Fulfilling New Year’s Resolution to Hit the Gym

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Sports Medicine Expert Dr. Kevin Plancher on working out without getting hurt

In February and March, many people remain resolute about their New Year’s vow to get in shape. Yet it’s important to exercise caution during a workout because as health club memberships surge after January 1, so do the number of related injuries.

Some are pure accidents: more than 50,000 exercisers a year are treated in emergency rooms after falling off exercise balls and treadmills, dropping heavy weights on their toes, and tripping on jump ropes. Other injuries are easily preventable, according to Dr. Kevin Plancher, a leading sports orthopaedist and Associate Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in NY.

It doesn’t matter how fit you are – an injury can occur after bench pressing too much weight or hunching over the stairstepper. The other risk? Taking a hiatus to recover can sap that New Year’s motivation and send people back to hibernation.

Dr. Plancher has ten suggestions to keep a workout from becoming a work-over:

Accept your limitations As the musculoskeletal system ages, bones lose density and strength; ligaments and tendons stiffen, lose circulation, and become more vulnerable to injury; cartilage becomes stressed and susceptible to tearing; and muscle mass decreases. When you reach middle age, this can lead to "boomeritis" injuries such as tendinitis and bursitis. “If you repeat a motion that forces the muscles will work in a misaligned way, it will catch up with you,” Dr. Plancher says. “That’s why high repetitions with low weights are always advisable.”

Feet first “If you participate in an activity more than three times a week, you need shoes designed for that activity,” Dr. Plancher says. “Many people wear running shoes to the gym, but they are designed to put your foot and leg into the best position to propel you forward.” If they are worn for activities with a lot of side-to-side movement, it can cause the ankle to roll to the side, wrenching the ligaments, and causing a sprained or even broken ankle. Cross-training shoes are a better choice for sports like tennis or step classes. Regular exercisers should replace their shoes every twelve months, or at the first signs or wear (running shoes should be replaced every 480 to 800 kilometers).

Warm up first Don’t stretch cold muscles. Run in place for a few minutes, breathe slowly and deeply, or gently rehearse the motions of the exercise to follow. “Warming up increases the heart and blood flow rates, body temperature, and loosens up other muscles, tendons, ligaments, and joints to decrease the risk of injury,” says Dr. Plancher.

Now stretch Begin stretches slowly and carefully until reaching a point of muscle tension. Hold each stretch for 10 to 20 seconds, and then slowly and carefully release it. Inhale before each stretch and exhale as you release. Do each stretch only once. Never stretch to the point of pain, always maintain control, and never bounce on a muscle that is fully stretched. It’s a good idea to do daily strengthening exercises at home to maintain flexibility, including wall sits, lunges on the floor, or climbing stairs.

Concentrate on muscle groups, not individual muscles “People hurt themselves when they put too much emphasis on one muscle — getting huge biceps or lats, for example,” Dr. Plancher notes. Instead, target more of your arms or shoulders with moves like the chest press or back row. “The best exercises work several muscles simultaneously; they give you better results because you’re building functional strength.” He recommends waiting people 48 hours before working the same muscle group again.

Mix it Up Cross-training — regularly switching from one activity to another — is more beneficial than consistently doing the same routine. It prevents mental burnout and different activities target slightly different muscle groups.

Go pro Putting too much resistance on a machine or using incorrect form can lead to injury. Letting the knee extend beyond the toes during a lunge or squat or using momentum to lift heavy weights are risky moves. Use mirrors, if available, to monitor your form and technique. “Remember to never lock out or lock in but rather work in the mid- range,” says Dr. Plancher. Consider signing up with a personal trainer (most health clubs offer new members one to two free sessions) to ensure that everything is in proper alignment.

Hands off With cardio machines like the elliptical trainer, keep your hands resting lightly on the handrails — not at your sides, elbows locked, supporting all your weight with a death-grip on the rails. A hunched position can keep you from breathing deeply and the improper spine alignment can be jarring to your shoulders and elbows. People tend to put a really huge incline (or high resistance) on the machine and then grab on. “If you need to hang on for dear life, your setting is too high,” says Dr. Plancher.

Rest In general, strength training should be performed at least two to three times a week with rest periods between training days for proper muscle healing. Unless you have other restrictions, do 8 to 10 exercises, starting with the larger muscle groups first. A good starting point is to perform 2–3 sets of 8–12 repetitions. Perform a full range of motion in a controlled manner; fast movements should be avoided. When that gets easy, Dr. Plancher says, you can increase the load by 2 percent (and no more than 10 percent).

Head and shoulders above Skip behind-the-head moves, such as the lat pull-down, which can put enormous strain on your shoulders. Only people with very mobile shoulder joints can keep their spines straight enough to do this exercise properly; otherwise, it can lead to shoulder impingement or a tear in the rotator cuff. When doing bench presses or flys, don’t let your hands drop below your shoulders (such overextension can cause injury). Substitute an incline press for a military press to avoid shoulder impingement.

About Dr. Plancher: Kevin D. Plancher, M.D., M.S., F.A.C.S., F.A.A.O.S., is one of the nation’s leading orthopaedic surgeons and sports medicine experts, specializing in the treatment of knee, shoulder, elbow and hand injuries. He is Associate Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in New York City and the Head Team physician for the professional lacrosse team, the Long Island Lizards. Dr. Plancher is on the editorial review board of the Journal of the American Academy of Orthopaedic Surgeons.

In 2007, 2008, 2009, and 2010 Castle Connolly Medical Ltd., a New York City research company, named Dr. Plancher America’s Top Doctor in Sports Medicine. Every year from 2001 to 2010 he has been included in Castle Connolly’s list of Top Doctors in the New York Metro area, as published in New York Magazine's yearly "Best Doctors" issue.

Dr. Plancher received his M.D. degree (cum laude) and an M.S. degree in physiology from Georgetown University in Washington, DC. He completed his residency at Harvard University’s orthopaedic program and a fellowship at the Steadman-Hawkins Clinic in Vail, Colo., where he studied shoulder and knee reconstruction and served as consultant to the clinic for six years. He has been team physician for more than 15 high school, college and national championship teams.

An attending physician at Beth Israel Hospital in New York City and Stamford Hospital in Stamford, CT, he maintains offices in Manhattan and Greenwich, CT, http://www.plancherortho.com. Dr. Plancher lectures extensively in the U.S. and abroad on issues related to orthopaedic procedures and injury management. He also has been named to the sports medicine arthroscopy program subcommittee for the American Academy of Orthopaedic Surgeons. Dr. Plancher has been awarded the Order of Merit (magna cum laude) for distinguished philanthropy in the advancement of orthopaedic surgery by the Orthopaedic Research and Education Foundation. In 2001, he founded The Orthopaedic Foundation for Active Lifestyles, a not-for-profit foundation focused on maintaining and enhancing the physical well-being of active individuals through the development and promotion of research and supporting technologies, http://www.ofals.org.


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