Introdution
Chapter 1 - Been There, Done That
Chapter 2 - Injuries: Tips for Prevention, Treatment, Recovery
Chapter 3 - Case Studies: Meet My Friends
Chapter 4 - Use this Information
Correspondence Course Assignments
Online Course Descriptions
"How to Order."
I Am SO Sore.
An Ounce of Prevention
A Vocabulary for Injuries
RICE Is Nice
Let's Get Physical (Recovery)
Reactions to Injury
Attitude for Accomplishment
Mind/Body Psychowhat?
The Inner Conflict - FEAR
On Saturday morning you decide to try a new sport or activity. It proves to be fun and a great workout and you plan to do it again in a day or two. On Sunday or Monday morning you wake up to muscles that beg you never to move again. Is it cause for concern? Have you injured yourself?
To an extent, discomfort is a price paid for exercising with the intent to improve one's fitness performance. It is very important to learn the difference between the "good" pain that accompanies muscle strengthening and the BAD pain that signals an injury.
There are several different sensations that may be called pain:
Muscle stiffness does not produce actual pain and occurs when a group of muscles have worked hard for long a period. Fluids collected in the muscles during exercise are absorbed into the blood at a very slow rate. They then become swollen, shorter and thicker, and resist stretching. Light exercise, massage, and passive mobilization assist in reducing stiffness.
Acute soreness or the "burn" of fatigue pain occurs during exercise and is the result of lactic acid buildup in the working muscles. Lactic acid is a by-product of energy metabolism. This pain is not serious and goes away soon after exercise is ended.
Delayed Onset Muscle Soreness, or DOMS, follows an unaccustomed exercise or action. Your muscles that are exercised beyond the usual level of exertion feel the discomfort signaling adaptation to a new stress. This muscle soreness has no known permanent risks. DOMS appears 24 - 48 hours after exercise. The exact cause of DOMS is unknown and is the subject of much research and some controversy. The most popular explanation for this pain is the microscopic tearing of the muscle cells during exercise movements. Muscle pain is the result of cell breakdown and inflammation that irritates the nerves.
A higher level of DOMS seems to happen after workouts that emphasize eccentric contractions, or extended lowering of the weight. Eccentric contractions cause a high amount of intracellular friction and tearing thus causing more soreness.
Several positive things occur after experiencing DOMS. The tearing down of the muscles causes the body to rebuild them stronger than before within four to 48 hours. The first time you do a new exercise you will be sore, but after that the same exercise routine will not cause much pain. It is important to give your sore muscles enough recovery time.
You can continue your exercise carefully even when experiencing DOMS. Remember, it is not unusual to have some stiffness or soreness at beginning of workout and it takes about 10 minutes to see normal performance. The warm-up is a good time for self-evaluation of how hard the workout should be with DOMS. Train, don't strain. It is OK to exercise with sore muscles, but don't increase your normal intensity unless the soreness disappears after the warm-up. If needed lighten the intensity of the workout and save working harder than usual for a day when you are very strong and fresh. If muscle soreness or pain increases after you begin exercising, stop and use ice on the muscles.
There are several things you can do to reduce the experience of DOMS. Train consistently, several times a week. Do not increase the duration and intensity of a workout on the same day. Stretch after your workout holding the static stretches for 30 - 60 seconds. Some other pain relieving methods are applying ice to restrict swelling, using liniments, and post-exercise massage. If you want to use over-the-counter pain relievers remember that aspirin or ibuprofen reduce inflammation, whereas acetaminophen (Tylenol) is not an anti-inflammatory medication. Avoid ultrasound and heat on sore muscles as both increase both swelling and pain.
Overuse and the accompanying pain results from tearing the muscle down too much with nothing left for rebuilding. When you do not allow muscles and connective tissue time to recuperate between workouts, inflammation of a tendon or other connective tissue can happen. It is a chronic condition which produces the continuing ache of a dull pain. Overuse is major cause of serious injuries.
Sudden, sharp pain during exercise is your body telling you that something is wrong. If this occurs, stop the exercise. It may even be necessary to call your doctor. All active people should be aware of the warning signs of exercise injuries:
Remember, your body responds to activity in many ways. By listening to the messages it sends you, you can keep active and minimize the discomfort of muscle soreness.
