1. Weekend Warriors and Injury Prevention David Berkson, MD Drexel University COM Family Medicine/Sports Medicine

2. Overview u Define Weekend Warrior u Reasons for Injury u General Prevention u Sport-specific Prevention u Wrap Up

3. Weekend Warrior - Definition u Part-time participant in fitness activity u Most commonly on weekends u Usually attempts to squeeze in all fitness activity of the week into small number of sessions (one or two) u Usually does more than his/her body is ready to do

4. Weekend Warrior - Why?? u “Not enough time during the week to fit in workouts.” u “Can’t find people to participate in the activity I want during the week.” u “Too much of a hassle to get up early or stay away from home late.” u “I don’t know, I’m lazy.”

5. Weekend Warrior - Problems u Sprains u Strains u Fractures u Pulled muscles u Contusions u Lacerations u Etc, etc, etc...

6. Weekend Warrior - Problems u The most common reason for injury during participation is trying to do more than the body can handle

7. Weekend Warrior - Problems u Why does the body have trouble handling the stress of participation?? u Muscular Fitness u Cardiovascular Fitness u Nutritional Fitness u Improper Technique

8. Avoiding Problems u Best ways to prepare the body for the stress of being a weekend warrior: u Turn the weekend warrior into a routine exerciser u Improve nutrition u Proper technique during activity

9. HOW?????

10. Fitting Fitness In u Physical inactivity can be as damaging to health as smoking u Need to make exercise/workouts work for you u Exercise does not have to have military mentality u Should be fun and enjoyable

11. Fitting Fitness In u First step - commit yourself to daily physical activity u Pencil an appointment for a fitness session and make it mandatory u Second step - goals, short and long- term

12. Fitting Fitness In - Tips u Bits and pieces u Avoid “all or nothing” viewpoint u Be realistic u Keep perspective

13. Fitting Fitness In - Tips u Keep equipment on hand u Grab a friend/partner u Utilize spare time

14. Recommended Workouts u 3-5 sessions/week of aerobic workouts u 2-3 sessions/week of strength training u 2-3 sessions/week of flexibility u Start low and gradually build up

15. Aerobic Workouts u Running, biking, brisk walking, etc. u 20-60 minutes per day u Split time into multiple smaller workouts u Be creative with time at work and home

16. Creative Workouts u Use stairs u Walk longer/farther u Carry one bag of groceries at a time u Start a hobby that involves movement u Chores are your exercise friend u Turn off the TV u Learn to dance, new sport u Join active groups

17. Strength Training u 1 set each of 8-10 exercises involving all major muscle groups u 5 reps or less - muscle building u 8-12 reps - muscle/tone/aerobic u 12-20 reps - tone/aerobic

18. Strength Training u Technique is key - bad technique leads to more injuries u Keep dumbbell/barbell on hand for “down time”

19. Flexibility Training u Stretch all major muscles u Can be done almost anywhere - home, work, car, etc. u Don’t forget about head/neck/back u Technique is very important - use partner

20. Nutritional Fitness u Exercise requires energy u Adequate calories is one of keys to enhancing performance u Follow food guide pyramid to include proper amounts of all 5 food groups u Satisfy macronutrient and micronutrient requirements

21. Carbohydrates u Muscles use carbs as primary source of fuel u High-carb diet increases stores and improves performance u 60-70% of daily calories from carbs

22. Carbohydrates u Longer exercise sessions can deplete muscle carb stores u Consume 30-75 grams of carbs per hour of exercise u Eat large carb meal within 2 hours after extended workout/exercise to replace lost stores

23. Fats u Secondary source of energy for exercising muscles u More important for prolonged, low intensity exercise u 20% of daily calories from fats - mostly unsaturated

24. Proteins u Minor role in energy u Current recommendation is 0.4 grams protein per pound of body weight u Athletes/active people require more u 10-20% daily calories

25. Vitamins & Minerals u Not directly related to energy, but essential for food metabolism and energy production u Most commonly deficient: iron and calcium u Women require higher amounts of iron and calcium than men

26. Water u “The Ultimate Nutrient” u Makes up 60-70% of body weight u Makes up 70-75% of muscle u Extremely vital functions in the body

27. Water - Vital Functions u Helps digest food u Helps lubricate joints, cushion organs u Transports nutrients/waste products u Carries waste products out of the body u Regulates body temperature

28. Dehydration u Disrupts ability to perform optimally u First few hours, water lost from blood volume u Next cells lose water and become overheated u Impaired functioning

29. Dehydration u Water loss of 9-12% of total body weight can be fatal u Hydration is one of the most frequently overlooked aspects of fitness/exercise

30. Staying Hydrated u Thirst - the natural hydration meter u Adequate under resting conditions u During exercise you lose water faster than the brain realizes u By the time you feel thirsty, you are already dehydrated

