Exercise Guide

Many sports injuries cause a progressive permanent osteoarthritis that will prevent a person from exercising to cause the very diseases that a regular exercise program is supposed to prevent. Sports medicine surgeon James Garrick, writing in the medical journal Lancet (December 2005), explains why. You are supposed to exercise. It makes you stronger, faster, healthier and may even prolong your life. However, every time you exercise, you risk injury and many sports injuries last forever. Depression, heart attacks, strokes, obesity and diabetes are all associated with a sedentary lifestyle. A twisted ankle can change an active person into a sedentary one. A torn anterior cruciate ligament or meniscus of the knee has a greater than 50 percent chance of causing permanent pain within five years, regardless of the treatment.

If you tear your anterior cruciate ligament of you knee, you must have it repaired as soon as possible. After it is repaired at surgery, you have an almost certain chance of tearing it again if you try to return to a competitive sport. When your heel hits the ground during running, your foot stops moving suddenly, forcing the upper femur bone to slide forward on the lower tibia bone at the knee. The anterior cruciate ligament prevents the femur from sliding too far forward and shearing off the cartilage in your knee. Once you tear your anterior cruciate ligament (ACL), even if it is successfully repaired, you have a weaker ACL that still lets the top femur slide forward on the tibia and shear off cartilage. So running causes you to lose cartilage until you lose it all, bone rubs against bone and you hurt 24 hours a day. The only treatment then is a knee replacement. So anyone who has broken cartilage or ACL in his or he knee should never run again for the rest of his or her life.

On the other hand, strengthening the muscles of your upper leg stabilizes the knee and helps to delay and prevent a knee replacement. Anyone with broken cartilage or a torn anterior cruciate ligament in the knee should try to pedal a bicycle every day. Pedaling is done in a smooth rotary motion without sudden stopping, so it does not cause sudden forward movement of the femur on the tibia and does not shear off additional cartilage from the knee joint. If you pedal against increasing resistance you will strengthen the muscles around the knees and increase their stability so there is less wear on the cartilage.

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in four specialties, including sports medicine. Read or listen to hundreds of his fitness and health reports at http://www.DrMirkin.com

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The string of people I know suffering from summer colds as well as persistent injuries influenced this column. Hopefully this will lend some insight into your ailment.

Should I exercise when I’m sick? That depends on how sick you are and how well you know your body. If you feel slightly under the weather with a little runny nose for example, you’ll most likely be alright to do a light workout. But if you’re feeling light headed or have body aches, I would suggest against it. Also, you are your own best judge as to how sick you are, and over time hopefully you will get to know your body and be able to judge weather or not it’s a good idea. If you push yourself to workout out when you’re really sick, you will only worsen your condition and then be out for an even longer period of time. It’s a delicate balance and usually only experience will lead you to make the correct decision.

How do I rehabilitate an injury? If you strain a muscle, the best protocol is RICE, which stands for rest, ice, compression, and elevation. This will help the inflammation to go down and allow the strain to heal. During the healing phase which will vary in length according to the severity of the strain, you will want to refrain from strenuous activity of the injured body part. However, light exercise after an initial rest period is recommended to keep the area active in order to heal faster. For example, if you strained your calf muscle, you would probably want to refrain from running, but slow to moderate walking would encourage the healing process. Once the pain has subsided, slowly increase the exercise intensity. If you have doubts, seek the advice of a doctor or trainer for your specific strain.

When is it better to use heat to treat an injury? Heat promotes healing by increasing blood flow to the affected area. Ice, however, is important during the initial inflammation phase of an injury and thereafter following any bouts of exercise which may cause inflammation. Heat can be applied in between icing or before bed provided the affected site is not inflamed. I’ve gathered from my own experience after straining my low back during training, that once the inflammation disappears but the soreness is still present, heat can prove beneficial. My back continued to hurt for three days following the initial injury, but upon application of a heating pad before bed on the fourth night, my back was back to normal the next day. Use caution with the heat setting and I don’t recommend sleeping with the heating pad on throughout the night.

Remember, if you have reservations about the severity of your illness or injury, you should seek the professional opinion of your physician.

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