Exercise has numerous benefits for virtually everyone. However, it's important for all active people to be aware of the possibility of injury. There are two major causes of injury. The first kind is intrinsic. The body may have physical characteristics that may lead to injury, such as alignment abnormalities, differing leg lengths, muscle imbalances and weakness', or lack of flexibility.
The other kind of injury is from extrinsic or outside causes, such as improperly fitting shoes, misuse of equipment, exercising on the wrong surface, and incorrect exercise prescription.
Then there are the plain old accidents, caused by being human, such as tripping, bumping into things, and the accidents that are caused by outside situations, like car accidents, which affect the ability to exercise.
Realistically, for everyone who exercises, the chance of injury is real. Who is most likely to get injured? There seems to be two groups of people who suffer the most activity related injuries. The athletes who push the limits of their sport and what their bodies are capable of run a high risk of injury. Pushing the limits is necessary to break records and achieve what nobody else has done. These athletes realize the risk they take and they assume the possibility.
The second group of exercisers who often suffer injuries are the "weekend warriors" or occasional exercisers who don't work out regularly enough to thoroughly condition themselves for activity. This is a different way to push the limits of what the body can do and risk injury. It is preventable.
If you do get injured, proper management can lessen the recovery time and keep a person active. Even better is learning how to prevent injuries in the first place. Potential injury during exercise can be avoided or somewhat controlled by a moderate approach to exercise. You may want to examine the following areas of your fitness program.
Safe exercise sessions begin with the proper attitude. You should be mentally ready to participate and direct your attention fully to each exercise. A thorough warm-up prepares the cardiovascular and muscular systems for exercise, while the cool-down and stretching after a session prevents abnormal heart responses and muscle soreness.
Excessive, repeated stress causes failure of the overused body part, resulting frequently in a chronic injury. This type of injury may have a gradual onset with no specific initial injury. It may last for several weeks, often getting neither better nor worse. If continued stress to the injury occurs it may become an acute injury, one with a specific incident which caused pain. Acute injuries, like ankle sprains, may also occur without being related to a chronic injury.
During impact aerobic activities stress is placed on feet, ankles, lower legs and knees, and most activity injuries occur in these areas. Several factors can contribute to preventing these injuries. The surface you exercise on is important. When jogging, remember a smooth dirt track is more resilient than cement. During dance exercise, the flooring should determine how much impact the routines should have. The best floor provides both cushion and stability. Wood floors over airspace are best. Also acceptable is a heavily carpeted and padded concrete floor, but be careful about twisting or sliding movements. Linoleum over concrete is the worst surface for impact aerobics, so low impact routines are best on this surface. If you have to exercise on an undesirable floor, use a high-quality exercise mat for impact activities done in place. Your shoes are as important as floor surfaces for shock absorption and injury prevention. Purchase the best exercise shoes you can afford and use a salesperson who knows how exercise shoes should fit.
The number of days and length of each exercise session will affect your chance of injury. High intensity activity done frequently over a long time will have a cumulative stressful effect. The average person should only participate in one type of high-impact activity and no longer than one hour at a time, three to four times a week. If more exercise is desired, do another low impact activity such as biking, walking, or weight training.
When working at your target heart rate during aerobic exercise, the worst strategy is to abruptly stop and stand still. During aerobic exercise the levels of two natural stimulants produced by the adrenal glands increase. Blood pressure also increases. During cool-down the blood pressure drops but the levels of the adrenal stimulants continue to rise, causing the possibility of cardiovascular injury if exercise is ceased abruptly. So the body must be allowed to return gradually to its pre-exercise state with a slow cool-down. Don't stand motionless while taking your pulse, and after exercise don't stand still or sit until your pulse is below 100 beats per minute.
Body mechanics are important during aerobics and resistance training. Take the time to learn proper breathing patterns, posture, and lifting techniques. You will get a better workout and avoid dangerous biomechanical positions. It is always safer and more effective to move in a controlled manner than to use rapid actions that snap, jerk, or bounce the body, which add to the stress on the musculoskeletal system.
Remember to work for balanced development of muscles in the front and back of the body. If you already have a chronic injury or condition, avoid exercises that will aggravate it and learn the ways to train your injury prone areas by emphasizing muscle balance. Take the time to learn the specific exercises you need and do them regularly.
In preventing shoulder injuries, avoid overuse. The shoulder is involved in almost every upper body movement, and it can suffer from too much overload.
To protect your back, keep your knees slightly bent and your lower back in a natural curved position when supporting weight with your upper body. This keeps the load off the lumbar spine and its muscles. With leg exercises, keep your toes and knees lined up with each other to protect your knees.
