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Learn how to exercised properly to achieve your goals.

Just Do It! 5 Tips to Help You Exercise Safely

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From biking and jogging to playing golf, tennis and weekend basketball, millions of us regularly enjoy athletics. As we all know, there are many benefits to participating in sports. To do it safely, it’s important to take precautions, otherwise we run the risk of incurring injuries that not only cause us pain and inconvenience, but also cost us financially in terms of medical expenses and lost productivity.

At the Kaplan Center, we encourage all our patients to engage in some level of regular physical exercise to improve their health. Time and time again, however, we’ve found that most people can benefit from learning more about how to exercise properly — the goal being to gain strength and flexibility while avoiding injury.

Whether you are a competitive athlete or just starting a new exercise routine, here are 5 tips that everyone who is physically active should consider adopting:

1) Customize your workout to achieve your personal fitness goals.

Whether your goal is to improve your cardiovascular health, body composition (including the ratio of muscle to fat), strength, endurance, or your position and motion awareness, not all exercise is the same, and more is definitely not necessarily better!

  • To improve your cardiovascular health: You will need to get your heart rate up to 70-85% of its maximal rate for at least 30 minutes per day, three days a week. To determine your maximal heart rate, subtract your age from 220. (e.g. The maximal heart rate for a 50-year-old is 170 (220 – 50 years = 170), so his or her target heart rate will be 70 to 85 percent of 170, or between 120 and 145.)
  • To improve your body composition (ratio of fat to muscle) and to optimize your body’s fat-burning capacity: You will want to exercise in a way that gets your heart rate up to 40-60% of your maximum heart rate.
  • To increase your muscle power and endurance: To maximize muscle power, you should engage in a lower number of total exercise repetitions at a higher level of weight/resistance, whereas to improve muscle endurance, you’ll need a higher number of repetitions at a lower weight/resistance. For example, athletes wanting to develop power might design a program where they perform 2-3 sets of 10 repetitions, with each lift set at 70% of their single-repetition, maximum weight. On the other hand, to develop endurance, the same athlete should perform 2-3 sets of 20-30 repetitions, with each lift set at 30-50% of their single-repetition, maximum weight. Your single-repetition, maximum weight is how much weight you can lift one time using the maximum effort that you can safely exert. Be very careful not to push past your maximum limit when you test yourself – you don’t want to get injured before you get started!
  • When strengthening: Work with a qualified and experienced physical therapist, personal trainer, or athletic trainer so that you can develop proper form and safe sports-motion habits early on. Give yourself a day between exercise sessions to allow for muscle cell repair and growth, for example, doing upper body strengthening on Mondays, Wednesdays, and Fridays, and lower body strengthening on the other days. When increasing your exercise intensity, a generally safe approach is to increase your weight/resistance level by no more than 10% every 2 weeks.
  • To improve your motion awareness and bone strength: Consider cross-training with yoga, soccer, basketball, tennis, or other activities that encourage side-to-side movement and speed changes. Research has shown that pure long-distance runners, particularly women, can actually be more at risk for stress fractures because the straight-line movement of running only strengthens bones in one plane, whereas cross-training strengthens bones in a more complete, multi-directional fashion.

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2) Ditch the myth about stretching prior to exercise to prevent injury.

Contrary to popular belief, scientific reviews indicate that stretching only before and after intense exercise does little to prevent injury. What does matter is your baseline level of flexibility. In other words, if you are already flexible, you have some reduced risk of muscle injury even if you do not stretch much before you exercise. But if you are not very flexible, doing a bunch of stretching just before exercise is unlikely to prevent muscle injury. Therefore, you need to stretch regularly over a period of time, and not just as a method of warming up before exercise.

  • To stretch correctly: Hold each position for a minimum of 30 seconds. If the stretch is not held long enough, then the muscle fibers will simply return to their pre-stretch length after you stop, and your stretching will be of minimal benefit. Once a muscle is properly stretched, the effect lasts for about six hours. Therefore, to improve flexibility most efficiently, one should stretch three times per day, for at least 30 seconds per muscle stretched.
  • Be aware that having too much flexibility can be as much of a problem as having too little. For example, with increased flexibility, the ligaments holding our joints together can become more vulnerable to being overstretched and sprained. How flexible is too flexible? The Beighton Hypermobility Score, which is easily located on the Internet, provides a quick method to rate joint hyperflexibility. If you are already very flexible, then stretching may not be in your best interest. Instead, focus on strengthening and balancing your muscles, which will help stabilize and protect your joints and ligaments.

3) Consider integrative treatment options if you sustain an injury.

