Joint Health and Injury




Physical fitness and athletics have become a very important role in our society's well-being and health. This can offer potential health benefits for individuals of all ages, such as cardiovascular enhancement, strengthening and combating obesity and osteoporosis. Unfortunately, most of us have significant time constraints and lack of knowledge when developing exercise regimens, leading to improper technique and conditioning. As a consequence, injuries occur.

The more common injuries include ligament strains and sprains, muscular cramping and tearing, tendonitis, and generalized "overuse syndromes" resulting in soft tissue pain that may prevent return to activity.
With throwing activities, patients may develop common problems such as rotator cuff strain or impingement, tennis elbow, neck strain, and tendonitis.
Running and jumping activities may lend to knee and ankle sprains, muscular strain, and tendonitis.
Typically, these injuries occur in two types of athletes. The first is the "weekend warrior" who is not conditioned well and sustains traumatic injury to the soft tissues or joint as the result of a sudden force to the structures. The second person is one who is continually participating and sustains "overuse injuries", typically tendonitis, as the result of not enough rest and interim conditioning.

More violent and "highspeed" injuries result in ligament and cartilage tears, fractures, and damage to joints. In the event of injury associated with joint or limb swelling, deformity, or persistent pain, medical care should be obtained immediately.

Upon returning to sport or exercise after healing an injury, be sure that you are pain free and that full mobility of the joints has been achieved. An appropriate guideline for returning is to proceed at 50% intensity and duration. If functional and pain free at that level, then gradually increase 10% at a pain free level until at the usual level of activity.

The protective layer in our joints is the cartilage. Over time of prolonged impact loading such as running and jumping, the cartilage layer can wear away, resulting in arthritis. Not all bodies and physical activities are created the same. Therefore, one should be aware of signs of joint pain which may preclude further participation in those types of activities. To try to prevent these problems, a safer approach to exercise incorporates low impact activities such as bicycling, aquatic programs, and most gym equipment. Some formulations such as Glucosamine Chondroitin and MSM have been shown to be safe dietary supplements which promote healthier cartilage. In fact, many patients who have osteoarthritis believe these supplements also decrease their joint pain. Some patients however may develop more significant joint damage which may require use of medications, physical therapy, and even surgery. Recent advances in surgical techniques have now allowed faster recovery and return to activities by the development of "minimally invasive " surgery.

Fortunately, most of these injuries may be prevented with correct methods of training and proper equipment. When beginning an exercise program or sport, the following parameters should be considered to achieve an optimal training effect: frequency, intensity, duration, and type of exercise. This should certainly be individualized because no two people are the same. A sound program includes three key types of exercise: aerobic (cardiovascular), resistance training (strengthening) and stretching. A personal trainer can be of great value in education and guidance when developing a program. Adequate fluid intake, electrolyte replacement as needed, and a well balanced diet is necessary with the program. Equipment is also equally important in preventing injury. Exercise or sport specific clothing, especially footwear, is necessary to achieve desired results both efficiently and safely. With following these principals and done in moderation, a balanced approach to improving and maintaining health and fitness can be achieved.

Steven Sanders M.D.