Avoid exercises that don't feel right to you even if other people swear by them. Each person is different and not all exercises are suitable for everybody. Any exercise that always causes you discomfort or pain should be eliminated or modified. Also avoid the following high-risk exercises: full squat, back hyperextension involving grabbing the feet, hurdler's stretch, straight-leg sit-ups, and the plough exercise.
Many people enjoy working out on machines for both cardiovascular and resistance exercise. Use those that allow natural movements. If a piece of equipment doesn't feel right for you or if you feel pain while using it, switch to another machine.
One of the best ways to make sure your exercise program is safe and effective is to use a good personal trainer to help you design your routine. In addition to this, remember to drink ample water to prevent dehydration. If you are ill, skip the exercise until you are well. Your body needs rest to heal itself.
Excessive repeated stress can produce a chronic injury that has no specific initial injury. A continuing ache indicates possible inflammation. It's important to seek help for chronic injuries and eliminate or modify any exercise that causes pain. Some of the common overuse injuries that occur from exercise include:
Sudden, sharp pain during exercise is serious, indicating an acute injury resulting from a specific incident. If you find yourself sustaining an injury, apply the RICE principle:
Contact medical help if any of the following occurs for more than three days:
If you do hurt yourself, treat the injury immediately. Swelling is the body's response to injury, but if it is controlled and minimized, there is less pain and normal movement can be resumed quicker.
Recovery from an activity injury starts with accurate knowledge about rehabilitation, the approximate length of recuperation, and reasonable expectations during recovery. An injured exerciser should develop an understanding of athletic injuries and the recovery process.
Try to establish good communication with your doctor so you can explore all of your options. Be responsible for yourself, doing whatever you need to heal. Follow the doctor's instructions and take the medication that may be prescribed.
Most active people who get injured feel they must regain movement as quickly as possible. That is true, up to a point. Here are some basic guidelines for exercise after an injury. If you are under the care of a doctor or physical therapist, follow these tips with any adjustments they recommend.
The basic exercise rules during recovery are: If your injury hurts at rest, don't exercise it. You may try exercising a bit when the pain subsides. When you can move it without pain, gradually increase the workload and intensity. If the pain returns, cut back on the exercise.
During recovery, passive flexibility exercises can slowly and gently re-establish your range of motion. Any stretching should be pain-free. Isometrics can be slowly added. Create muscle tension in the injured area, but stop short of pain. Hold for a slow count to 8, and relax, doing 3 sets.
Calisthenics are added later in the healing process. Go through a normal range of motion with light resistance weights or self-resistance. Do not work through any pain, but gradually begin to build your strength. You can increase the amount of resistance as your recovery progresses.
When you are ready to return to normal activity, begin exercising at 50% of your normal intensity and time. Concentrate on the motor skills needed to produce movements smoothly and efficiently. Slowly build back up to 100% in intensity and time.
You don't have to forego fitness while you are injured. It is possible to tailor an exercise program to the body parts that are free from injury. Limit your activities to things you can do comfortably, avoiding pain at the site of the injury.
Injury is both a physical and psychological phenomenon. When a regular exerciser is injured, strong emotions usually result, paralleling the stages of grief.
The first reaction is denial, disbelieving that there really is an injury. Some athletes continue to exercise and find that further injury results with a longer recuperation. Attempting to put the injury on hold for "just one more session or competition" is referred to as the bargaining stage.
Anger follows denial and is directed at oneself and possibly others too, for being unable to perform at the usual level. Injury makes many people feel worthless and lowers their self-esteem. It's common to feel that you have let yourself down if you are unable to exercise. Depression and the feeling of great loss occurs next, even if the injury is only temporary.
The final stage of the grief process following an injury is acceptance. The exerciser accepts the reality of the injury and begins to take a constructive approach to healing.
Understand that each of these stages serves a purpose and everybody goes through them during a time of loss. The following section offers some ideas and suggestions for faster mental healing.
The physical inconvenience of an injury is not as big as the mental hurdles. What happens in your mind plays an important role in a successful, quick rehabilitation. A recommended attitude to have toward an injury is to view it as something to work with, rather than against. By taking a constructive approach to healing, you may learn some new things about yourself, explore new interests, and appreciate a new reality about your physical self.
