Increasing the intensity and duration of an exercise program too quickly can lead to injury.

The American College of Sports Medicine (ACSM) has previously promoted the concept of “Exercise is Medicine.” Some have said that if exercise were available in pill form, it would be the leading prescription medication because of its wide-ranging health benefits. Fortunately, it isn’t, and like all great things in life, it must be attained through hard work.

Exercise in our society has continued to gain tremendous popularity and the fitness industry is booming, which has resulted in helping people develop healthier habits. There tends to be an attraction to high-intensity exercise in our society, likely due to the excitement and the reward it provides. Exercise classes and workouts such as Zumba and CrossFit continue to gain tremendous popularity and have helped people to stay motivated and continue exercising. Unfortunately, there’s a downside to participating in high intensity exercises — an increased risk for injury.

Exercise-related injuries come in different forms. Some injuries result from falls or trips, while others are the result of poor choices, inadequate preparation and over-training. The following are common mistakes that I often see in my practice:

1. Increasing the intensity or duration of a new exercise too quickly.
2. Exercising beyond the point of fatigue, where technique and form can suffer and leave you susceptible to injury.
3. Choosing exercises that promote fitness strengths, but don’t address potential weaknesses.

Fortunately, exercise can be done safely to maximize gains and prevent injury. The first step is to choose wisely. Choices need to be made regarding the types of exercise, along with the frequency and duration of sessions. Beginners should choose low impact, low intensity activities to give their bodies a chance to adapt to the new stress. Start low and slow and gradually increase your duration. Find a good balance between flexibility, strength and even balance training. Some individuals will need to spend more time on one aspect of fitness. For example, individuals who are tight but strong should consider incorporating flexibility exercises into your routine, while individuals with hyper-mobility and excessive flexibility should focus on strength training and stability in their routine.

Preparation is just as important as making wise choices on the types of exercise to participate in. “Train to play” is a commonly used phrase in sports medicine which means that an athlete needs to prepare, train and condition their body properly for a sport to improve performance and decrease the risk of injury. The same holds true for all types of athletes and forms of exercise. The body must be conditioned and trained properly in preparation for a specific form of exercise to reduce the risk of injury.

What to Consider if You Are a Beginner:

1. Check with your primary care physician to make sure you can safely begin an exercise program.
2. Consider consultation with a physiatrist and/or sports medicine physician or physical therapist to receive an individualized exercise prescription.
3. Incorporate a warm up into your routine. Ten minutes of light activity that mimics the exercise you will be performing that day is highly recommended. For example, walk briskly and perform dynamic stretches and movements before jogging.
4. Begin with low impact aerobic exercise (i.e., walk, cycle, or swim) and gradually increase your duration to 2-3 hours per week
5. Include a cool down for an additional 10 minutes to get the body ready to transition out of exercise. This is a great time to perform passive stretching to improve range of motion and flexibility.
6. Address any postural issues and muscle imbalances early on. If you exercise with poor posture you will just further support this poor posture. Look to improve poor posture, stretch tight muscles and strengthen weak muscles.
7. Use well respected resources for additional tips and guidelines.

For those who are more advanced, it’s important to follow the beginner tips, but to also recognize that activities such as cross-training can become an extremely important aspect of your exercise routine. Cross-training is also a concept that is helpful in preventing overuse injuries as many individuals who perform the same exercises over and over again are at an increased risk. Choosing a variety of exercises to perform each week will decrease the risk for overuse injuries. Also, addressing muscle imbalances, or when tight muscles become tighter and weak muscles become weaker, may become worse the longer you participate in your favorite exercise. Continue to address strength and flexibility deficits with the help of your physician, therapist, and/or trainer.

There’s no time like the present to either begin a personalized exercise program or fine-tune your existing program. Take into account your current fitness level, consider your body type (strong and inflexible or loose and hypermobile) and follow the tips above. Make wise choices on the types of exercise you participate in and prepare or train your body to perform the exercise you choose safely and effectively. Consider consulting a physician and/or physical therapist with special interest in exercise prescription and counseling to help answer questions and offer guidance on your personalized fitness routine.

Dr. James Wyss, Physiatrist, specializes in the non-operative management and rehabilitation of common musculoskeletal and sports injuries. He has a special interest in sports medicine, rehabilitation, exercise counseling, injury prevention programs, musculoskeletal ultrasound and interventional spine procedures.

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