Carl A. DiRaimondo, M.D.chambermanitowoccounty.org/resources/gettingreadytogetactivedr.p… ·...
Transcript of Carl A. DiRaimondo, M.D.chambermanitowoccounty.org/resources/gettingreadytogetactivedr.p… ·...
Carl A. DiRaimondo, M.D.
Orthopaedic Associates of Manitowoc
Presentation GoalsThe effects of aging on our bodiesThe physiological benefits of exerciseExercise types and program designHow to initiate a new exercise programHow to prevent and treat overuse injuries associated with exercise
DefinitionsExercise
Bodily exertion for the sake of restoring the organs functions to a healthy state or keeping them healthy
Stedman’s Medical Dictionary (25th edition)
Cross trainingCombining exercises to work various parts of the bodyReduces risk of overworking single body part
Envelope of functionEach individuals’ level of ability and tolerance to exercise
Can expand with appropriate trainingNot infinite
The Effects of AgingMuscle size and strength decreasesBone mass and density decreasesTendons and ligaments become less elasticJoint cartilage degeneratesBalance control deterioratesMetabolic rate slows
The Effects of AgingCombine all the effects…
Increased body weightIncreased risk for injury/pain/stiffnessIncreased risk for fallsIncreased risk for major medical problems
High blood pressureHigh cholesterolDiabetes
Benefits of ExerciseImprove strength, endurance, and flexibility
Muscles, tendons, bones, ligaments and jointsReduce risk for injury, pain, stiffness
With proper programImprove mobility and independenceImprove balance and posture
Reduce risk of fallsMaintain or reduce body weight
Benefits of ExerciseImproves heart and lung function
Increases metabolic rateReduce medical risksReduce cancer risk (breast and colon)Improve psychological well‐beingImproves immune responseImproves sleepImproves chances of living longer
Risks of ExerciseInjury to joints, muscles, bone etc…
Overworking tissues not yet acclimatedTypically when starting a new exercise or when attempting to increase exercise program
General medical concernsUnderlying heart, lung, kidney diseaseCheck with regular physician before starting
Exercise
BENEFITSRisks
Types of ExerciseBalanced exercise program
Range of motion/flexibilityStrengtheningEndurance/cardiovascular
Alternate workout programsCross training
Utilize different muscle groupsAvoid repetitive stress on same body regions
Range of MotionStretching
Reduces stiffness and improves flexibilityWork within motion joint allows
Used as warm‐up and cool‐down exercisesExamples…
YogaTai ChiPilates
StrengtheningMaintain or improve muscle strength
PowerMax rep
EnduranceNumber of reps
IsometricTighten muscle without moving joint
IsotonicMove joint as muscle tightens
Lower resistance and higher (15‐20) repetitionsLess risk for injury
StrengtheningCore exercises (stabilization)
Consists of…Back, abdominal, hip, and thigh regions
Will improve exercise performanceWill reduce incidence of injuryShould be part of a balanced exercise program
EnduranceImprove cardiac and pulmonary efficiencyImprove aerobic capacity of muscleMost effective for weight reductionFind balance between high impact and low or non‐impact activity
High and medium impactRunning and jumping
Low and non‐impactWalking, elliptical trainer, stair stepperBiking and swimmingCross country skiing
Getting StartedOften the toughest part of exercisingCheck with regular physician to determine safe level of exertionSet reasonable goalsMake it fun!
