derail this motivation faster than a nagging injury. After all, your main reason for exercising may be to make yourself feel better, and injuries accomplish exactly the opposite. But before you resign yourself to a negative, "What's the point?" attitude, read on. This week, we'll show you how to greatly reduce your chance of getting injured in the first place. Next week, we'll discuss how you can get back on your feet quickly when you do get injured.

Why we get injured

There are two types of injury: acute and chronic. An acute injury occurs when something overloads your system beyond its capacity to buffer it—like getting hit by a car or falling off your bike. A chronic injury is one that's created by overusing a body part until it breaks down.

Acute injuries can't be prevented. Nothing can prepare you for a car accident, unless you know how to construct a Batman^® suit. But you can prepare yourself to better fend off minor acute injuries. Exercise can help you strengthen your body into your own natural version of a Batman suit. It won't fend off a car, but it can prepare you to deal with adversity more efficiently.

Chronic injuries can almost always be avoided, because overuse injuries are generally due to muscular imbalance and/or lack of proper range of motion. By properly training your body, muscles will be balanced, bones will be dense, and body parts will be supple. When you get this formula right, chronic injuries almost never happen.

But doing this is easier said than done. Even top-flight athletes have trouble keeping their bodies in balance. The reason is that it takes both dedication and discipline. Most of us just want to do whatever it is we find entertaining when we exercise. The little things that keep us injury free can be mundane. As boring as this may be, it's a lot more fun than being injured. Let's take a look at the basics of staying healthy.

Warming up

Warming up properly seems like a waste of time. Who hasn't at one time or another jumped right into an intensive workout like P90X^® or Turbo Jam^® and walked away unscathed? But if you want to remain uninjured, nothing stacks the odds in your favor as much as thoroughly warming up your body to get it ready for the rigors of exercise.

Acute injuries aren't just accidents. Putting stress on a cold system can cause acute injury, even with resistance you can normally handle easily. The reason is that when you're cold, your muscles are actually gel-like. As they warm up, they become less viscous, kind of like oil in your car engine. This process is called thixotropy. As you increase your heart rate, your core body temperature heats up. When this happens, your muscular viscosity decreases, and you become more supple and ready to handle the stresses of exercise.

A proper warm-up starts out slow and gradually increases in intensity. Once your blood is moving, easy, short stretches help elongate your muscles so they're ready for the intense contractions that will happen later. Note that long, slow stretching should be avoided as part of the warm-up. The type of stretching you do to increase your flexibility should be done postexercise. Preexercise stretches should remain very low on the intensity scale. They serve only to loosen up the body to its current range-of-motion abilities, not to increase that range.

Cooling down

A good workout stresses your body. Your heart rate increases to near its maximum and muscles are contracted at high speed. If you finish a hard workout and walk away without a cooldown, your body settles into a contracted state. When this happens, the damage incurred during the workout is exacerbated and your body can't recover well. A proper cooldown eases your heart rate and stretches out your muscle fibers. This begins the healing process and speeds up your recovery time.

A good cooldown consists of moving your body more and more slowly, allowing your heart rate to drop. When it gets low enough—under 100 beats per minute—you should begin stretching out all the muscles you worked during your workout. It's best to start with easy ballistic stretches. These can be followed by slower, longer static stretches. If you want to do a full-blown stretching session with the aim of increasing your body's range of motion, this is a good time to do that.

Staying limber

As I said before, working out contracts your muscles. To stay in balance, you need to stretch them out. Failing to stretch out your muscles leaves their fiber strands knotted together. Muscles in this state are very susceptible to overload and hence injury. Properly stretched muscle fibers have far more of a buffer zone than unstretched ones. They can take the same force loads more easily because they have more room to contract. Staying limber is a good way to avoid injury.

Rehab before you need it

If you've ever been to a physical therapist, you've probably been given exercises that help rebuild an injured area. These tend to be low-intensity movements that stress not only your prime mover muscles, but also the smaller muscles that stabilize the larger ones. For some reason, many older-style exercise programs often leave out training these smaller muscles. This is bad, because when you build up one muscle group more than another, your body becomes imbalanced. When you have a muscular imbalance, you're highly likely to become injured. This leads to a quandary for many of us. We can't go to a physical therapist before we're injured, yet if we don't, it's hard to know when we're out of muscular balance.

Fortunately, most modern exercise programs consider this situation. P90X, for example, has many different workouts that focus on both prime mover and stabilizer muscles. But it's still easy to become out of balance because life often throws us into situations where muscular imbalance is likely to happen. Sports, yard work, and even sitting at a computer typing and "mousing" can create imbalance. Offseting this imbalance can be complicated, but here are some ideas:

1. Have an annual assessment from a physical therapist. Your PT can put you through a series of exercises that can determine your muscular health. If he or she does find an imbalance, it can usually be remedied with a few simple exercises.
2. Remember those physical therapist visits. Whenever you're sent to a PT, remember the exercises you're given there. Once you've injured an area, that area will always be susceptible to being reinjured. You should do the exercises prescribed, at least on occasion, for the rest of your life. If you (like me) have enough injuries, your arsenal of rehab exercises begins to grow, and eventually you'll know how to avoid any imbalances.
3. Do yoga. It targets muscular balance more than any other type of exercise. Doing yoga for a day or so per week will keep your body both balanced and supple, as well as greatly facilitating all other training. Try Yoga Booty Ballet^® to satisfy your yoga needs.
4. Total Body Solution^®. Debbie Siebers and neurophysiologist Chad Waterbury have created a DVD program that features a series of assessments and drills to increase range of motion, help relieve pain, and prevent strain in commonly stressed areas like the shoulders, neck, core, lower back, and knees.