Put the injury in perspective. It is acceptable to feel loss and sadness but don't wallow in self pity or anger. One way to stay afloat and have enough energy to handle your situation is talking about your feelings with a good friend. Spend time with positive people who understand your situation and limitations and support your progress.
Keeping a log of the rehabilitation process helps the injured exerciser set reasonable goals and feel more in control. Specific goals should be set based on how long healing will take. Break major objectives into small achievable goals and track each easy-to-reach goal to its successful accomplishment. You will see the pattern of your recovery unfold before your eyes.
Think to find positive emotions. Positive thinking is a skill and requires practice. Images of a positive outcome during adversity will allow your crisis to become an opportunity to grow. Avoid words like "can't" and "never."
Make YOU a priority. You may think that your family, friends, and workplace cannot continue without your normal contributions. However, when you are injured, YOU are the priority. You must take the time necessary to heal. You do yourself and others no needed service when you are hurting. You deserve to recover and feel good again, so take the time to do it.
Exercise psychobiology is the study of the mind/body connection and the sensory, motivational, and emotional drives that are required to operate within one's genetically determined limits of performance. Through studies on athletes, the mind/body factor has been shown to govern exercise performance. Attitude, mental stress, self-regard and perceptions of exercise fatigue all have a discernible effect on how effectively a person is able to exercise.
The mind/body component can add significant psychological benefits for all exercisers, not just athletes. Mindful exercise and mixed intensities decrease negative emotions, such as anxiety, and increase positive emotions. Mind/Body fitness helps build a mental flexibility in life making it easier to cope when the situation calls for a slower rhythm. Mind/Body fitness aids healing.
Apprehension about first encounters with exercise or sport after injury, is handled by the body as stress. When a stressful event is interpreted as a threat, the nervous and hormone systems respond by stimulating a release of stress hormones from the adrenal gland. This produces feelings of anxiety and can reduce one's exercise efficiency and increase the sensations of fatigue.
If the same event is perceived as a challenge and a hopefully successful outcome, there is a release of epinephrine and norepinephrine from the adrenal gland, which leads to a more positive response. When negative threats are turned into positive challenges and the mind is relaxed, anxiety is reduced and more energy is available for exercise performance.
There is a process for entering the "flow state", a sense of well-being in which you lose all sense of time and the outside world, and experience enjoyment, concentration and a sense of purpose. It is possible for anyone to enjoy this mental state with a little preparation, even during injury rehabilitation.
Visualization is a good way to get into a state of concentration. The mind doesn't know the difference between an actual event and a vividly imagined one, so picturing yourself performing a technically correct movement or set of movements will alert your muscles and enhance your performance. Stay in the present. Concentration is broken with negative thoughts or future demands, so put aside any concerns or worries during your training. When you are totally in the present, peak concentration and performance occur. Allow any distracting thoughts to simply drift in and out, like waves washing up on the shore and retreating out to sea. As you perform your exercises, visualize the exact muscles as they work, and also focus on your posture, alignment, and technique.
If you have some doubts about your ability to perform, use positive self-talk. "Fake it to make it" describes the verbal or nonverbal expressions you say about yourself that heightens good feelings. These affirmations will eventually be believed if they are repeated often. Remember, the mind thinks in pictures and learns by imitation, so telling yourself how great you are doing will help make it happen.
Disassociation seems contradictory to self-talk, but actually compliments it. Learn to draw out of yourself, to be free from internal distractions like self-criticism and comparisons to others.
Relaxation and visualization after a training session can help reinforce the learning during the recovery and leave the exerciser feeling calm, yet refreshed. Positive visualization can include seeing and encouraging the healing process in your body. You can also visualize yourself participating in your sport. Picture a stronger and healthier you and enjoy the image.
Relaxation is enhanced by slow, deep abdominal breathing to release tension and allow for optimal blood and oxygen flow to the entire body, creating a sense of well being. Relaxation and stress reduction techniques develop new ways of thinking and training.
Try these techniques and use the ones you like the best for additional assistance in the process of injury rehabilitation.
After an accident there is a normal conflict between wanting to resume your sport and fear of it. I had already experienced occasional anxiety in the months before my accident while learning hang gliding. After all, flying with just a wing above you is not the most natural state to be in. As I mentioned already, I initially had plans to return to flying. I took advantage of my down time and went through a motivational tape series with the specific goal of developing a plan for resuming my sport and working through my fears. It helped tremendously in reducing the fear level I was experiencing and my final decision to postpone my return to the sport was made for reasons other than pure fear. I now share a fear reduction program with you.