Getting StartedChoose exercises that can be done year roundStart slow
Allow body to get accustomed to the activityFlexibility exercises very important when starting
Establish a scheduleComfortable time of day
Wear comfortable clothing and supportive shoesWalking or running shoe
Arch supportBreathable, layered clothing
How Often?Initial goal
30 minutes of balanced exercise5 days per week
Break into more than one daily session if necessaryBuild up duration and frequency of exercise gradually
Goal5 days per weekBalanced program
30 minutes of endurance exercise per each session
Consider using daily chart to track time exercising
NutritionBalanced diet
Carbohydrates2/3 of daily caloric intakeFruits, vegetables, whole grains
Protein1/3 of daily food intake
Protein‐rich foodsBuilding block for muscleProtein‐rich snack
After muscle damaging workoutHeavy weight‐trainingLong endurance event
Fat20‐30% of daily caloriesPart of all cell membranesEssential fatty acids
Omega‐3
HydrationAppropriate hydration essential for optimal performance
2% body fluid loss impairs performance>2% can impair cardiac and mental function
Fluid intake guidelinesPre‐workout
16‐20 oz. 2 hours before10 oz. 20 minutes before
During workout4 oz. per every 15 minutes
Post‐workout24 oz. per every pound of body weight lost
Exercising TipsBefore exercise
Warm upRange of motion and light strengthening exercises for ~15 minutes prior to starting endurance exerciseStart at slow pace and gradually increase pace
Apply heat to area you will be exercising
Exercising TipsDuring exercise
Exercise at comfortable paceShould be able to speak
Breath regularlyDon’t hold breath
Keep well hydrated
Exercising TipsDuring exercises
Warning signsChest tightness or painSevere shortness of breathFeeling lightheaded or nauseatedSharp joint or muscle pain
Cease exercisingContact your physician
Exercising TipsAfter exercise
Cool down5‐10 minutesAllow heart rate to slow down and muscles to relaxSlower pace of exercise activityGentle stretchingApply ice to areas exercised (15‐20 minutes)
Injury Prevention“An ounce of prevention is worth a pound of cure.”
Ben Franklin
Many injuries associated with daily fitness can be avoidedProper planning of fitness program and progression
Consulting with regular physicianWorking with a fitness trainer
Injury PreventionMajority of injuries due to overuseBuild up of microscopic trauma to tissue
Tissue breakdown exceeds tissue healingDesigning programs that do not exceed this balance will reduce injury risk
Cross training programWork within envelope of function
Be aware of climate as well as clothing
Common Overuse InjuriesFoot and ankle
Plantar fasciitisPain bottom of heel/arch
Achilles tendonitisPain back of heel or lower calf
Knee/lower legPatella tendonitis
Pain at edge of patella
Shin splintsPain mid and lower shin
Common Overuse InjuriesHip
Trochanteric bursitisPain outer hip and buttock
BackMyofascial strain
Pain along spinal column
Common Overuse InjuriesShoulder
Bursitis/tendonitisPain front/side of shoulderWorse when reaching
ElbowTendonitis
Tennis elbowPain outer elbow
Wrist/handTendonitis
Common Overuse InjuriesStress fractures
Any weight bearing jointWomen > men
Lower bone density with ageFemale triad (Teens and 20s)
Stress fractureAbnormal menses
Due to high level of exerciseEating disorder or poor caloric intake
RunnersPoor calcium and vitamin D intake as teens/adultsSymptoms
Pain and swellingOften warm to touch
Common Overuse InjuriesStress fractures
Important to distinguish from soft tissue injuryCan lead to complete fracture if neglectedTreatment
Reduce stress to injured boneTypically heal without surgery
Consider surgery if stress fracture of hipOptimize calcium and vitamin D intake
1200 mg calcium and 1000 IU vitamin D dailyMay take 8‐12 weeks to heal
Injury TreatmentIn general…
Cessation of activity causing painIce to affected areaOral anti‐inflammatory/analgesic useContinue exercises that do not create symptomsSelf‐assess and correct for any causative abnormality
BiomechanicsExercise program/progressionAthletic equipment
Gradual resumption of activity when symptom free and causative factors corrected
May take several weeks
Injury TreatmentSeek medical care if…
New onset joint swellingUnable to bear weightMechanical catching of jointSymptoms persist or progress despite rest and activity modification
Injury TreatmentPhysician assessment
Evaluate for significant tissue injuryCartilage, muscle, tendon tearsFracturesAggravation of degenerative joint arthritis
Look for abnormalities in…BiomechanicsExercise program/progressionAthletic equipment
Treat any underlying structural abnormalityNonsurgical treatment most common
Coordinate appropriate rehabilitation
Injury TreatmentPhysical therapy
Reduce inflammationAssess abnormalities in joint/muscle function
Kinetic chainForces transmitted from ground through body and back to the ground
Corrective exercisesRestore balance of muscle forces/flexibility
Balance limbLength
Heel liftCorrective shoe orthotics
Neutral foot arch
ResourcesLocal fitness trainers
YMCA, Wellness Center, Planet Fitness, etc…The Internet…
Arthritis Foundationwww.arthritis.com
Multiple running, cycling, cross‐training sitesMedical professionals
PhysiciansPhysical therapists
Questions?
Carl A. DiRaimondo, M.D.
Orthopaedic Associates Manitowoc, WI
682‐6376