It’s often not a single incident that contributes to injuries such as tendinitis, muscle strains, and joint sprains. Although trauma can be a factor in some cases, many people don’t know what caused their pain. It usually develops as part of a gradual process of wear and tear and muscle imbalances. And then one day when you bend over, like you do every day, your body sends you a message that it won’t take any more.
You’ve gone too far. It’s “the straw that breaks the camels back.”

Many times our postural habits and patterns of activity contribute to imbalances in the body where some muscles become weak, and the opposing muscles become tight. This creates uneven forces at the various muscles and joints, and can cause injury. The other day while biking, I felt my right hip flexor getting really tight. I started to notice that when I coasted down a hill, I always rode with my left leg extended straight on the pedal and the right leg bent (so my right hip flexor was always in a shortened position, and the left relatively stretched). As I became aware of this, I changed the pattern that I unknowingly had fallen into, and started to alternate which leg I straightened. I noticed a difference in how my body felt as a result. So something as simple as that can wreak havoc on the body and contribute to pain and injuries.

So what can we do to reduce the likelihood of these sorts of gradual injuries? Here are a few suggestions:

1. Cross train: varying your sport or activity reduces the likelihood of overuse and imbalances 2. Stretch the major muscle groups on both sides of the body 3-5x/week or after any workouts 3. Engage in regular strength training to optimize muscle strength and reduce stress on the joints 4. Allow 1 or 2 days off a week to allow the body to rest and recover 5. Be aware of postural habits that you may have; if you notice pain when performing an activity, try to look and feel what’s happening in your body 6. Eat a well balanced diet and maintain a healthy weight to reduce overall stress to the joints

We can’t prevent every injury, but we can certainly try.

This is the time of year when many of my patients express frustration at not being ableto enjoy gardening because of pain or an injury. Personally, I look forward to making changes to my perennial garden and planning our vegetable and herb garden each spring. And though I’m careful and try to be safe, there are evenings where I find myself sore from a day’s worth of digging and planting.

The back, neck, knees, and shoulders are often taxed with the various motions and positions assumed while tending to a garden. Kneeling, for example can be hard put a lot of pressure on the knee joint and bursa. Squatting repeatedly or for sustained periods can be aggravating to the knees, low back, pelvis, and hips. Raking, weed pulling, and digging require the neck and shoudlers to do a lot of work. So what’s a gardener to do?

I always promote the use of proper body mechanics, however I am realistic too. It’s often difficult to keep the joints in neutral alignment whn working in the garden. In situations where the body is under stress or working in a less than ideal alignment, the following tips may help prevent soreness and injury:

1. Vary your position every 5-10 minutes. Alternate between half kneeling on one knee, kneeling on both knees, and squatting when working low to the ground. It’s also a good idea to vary between standing and squatting to minimize the likelihood of strain to the joints and overuse type injuries.
2. Stretch often. Every 10-15 minutes, do a few simple stretches. Since a lot of positions I find myself in when gardening involve bending forward, I try to do stretches where I bend backward. Placing the hands on the lower back and gently arching back while standing is a nice way to stretch the front of the body. You can also do various stretches for the neck, chest, hip, and hamstring. This gives the muscles a well deserved break, allows better circulation to reach the tissues, and helps restore symmetry and balance to the body.
3. Don’t overdo it. (This is where I often go wrong.) I sometimes get on such a roll and can be in the garden for hours working. Try to limit the length of time you spend to perhaps one hour, maybe more or less, each day.
4. Sit back and enjoy. Allow yourself time to relax and take in the sights and sounds in your garden, even if you aren’t finished.

Sitting with the legs crossed is something many people do. If you have any back, hip, or knee problems, it may be best for you to try to break this habit and there’s a few reasons why.

1. It creates an imbalance in the pelvis. When you sit with let’s say the right leg crossed over the left, the right side of the pelvis shifts higher than the left. This creates an uneven alignment throughout the lower spine that translates all the way up to the neck. Anatomical imbalances such as these, particularly when prolonged or sustained, can eventually contribute to dysfunctional posture and pain. Sciatica, sacroiliac instability, and low back pain can be caused or exacerbated by this way of sitting.

2. You probably always cross the same leg on top. The majority of people always cross the same leg on top. It’s a habit, the body gets used to it, and the muscles around the hips, knees, and pelvis change in response to this. This also applies to when you sit cross legged on the floor. If you sit down on the floor without thinking about it, then change which leg is positioned in front, it will most likely be a very obvious difference in how comfortable you are. (I always have students in my yoga classes switch which leg is in front to create better balance in the body.)

3. Crossing the legs places strain on the knees. When the leg that’s crossed is positioned with the top knee out to the side and the ankle resting on the opposite knee, the ligaments on the knee can be stressed. There can be compression of the cartilage within the knee which can also be damaging over time.