Musculoskeletal injuries are extremely common; in fact, it is estimated that over 100 million injuries occur every year worldwide. Of these, 30-50% involve ligament and tendon injuries. Fortunately, there are several effective options available to treat these conditions, including osteopathic manual therapy (OMT), platelet-rich plasma (PRP) therapy and prolotherapy, which enhance the body’s own healing capability to repair damaged tissue. A growing body of medical research has demonstrated the effectiveness of these therapies in treating various painful conditions of the neck, shoulder, elbow, hand, low back, hip, knee, and ankle.

  • OMT is a non-invasive therapy that applies gentle pressure and movement to stretch muscles, soft tissue and joints for proper alignment.
  • PRP therapy involves taking a patient’s blood, centrifuging it to concentrate the platelets — which contain numerous growth factors responsible for tissue healing as well as blood-clotting factors — and then injecting it into the injured area to promote healing.  Professional athletes often use PRP to help them recover and return to their sport more quickly.
  • Prolotherapy is another injection method which uses simple fluid solutions other than blood for treating injured tendons, ligaments, and joints.

4) Be cautious about taking anti-inflammatory medications.

Although inflammation has a bad reputation for causing many painful conditions, it’s essential to the process of healing. After an acute injury, healing occurs in three complex phases over a long period of time, during which new connective tissue is created that replaces and reinforces the injured tissue. The first of these phases is inflammation, which causes pain in order to restrict our range of movement to protect the area from further injury. Perhaps even more importantly, the inflammation triggers cellular activity that initiates healing of the damaged tissue. The inflammatory phase typically lasts 4-6 days.

Although clinical research has shown that taking an anti-inflammatory after an acute injury can speed one’s return to activity by decreasing pain, several studies also have demonstrated that using an anti-inflammatory immediately after being injured can reduce tendon and ligament strength during healing. In sum, taking anti-inflammatory medication can interrupt the inflammatory process and thereby reduce the potential, maximal healing of the injured area.

We tell patients to try to avoid using anti-inflammatories, such as Aspirin (unless you are taking it for heart protection), ibuprofen (a.k.a. Motrin, Advil, Nuprin) and naproxen (a.k.a. Aleve, Naprosyn) for at least the first few days after injury. Instead, I recommend taking acetaminophen (a.k.a. Tylenol) up to 4000 mg. per day, as long as you do not have any liver problems and are taking it for less than a two-week period. In cases of more severe pain, you should consider seeing your doctor for a check-up and, if appropriate, obtaining a prescription for a muscle relaxant or other pain medication that you can take for a few days until the pain from inflammation subsides.

5) Be diligent about getting regular physical exams to address significant or persistent injuries.

Routine physical exams are very important for identifying conditions that may affect your ability to exercise safely, such as certain heart and lung problems or uncontrolled high blood pressure. Let your provider know about any concerns you have regarding your exercise regimen. It’s also a good idea to see your provider if you are experiencing any of the following:

  • An inability to bear weight on an injured limb due to severe pain
  • Pain that persists for more than 3 or 4 weeks without improvement
  • New or progressive numbness, tingling or — especially — weakness in your arms or legs
  • Persistent dizziness or light-headedness during or after exercise
  • Head, neck or back injuries that are causing deterioration of your balance, problems with your mental faculties, or changes in your bladder and/or bowel function (any of these symptoms could indicate a rare but urgent medical emergency!)

When a medical problem is exercise-related, for the best results, you need a medical specialist who can not only comprehensively assess your musculoskeletal system, but also provide you with the widest range of treatment options, from the least to the more invasive procedures.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was reviewed and updated in January, 2024.

concussion

Concussion: Signs, Symptoms, and What To Do

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Sports-related concussions (SRC) are a growing public health concern. According to the Centers for Disease Control and Prevention (CDC), 1.5 million Americans suffer from a Traumatic Brain Injury (TBI) each year, and three-quarters of these are classified as concussions or “mild” head injury. But the side-effects of a concussion can be anything but mild. A single incident can result in weeks of recovery, missed obligations, lingering headaches and even migraine, brain fog, and dizziness. The cumulative effect of multiple concussions is even more profound and can lead to an increased risk of neurodegenerative health problems later in life.

While getting back in the game and “shaking it off” may be appropriate in certain situations, anyone who suffers a blow to the head during practice or a game should immediately stop playing, particularly young, active children whose brains are not yet fully developed and therefore more susceptible to injury. Downplaying the incident or ignoring it, particularly in the minutes just after it occurs, could result in longer recovery as this study in Pediatrics concluded: “SRC recovery time may be reduced if athletes are removed from participation. Immediate removal from play is the first step in mitigating prolonged SRC recovery . . . “

Dr. Bennet Omalu’s research on professional football players and chronic traumatic encephalopathy (CTE) brain degeneration was highlighted in the major motion picture Concussion and helped put this conversation into mainstream media. Now, communities and organizations around the country, drawing on the research of Dr. Omalu and others, are working diligently to increase concussion awareness among coaches, players, and parents, and to develop protocols for dealing with sports injuries.

