Physical Activity: Helping Without Harming Ourselves

By Bob Gorinski 

Now more than ever, Americans are realizing the tremendous physical, mental, social, and other benefits of regular physical activity. Approximately 25% of adults meet or exceed the exercise guidelines recommended by the Centers for Disease Control and Prevention.

As a physical therapist specializing in the evaluation and treatment of injuries and movement-related problems, I’d like to address another key facet of many studies examining this trend in America’s improved exercise habits: injury. Consider these facts:

• 25% of physically active adults report they incurred a moderate to significant exercise-related injury in the previous 12 months.
• In 2019, over 3 million exercise-related injuries resulted in trips to the emergency department. Millions more less severe injuries occurred.
• Higher intensity exercise is associated with more frequent and severe injuries.
• Repetitive overuse injuries due to the combination of exercise and the day-in, day-out demands of life abound. It is my observation that the most typical problems are difficult to quantify for scientific study.

Do we find ourselves “between a rock and a hard place” here? At this point, I may need to remind you that sedentary living at the computer desk and on the couch comes with its own set of significant risks and problems!

The solution to the exercise/injury dilemma does require time and effort. Thankfully, there are relatively simple measures we can take to minimize the risks of being physically active and doing what we love.

Over the years, I have noticed patterns and trends among my physically active clients who suffer injury. At the root is our tendency to expect far too much, too soon, from our bodies. The vast majority of mass-produced fitness plans and programs are marketed to us in this manner. Unrealistic and short-sighted expectations—and eventual injury and burnout—may be some of the ramifications.

We all naturally and continually work at the areas of fitness we enjoy and that come easily, while neglecting weaker components. And yes, sometimes accidents do happen, or we simply hurt due to nagging long-past injuries. Here are just a few of the most common patterns that I have witnessed over the years. If you’re physically active, see if you happen to fit into one of these four generalizations:

• If you have lower back pain or hip issues like bursitis, tendonitis, or instability of the pelvic bones (often diagnosed as sacroiliac dysfunction), you may want to temporarily curtail Zumba or other Latin dance type activities. They often claim to work core muscles, and to some extent they do. But this generally occurs in positions that do not teach and maintain trunk and pelvis alignment and stability. This is especially unhelpful when it comes time to lift a bag of yard mulch or vacuum the living room.
• Some love to lift a lot of weights, but all the time on the bench press or weight machines would likely be much better spent working on body control in proper posture, balance, and flexibility. Weekend warriors should not expect to suddenly jump, sprint, and more without preparing their bodies. If you are going to compete in middle age, spend the time preparing specifically for the activity. Nearly countless times over the years have I been asked questions such as, “Bob, what should I be doing for this hip flexor strain?” I attempt to provide the best suited advice based on a number of factors, but ideally, such problems can often be minimized by building up gradually before you try to go out on the softball field and stretch that single into a double. As the years go by, expectations absolutely should change.
• Flexible individuals often focus on maintaining and increasing flexibility through various forms of yoga and similar activities. But remember, the muscles, bones, joints, and nervous system are integrated as a fine-tuned whole. It is entirely possible to have too much joint and muscle flexibility, which actually causes some loss of controlled mobility and increased wear-and-tear on congruous bony surfaces. Those who have attained sufficient flexibility benefit greatly from devoting time to develop strength and body control under moderate resistance.
• Some are intensity hunters! They love the thrill of the runner’s high, the pre-workout jitters, the push into greater capacity, and the feeling and results that come with doing a lot of challenging work in a relatively little amount of time. These individuals often need to be far more mindful of recovery. Cycling through exercises and physical tests and a week off for vacation is not nearly enough. Even professional athletes value and schedule drastically different phases of training and preparation throughout the year. In our 30s, 40s, and 50s, we should not expect to compete against ourselves and our peers week in and week out without eventual injury, physical stagnation, and burn-out.
• Many using exercise as part of their weight loss or maintenance plan are in the daily or near-daily habit of doing lower intensity activities such as walking, light jogging, and various cardiovascular machines at the gym. This is great. However, as the weeks roll on, it does add up to a lot of wear and tear on the lower body. Hip, knee, and especially foot complications such as plantar fasciitis abound. It is often well worth the time to consult with a physical therapist or qualified personal trainer to teach you various means to work up a sweat with total body workouts that incorporate the upper body and low impact strength and flexibility components.

We can and we should stay active and well by primarily doing what we enjoy! However, if we want to keep moving, we need to temper what we like to do with what we need to do. Long-term health and wellness often requires both what we enjoy and what we need!

CDC Study Reported in CDC Morbidity and Mortality Weekly Report, 2020

As reported in Epidemiology of musculoskeletal injury among sedentary and physically active adults.