Issue Date: June 5, 2005
3 ways to stay in the game
USA WEEKEND teams up with "Men's Health" magazine on essential tips for everybody playing sports.
Summer is the season of superheroes. Not just "Batman" and the "Fantastic Four" battling in theaters, but also men launching golf balls and baseballs, leaping for spikes and rebounds. All of us want to be the hero of our game, and we're willing to expend superhuman effort in the process. But standing in the way is our archenemy: injury.
And for now, at least, it seems to be getting the upper hand. Musculoskeletal ailments -- those of the bones, joints, ligaments, tendons, muscles and nerves -- have surpassed the common cold as the No. 1 reason people visit a doctor, reports the American Academy of Orthopaedic Surgeons.
"Across all age groups we're seeing significant rises in injuries," says Nicholas DiNubile, M.D., a Men's Health sports medicine adviser.
Part of the reason: a concurrent rise in weight. And weight is a major stress on joints. "For every pound you're overweight, your knee thinks you're 5 pounds overweight," says DiNubile, who has a book, FrameWork: Your 7-Step Program for Healthy Muscles, Bones, and Joints, out next month. It's a wicked cycle, because once you get sidelined, you get sedentary -- and pack on more fat.
Flab isn't the only factor. Just as important is our ignorance of how to prevent sports injuries. Or how to treat and rehabilitate them. That's why we've created this three-step cheat sheet. It won't make you bulletproof, but it will help you fly through the summer unscathed.
1. Avoid injury
Some sports injuries are painfully hard to avoid, like a basketball to the face or a line drive to the groin. Heck, even the injuries you can see coming a mile away can be difficult to dodge -- if you don't take pre-game precautions. And according to Mark Verstegen, director of performance for the NFL players' association, that means addressing the cause of nearly two-thirds of all sports injuries: repetitive poor movements and abuse of misaligned joints.
Joints fall out of alignment for a number of reasons. Sitting in a car or behind a desk with poor posture can cause it, as can using improper form while exercising. Whatever the cause, once a joint gets out of whack and is then used repetitively -- for example, dribbling a ball or swinging a racket -- an injury is imminent.
Fortunately, there's a fix, Verstegen says: lengthening and strengthening the body's pillar -- hips, torso and shoulders. Case in point: In a recent study published in "Medicine & Science in Sports & Exercise," researchers tracked college basketball and track athletes and discovered that those who remained free of injury through the end of the season had 32% greater hip strength than those who had been sidelined.
"Improving pillar strength will make you more efficient at everything you do," says Verstegen, a certified strength and conditioning specialist. "You're going to improve flexibility, stability, speed, power, strength, endurance and balance."
Turns out one of the best tools for building a strong pillar is a Swiss ball -- one of those big, vinyl, air-filled balls used in gyms. In a six-week study published last year in the "Journal of Strength and Conditioning Research," researchers found that men who added two Swiss-ball sessions to their weekly training built midsections that were more than four times stronger than those of the men who didn't use the ball.
Your fitness plan should also correct muscular imbalances by loosening tight areas and strengthening weak ones.
Below are examples of exercises that will give you a strong pillar and balanced muscles.
For a free personalized preventive workout, go to coreperformance.com and enter code USA53015.
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These Swiss-ball exercises will help men and women gain strength and stability.
Lateral roll: Lie face-up on the Swiss ball so it's positioned between your shoulder blades, your hips are fully extended, and your knees are bent at 90 degrees (feet flat on the floor). Extend your arms straight out to your sides. Keeping your belly button pulled toward your spine and your glutes tight, roll across the ball to one side, reaching as far as possible, then roll and reach to the other side.
Knee tuck: Assume the push-up position, with your shins on the ball and your hands flat on the floor. Pull your knees toward your chest until your toes (or the tops of your feet) are on top of the ball. Then straighten your legs to push the ball back out.
These exercises hit areas that typically cause overuse injuries. You can find a foam roll and resistance tube in most gyms or at performbetter.com for under $30.
Tube walk: Loop the resistance tube around your ankles and stand with your knees slightly bent, your hands on your hips. Pull your belly button in toward your spine and sidestep 12 to 15 times to your right, then back to your left.