Fear, of physical harm or pain, of failure and the mental anguish that comes with it, or of the unknown, is an emotion that influences drive and motivation to participate in activities. No one is immune to fear. Everybody, from the beginning level exerciser to the elite athlete, has something that will cause fear. For the beginner, the fear is usually due to self-esteem issues and the fact that exercise is an "unknown,"
In a high risk sport, fear is the most natural thing. Sports psychologists view fear as "a part of human emotion that is prominent in sports." Statistically, these sports are less dangerous than driving a car. But the potential for injury exists. A large part of mastering risk sports is learning to understand and manage the fear they produce.
The sensation of fear is produced by neuroendocrine changes which prepares a person for the fight or flight response. This response is normal and important, and only becomes a problem when it is labeled "a problem" causing you to try to avoid it.
It is not recommended that you stay completely calm in a stressful situation. Some level of fear appears to help prepare for the stress. Studies of athletes show that the best performance happens when there is a degree of anxiety (fear) while preparing for the sport, then a "calm" immediately before performance.
Fear is a signal to pay attention to the situation. Fear can be triggered by subtle things. Experienced athletes can pick up on slight cues that something is different. When you sense fear, stop, mentally and/or physically, and evaluate the situation. There are a number of steps you can follow to use fear and anxiety and turn it into positive energy.
When you know you have a fear you can begin to work through it mentally. The most important first step is to not resist or deny the fear. You will send it underground and it will re-attack later and be much stronger. Face your fear and experience it fully. As it runs its course, the panic will subside, and a gentle calmness will slowly replace it. Now you can begin to work on your fear objectively.
Track your fear to its true source, whether a physical one or a mental one. Give it a name, then write about the fear as specifically as possible. On paper, push the fear to its ultimate, asking, "What is the worst you can do to me?" Then ask the fear, "What are the odds?" When you have the answer, figure out what you can do to make sure the odds are in your favor. Brainstorm all possible options, explore the possibilities. If the fear has become manageable and you want to move on to physically overcoming your fear, then proceed.
A key to managing fear during an activity is to take all safety precautions: Check your equipment and wear protective gear designed for your sport. Skill mastery is one of the best protections. Being taught by a qualified, experienced instructor will assist you in honing your skills. Many so-called advanced athletes get into trouble because they focus too much attention on the fun, advanced skills and seem to forget the basics. Remember, the mastery of the basic skills for any activity is what produces excellence and prevents unnecessary accidents.
While participating in your activity, focus your attention even if you feel fear. The goal is not to totally eliminate the fear, but to move through it. Focus your attention on the business at hand and your skills.
Positive self-talk is one of the best fear-coping skills, taking the form of technical instruction, general encouragement, an assuring mantra, or a metaphor that describes how you want to feel such as "grace", "power", or "speed."
Develop visualization and breathing techniques to help you focus your relaxation. It is impossible to be anxious and relaxed at the same moment, so learn to quickly relax at an optimal level, both physically and mentally.
Even by using all these techniques, most fears are reduced through gradual exposure to them. It may take several practices to desensitize yourself to your fears. If you aren't up to the challenge at one time or another, back off temporarily. In time confidence and skill will be gained and you may no longer experience as much fear.
In the western culture, women are more likely to acknowledge fear and talk about it. Men are more unwilling to admit to fear, which could make them even more vulnerable to debilitating fears. The psychological or ego-driven need to deny your emotions makes you potentially more victimized by them. Fear is often transformed into anger by men. Whether seen as fear or anger, the emotions expressed should be used in a way that produces a positive outcome for performance.
Not all fears can or should be overcome. Sometimes, despite all the precautions, skill mastery and attention control, fear still gets in the way. If you choose to discontinue a sport, be kind to yourself and live with your decision. Don't view your experience as a failure. You gave it a chance and learned about yourself.
Fear helps us make decisions about which risks are worth taking. A good goal is to focus on growing from the experiences. If you view fear as a normal part of life, you can use it as a powerful tool in your activities.
Introdution
Chapter 1 - Been There, Done That
Chapter 2 - Injuries: Tips for Prevention, Treatment, Recovery
Chapter 3 - Case Studies: Meet My Friends
Chapter 4 - Use this Information
Correspondence Course Assignments
Online Course Descriptions
"How to Order."