In a perfect world, medications would never produce side effects, operations would always be successful, and the best movie would win the Oscar. In that world, Harvard Men's Health Watch would be in every mailbox, and exercise would continue to prevent disease and prolong life without causing any aches and pains. For better or worse, perfection can never be achieved in the real world. It's a wonderful world, and exercise is wonderful for health, but people who exercise do run a risk of injury.
Although exercise rarely triggers serious heart problems, they must be the first concern for everyone who works out. To protect yourself, get a check-up before you start a serious exercise program. Listen to your body for warning symptoms such as chest pain, a racing or erratic pulse, undue shortness of breath, and light-headedness, and get help if you experience any of these symptoms.
Although cardiac problems are infrequent, musculoskeletal woes are relatively common. A study of 6,313 adults who exercised regularly found that 21 percent developed an exercise-related injury during the course of a year. Two-thirds involved the legs; the knee was the most frequently injured joint.
It sounds grim, but it's not. For one thing, injuries are much more common with intense exercise and competitive sports than with moderate exercise done for health. For another, people who exercise actually have a lower long-term risk of disability than sedentary people. A 13-year study of 370 exercisers age 50 to 72, for example, found that exercise was linked to a reduced risk of disability and a lower death rate, even among elderly folks who engaged in running, a high-impact activity.
Injuries do occur, but many are preventable, most are mild, and the majority will respond nicely to simple treatment at home. An old runner's adage boasts, "I have two fine doctors, my right leg and my left." It's true for disease prevention, but for injury treatment you'll also need your head and your hands. And you should know when to consult a health care professional.
Prevention. It's always the best treatment. Here are a few key tips:
Work yourself into shape slowly. It's the most important element of prevention, particularly for "weekend warriors" who may be tempted to go all out without preparing themselves properly. It's a growing problem, particularly for the baby boom generation; in fact, doctors have coined a new diagnosis, "boomeritis," for the phenomenon. Use a graded exercise program to get into shape gradually, and then stay in shape the year round.
Warm up before each exercise session and cool down afterwards.
Stretch regularly; exercise makes muscles strong, but they also get tight and short — stretching preserves flexibility and reduces the risk of injury.
Use good equipment; it's particularly important to have supportive, well-fitting shoes for weight-bearing activities.
Use good technique; a few lessons or a little coaching can improve your mechanics as well as your performance.
Don't overdo it. Fatigue and dehydration impair concentration, often leading to a misstep or fall. Overuse is the major cause of injuries; give your body a chance to rest and recover after workouts, particularly when you're first getting into shape. Alternate hard sessions with easier ones. Vary your routine so that you use different parts of your body; some people, for example, might walk one day, play tennis the next, and garden the third. A day off now and then doesn't hurt, either.
Recognition. If prevention fails, early detection is the next line of defense. Be alert for symptoms. A bit of soreness and stiffness is normal, but pain, swelling, diminished strength or mobility, and discoloration of the skin is not. Spot small problems before they become big ones. If your problem seems small, treat it yourself. But if you don't improve — or if you have a major injury — get expert help.