4. Circulation is compromised when the legs are crossed. The compression that occurs from the legs being crossed makes it more difficult for the veins to return blood from the legs back to the heart. This is why the legs can sometimes be felt to “fall asleep” if the legs are crossed for prolonged periods.This can be problematic especially for individuals with vascular disease, diabetes, and other problems with circulation.

So if you find that you cross your legs and you’re having a hard time breaking the habit, be aware of your body and switch which way you cross periodically to restore symmetry and reduce your likelihood of pain or injury.

A bad hip, knee, or ankle can make climbing up and down stairs difficult and at times unbearable. The weight bearing, changes in range of motion and strength required to coordinate the shifts in balance are demanding on the joints and muscles, and an injury can greatly affect the ability to perform this everyday task.

If climbing stairs is a problem, try this: go up leading with the good foot, and down leading with the bad foot. By doing a “step to step” gait pattern (as opposed to step over step), the amount of weight carried by the injured leg can be reduced, thereby reducing pain.

According to the American Academy of Orthopedic Surgeons, 90% of hip fractures occur as a result of a fall. Women are 2-3 times more likely to sustain a hip fracture, and the morbidity and mortality rates are quite high, with only 25% of people making a full recovery, and almost 25% dying within a year due to complications. There are some basic steps to take to help prevent falls and likelihood of a hip fracture. test

1. Vision is a primary factor for balance, and it is important to optimize vision for fall prevention. Get annual eye exams and ensure there is adequate lighting in your home. If you wake at night to use the bathroom, keep a night light on to reduce the risk of falling.

2. Wear proper footwear. A low heeled, supportive shoe provides stability for the foot which improves balance.

3. Use an assistive device if necessary. Although you may feel too young to use a can or walker, it is much safer to use one than to walk holding onto walls or furniture. If you need a device, be sure to use it all the time to optimize safety.

4. If you experience dizziness, talk to your doctor right away. Many medications can cause dizziness as a side effect, and it may be that you need your dosages adjusted. It can also be a result of vertigo, low blood pressure, and other equilibrium problems.

5. Perform stretches to maintain the flexibility in the calf and hip muscles. If you start to lose your balance, the first receptors to respond are in the ankles. They try to shift the weight onto the heels to adjust for balance, but tight calf muscles will make this response ineffective. The second area to respond is the hips. Maintain good flexibility of the hamstrings and hip flexors to allow for better balance.

6. Maintain as upright a posture as you can. The taller you stand, the less likely you will fall.

7. Make safety modifications within your home. Remove scatter rugs, install grab bars in the shower area, and use a shower chair if necessary to prevent slips and falls. Be sure the railings at any stairways in and outside of your home are sturdy.

If you have even one fall, discuss it with your doctor. S/he may refer you to a physical therapist who can help design a specific exercise program to help improve your balance, strength, and flexibility, and reduce your risk for fall related fractures.

If you’re at all like me or my running friends, at some point you’ve probably been off the road due to some type of injury, ache, or pain. Whether it be knee pain, hip pain, back pain, or foot pain, these injuries can be frustrating and halt your training or fitness routine. It’s highly advisable to discontinue running if you have an injury, as the high impact and repetition of running can cause more harm. That doesn’t mean, however, that you need to discontinue all activities. Here are a few alternative things you can try:

1. Swimming or Aqua jogging

Getting into a pool and swimming laps or using a water belt to do some aqua jogging is a great way to keep fit and active while minimizing strain to the muscles, joints, and ligaments. You will be able to maintain strength, flexibility, and cardiovascular health so once your injury heals, returning to running will be less difficult.

2. An elliptical trainer

Using an elliptical machine partly simulates running, but without the high impact. Since your feet stay planted, you eliminate impact but can still work for speed, strength, and endurance. Depending on the type of injury, the elliptical may still cause you pain. Adjusting the incline up or down may be a way to eliminate discomfort for some people.

3. Speed Walking

If you’re a runner through and through you may scoff at the idea of speed walking. This low impact workout still provides an excellent cardiovascular workout and promotes muscle strength and joint mobility. Speed walking up hills or on an inclined treadmill can be more difficult than running if you’re unaccustomed to such a routine.

4. Power Yoga

This form of yoga gets your heart pumping and works to challenge the muscles and the mind as you move through various poses. In addition to helping improve joint and muscle flexibility, it provides a wonderful opportunity to strengthen the lower body in multiple planes and directions.

As hard as it can be to stop a sport you love, it is so important for your rehabilitation and recovery to allow your muscles and joints some rest and protection. Finding alternative ways to exercise may help bridge your return to running, and also may open a new door to cross training, which may lessen your chance for injuries down the road.