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Overuse Exercise Injuries: Too Much, Too Soon Get the Right Equipment

Don't expect tennis shoes you¡ve had for 3 years to cushion the shock of whatever impact sport you want to do now. Invest in high-quality, well-fitting shoes, clothes, and gear. If you are a runner, for example, a variety of shoe styles and orthotics (custom-made shoe inserts) are available for specific problems, such as flat feet, high arches, or a susceptibility to particular injuries.

The best fitness programs combine three types of exercise: cardiovascular (aerobic), weight training, and flexibility work.

• Cardiovascular workouts increase energy and stamina, help control blood pressure, improve cholesterol and burn calories. Aerobic exercises can be high-impact (jogging, step aerobics) or weight-supported (rowing, cycling). To lessen your chance of injury when doing high-impact exercise, avoid the most unforgiving of surfaces, cement, and run on cinder, grass, dirt, and even asphalt.
• Weight training develops strength and balance. Free weights, exercise machines, stretch bands, and calisthenics all build strength. Dr. Deborah Saint-Phard of the Women¡s Sports Medicine Center emphasizes the need for strength training. "A one-hundred-twenty-five-pound woman running a ten «K¡ absorbs several tons of force. Running is seven times your body weight each time you put your foot down! The only things protecting your skeleton are the muscles around your bones; they act as shock absorbers. The stronger a muscle, the more endurance it has."
• Flexibility work helps prevent injury during exercise and promotes healing from injury. It can also reduce low back pain. Yoga, martial arts, stretching, and dance develop flexible muscles.

Do all three exercise types and you'll be less vulnerable to the gradual breakdown of a body structure that can lead to serious overuse injury, such as stress fractures, chronic knee or ankle pain, and sprains and strains.

The bodies of both new and aging exercisers can gradually adapt to progressively demanding programs involving aerobics, weight training, and flexibility work, but, as Saint-Phard points out, you not only need to build up gradually, you need to warm up properly before each session. A good warm-up, with plenty of stretching, increases blood flow to your muscles and maximizes their flexibility. Warm-downs, with stretching, are also important.

If you decide to make gym workouts a part of your program and are a newcomer to gym routines and equipment, it is crucial that you receive proper instruction from a certified trainer. Also, if you take aerobics or yoga classes, use common sense. As Stuhr puts it, "Work within your limitsÂgive yourself permission to back off. Catch up with the group on the next movement, or at the next class."

The Center advocates cross-training. Different types of exercise put stress on different muscle groups, and Saint-Phard suggests that you vary your activities, which gives specific muscles a chance to rest before being stressed again. "Rollerblade one day, play tennis the next. This is the healthiest way to attain your fitness goals."

Finally, tailor your program to your goals. For example, is your primary goal to lose weight? Cardiovascular exercise raises metabolism (temporarily) and also requires relatively more energy than flexibility training, so you burn more calories more effectively. If you want to lose weight, do 30-60 minutes of moderate-intensity aerobic activity 4 or 5 days a week and combine it with strength training, which helps takes off weight by building metabolically active muscle tissue.

To prevent overuse injury in any activity, be sure you have:

• Enough flexibility.
• Adequate strength.
• The right equipment.
• Proper technique.
• Sufficient warm-up and cool-down.

Remember, your body can't do at 40 or 50 what it did at 20. Make your motto "Train smarter, not harder" and you won't be sidelined by doing too much, too soon.