31. Staying Hydrated u Have to take into account baseline water loss u Lose 12 oz per day by breathing u Lose 24 oz per day through skin u Strenuous exercise can lose 4 lbs of water (2 quarts) per hour

32. Staying Hydrated - Complex u Body requires 1 ml of water for each calorie you burn u Inactive person burns 1500 calories per day = 1.5 liters of water u Active person burns 4,000 calories per day = 4 liters of water

33. Staying Hydrated - Simple u Weigh before and after exercise session u Need to drink at least 1 cup (16 oz) per pound of body weight lost u Must regain weight prior to next session u Plan on drinking that amount during next session to avoid dehydration

34. Staying Hydrated - Simpler u Monitor the color of urine u If urine is clear - drinking enough u If urine is dark - need to drink more u Urinate approx every 2-4 hrs, if going more than drinking too much

35. Tips for Staying Hydrated u Keep water bottle (filled) at desk at work u Stock refrigerator at home with water instead of soda u Flavor water more to individual taste u If exercise outside, bring frozen water bottle - water thaws at proper drink rate

36. u Which is better: WATER vs SPORTS DRINKS

37. Sports Drinks u Only needed if exercise session lasts longer than 1 hour u Not required if exercise frequently in small time frames u May provide better hydration due to taste - people will drink more if it tastes better

38. Athletic Shoes u Type of shoe depends upon type of foot and type and frequency of activity u Various activities infrequently - wear all- purpose cross trainers u Specific sport at least 3 times per week - wear sport-specific shoes

39. Athletic Shoes - Activity u Runners or Aerobics - shoes with good impact-absorbing cushioning u Walkers - heel impact cushioning plus good roll off at toes u Court sports - side-to-side ankle stabilization (sole can’t be too thick)

40. Athletic Shoes - Feet u Arch of foot - high, medium, low u High-arched foot not very flexible - cushioned shoe u Low-arched (flat-footed) too flexible - motion control shoe u Medium arched - stability shoe

41. Athletic Shoes - Fitting u Measure feet at end of day when largest u Measure both feet u Wear workout attire u Try on shoes - sizes vary by make u 1 thumb width from longest toe to end of toe box

42. Athletic Shoes - Fitting u Feel comfortable through arch u Hold heel firmly u Women need to be extra cautious u Some “women’s shoes” are downsized men’s shoes

43. Athletic Shoes - Maintenance u Allow time for shoe to adapt to foot and foot to adapt to shoe u Monitor condition of shoes as use them u 300-500 miles - cushioning wears out u Have multiple pair of shoes for activity and rotate

44. Running u Most common injury is overuse u Feet absorb 110 tons of energy every mile run u 70% of runners develop injury every year u Key is prevention

45. Injury Prevention - Running u Run less than 45 miles per week u Increase mileage < 10% per week u Run on soft, flat terrain u Stop running if have pain u Alternate hard and easy training days

46. Injury Prevention - Running u Stretch before run - calves, hamstrings, quadriceps, groin, back u Orthotics - only needed if have biomechanical foot problems and suffer from repeated injuries u Change shoes every 500 miles

47. Swimming u Most common injury is overuse u Most common problem is in technique u Shoulder injuries most common u In 1 year swimmers can complete up to 2 million arm strokes

48. Injury Prevention - Swimming u Continual reinforcement of proper stroke mechanics is essential u Stretching - arms, shoulders, neck, back, legs u Gradual increase in distance and intensity

49. Injury Prevention - Swimming u Swimming incorporates all major muscle groups u Muscle conditioning and strengthening is key in avoiding injury u Avoid overtraining in competitive swimmers

50. Tennis u Most common injury is overuse u Most common problem is in technique u Work on all-around flexibility and strength u Get expert instruction periodically to ensure proper technique

51. Injury Prevention - Tennis u Ensure proper warm up u Improve baseline cardiovascular conditioning u Stretch calves, quads, hamstrings u Stay hydrated

52. Injury Prevention - Tennis u Wear proper shoes and socks u Chose right racket and string tension u Care for minor injuries (blisters) early u Technique, technique, technique

53. Weight Training u Most common injury is overuse u Most common problem is technique u Start with appropriate program u Get instruction on proper weight and especially technique

54. Weight Training - Club Benefits u Adult stimulation u Social climate u Club professionals u Multiple exercise options

55. Free Weights vs Machines u Versatility u Motivational u Muscle grouping u Safety u Coordination u Directed Form u Isolation u Resistance

56. Conclusion u Best bet for weekend warrior is to increase baseline activity level u Avoid overuse by starting low, going slow, and ensuring proper technique u Remember proper nutrition and hydration