Foam roll massage: Lie face-up, with one calf resting on the roll. Move your body so your calf moves back and forth over the roll, pausing for 30 seconds at any tender point. Repeat with the other calf. Next (shown below), turn on your side and use the same technique to roll from your waist to your knee for both legs.
2. Beat and treat pain
So, despite your best efforts (and our best advice), you still ended up injured. No problem -- unless there's a bone poking through skin, you can't see straight, or any part of your body refuses to obey your brain's order to move. "These are things that require immediate emergency care," says Lorenzo Gonzalez, a physical therapist in New York City.
Otherwise, use PRICE to treat minor injuries. You're probably familiar with the acronym RICE, which stands for rest, ice, compression, elevation. Gonzalez says you also need "P," for protection. Here's the drill:
The basic ICE. An injury such as an ankle sprain disrupts tissue, allowing fluid from blood vessels to collect in the wounded area and cause inflammation. But when you apply a bag of ice (or, in a pinch, frozen peas) and then bind your ankle in an Ace bandage, you're constricting the blood vessels to prevent further inflammation, Gonzalez explains. Elevate your ankle above your heart so gravity will help draw the fluid away. (Note: "E" also can stand for "eat," as in "eat more citrus," says Gay Riley, a registered dietitian and certified clinical nutritionist. "Acidic foods decrease the acidity of blood, which means they promote a higher, more alkaline, pH and a less inflammatory condition." Fatty fish and walnuts are effective, too, thanks to their payload of omega-3 fatty acids and polyunsaturated fats, which increase the production of anti-inflammatory hormones called prostaglandins.)
The underrated "R." The need for rest might seem obvious, but too many men refuse to listen. What about "playing through the pain"? Unless your name is Curt Schilling or you have a multimillion-dollar endorsement deal with Nike, this maxim isn't meant for you.
The "P." Protect yourself with braces, sleeves and wraps. Even athletic tape offers protection -- and may relieve pain. Australian researchers found that patients who had their knees taped by a physical therapist once a week for three weeks had up to 40% less knee pain than untaped patients. Therapeutic tape is available at pharmacies, but see a physical therapist to learn how to use it. (You can find a certified PT near you at apta.org.)
Remember what we just said about resting? Well, we take it back -- sort of. The truth is, some targeted exercise is essential, if only to prevent your muscles from heading into hibernation. "When you injure a joint, there's almost a neurological feedback to the surrounding muscles that says, 'Quit working; shut down,' " says Andrew Bishop, team orthopedist for the Atlanta Falcons. Result: Your muscles begin to atrophy, which in turn extends the time it takes to return to action.
You can counter this process by doing isometric contractions, exercises that transmit a stimulus to the muscle without irritating the injury. Here's one for knees: Lie on your back, with knees bent. Straighten your injured knee, and press the back of your leg against the floor so your quadriceps contract. Do 50 to 100 contractions a day, and stop if you feel any pain.
3. Rehab right
Here's the funny thing about coming back from a sports injury: Feeling 100% doesn't mean you are. For example, once you injure an ankle, you're likely to re-injure the same ankle. And if that happens, the odds that you'll experience chronic ankle pain or instability can go up by 50%, according to research published in the "American Journal of Sports Medicine." This is why you need to rehab right the first time.
Initially, you want to restore the joint's range of motion and rebuild strength with simple movements like straight leg raises for lower-body ailments and external rotation for the upper body. Most people do this and then stop, but "this is where rehab begins," DiNubile says. "It's a shame, because a lot of insurers don't cover much physical therapy, and people tend to want to get out early."
Work with a qualified physical therapist as long as you can to learn techniques for building strength, cardiovascular endurance, flexibility, balance, agility and proprioception.
Proprio what? Proprioceptive training enhances the neural pathways that connect your brain to your muscles, helping them contract and relax in a more finely tuned manner.
Research shows that working with two pieces of equipment found in most gyms -- a balance board and a Bosu Balance Trainer -- improves proprioception and reduces the risk of re-injury. Dutch researchers found that spending five minutes on a balance board as part of a pre-workout warm-up can reduce ankle injuries by 60%. The men and women in the study did basic exercises such as standing on one leg or squatting on the board.
Sound silly? Not as silly as walking into another injury.
-- Scott Quill
To learn more, visit MensHealth.com and BestLifeonline.com.