Most of those who suffer a concussion do make a complete recovery. But knowing what to do when a head injury happens is as important as knowing CPR.

Symptoms of Concussion

Despite what you see in movies and on television, loss of consciousness typically does not occur with a concussion. Furthermore, the onset of symptoms can be delayed for hours or even days after a head injury, so stay alert for any new symptoms or behavioral changes during this post-injury period. Symptoms can include:

  • Temporary amnesia of the injurious event
  • Decreased concentration or “brain fog”
  • Difficulty learning new material
  • Headache or blurred vision
  • Sensitivity to noise or light
  • Emotional lability (involuntary laughing or crying)
  • Anxiety or depressed mood
  • Fatigue
  • Sleep dysfunction
  • Dizziness or imbalance
  • Nausea or vomiting
  • Physical weakness
  • Slurred speech

5 DANGER SIGNS

Seek immediate medical attention for anyone exhibiting any of the following symptoms:

  1. A change in consciousness, manifesting as difficulty staying awake or alert, not making sense when talking, or not being able to understand what is being said
  2. Progressively worsening headache
  3. An increase in nausea or vomiting
  4. Pronounced physical weakness
  5. Slurred speech

If none of the five big danger signs above are present, then it is ok to treat symptoms at home, following some basic guidelines:

  • Plan a slow return to activity. The brain needs adequate time to heal; however, current research suggests that when it comes to SRCs, too much rest following a concussion may prolong the recurrence of symptoms. It’s important to talk to a physician about the best time to return to activity though a 24-48 hour period of rest is usually recommended.
  • Develop a regular sleep cycle. 8-9 hours per night at roughly the same time each day will benefit the brain and promote healing.
  • Stay hydrated.
  • Avoid watching TV or spending too much time in front of a computer screen. Although it may be difficult to abstain from on-screen entertainment, watching television and playing on the computer strains the brain. Resting quietly is the best way to allow the brain to heal.
  • Be patient. If symptoms return after beginning an activity, it’s important to stop and take more time to rest.

It is important to communicate with a physician throughout the recovery process, especially if symptoms aren’t improving, or recovery is slow. In addition to physical symptoms, an untreated concussion can cause changes to brain structure that result in cognitive difficulties, personality changes, and altered emotional functioning.

Supplemental Medical Therapies to Support Recovery from a Brain Injury

  • Arnica is a homeopathic remedy that reduces inflammation and swelling from an acute injury; available either topically or in pill form.
  • Glutathione, when taken intravenously, helps to decrease the free radicals that can build up after a brain injury. Free radicals destroy neural synapses and lead to cell death that can cause brain damage.
  • Omega-3 is proven to improve brain function and may help reduce the neural inflammation caused by a concussion.
  • Physical Therapy can be an important part of a person’s concussion recovery. “Brain Gym,” also known as “physical therapy for your brain,” can help those who have suffered a brain injury regain brain-related functions such as memory, vision, speech, emotional balance, physical coordination, learning, and expression. Craniosacral Therapy is a very gentle form of manual manipulation that releases physical imbalances and restrictions as well as residual emotional trauma that has been stored in the body’s membranes and connective tissue. It frees the central nervous system to perform optimally, strengthening immune function, and providing pain relief.
  • Specialized Blood Testing – this can be useful if recovery from a concussion is slow or incomplete. This testing can identify genetic markers that indicate the propensity for developing chronic inflammation. When the markers exist, steps can be taken to proactively reduce inflammation so the body and brain can heal more efficiently.

Be realistic about the course of recovery. In the case of concussion or severe TBI, the course of recovery generally follows the same pattern: an initial period of impaired brain function, a period of improvement, and a period where the mental functioning stabilizes without significant additional deterioration or improvement. All of these stages can last hours, days or months, or the case of severe injury, years. Other factors affecting the extent and speed of recovery include the resiliency of the injured brain (especially if there is a history of concussion), the subsequent recurrence of brain injuries or sickness, and lifestyle choices such as getting sufficient rest, nutrition, exercise, and mental activity.

The best medicine is always prevention, but when a head injury does occur, a prompt diagnosis and appropriate treatment are essential to minimizing or avoiding serious health consequences.

Give the brain time to heal. The two-pound tissue between our ears is worth protecting!

Patricia Alomar, M.S., P.T. & Gary Kaplan, D.O.