As the hangovers clear on yet another festive season, I thought that I would get in early and write a blog on New Year's resolutions. Specifically, how best reduce the risk of injury upon resuming exercise after a prolonged period of time away from exercise.
The reason behind this is very simple: Without fail, each and every mid-late January, I get an influx of people coming into the clinic with an array of injuries that include lower limb tendinopathies (achilles & gluteal), calf/hamstring strains, rotator cuff injury, lower back and neck strains, that were all sustained during an attempt to try and get "fit and healthy" for their New Year's resolution. Ie. They resumed exercise after a prolonged period away from exercise.
For the most part, a majority of these injuries are due to the obvious: A rapid increase in exercise volume and intensity from previous levels of physical activity. However, a majority of these injuries could have also been prevented with an appropriate exercise plan.
So without further ado, here are my 8 pieces of friendly advice to minimise your chances of getting injured through the New Year period so that you can stick to your New Year's resolution of getting fit and healthy, and sustaining this physical activity right through the entire year and beyond:
Note: As you can see I have written this blog aiming it at the patient/client, so feel free to share these simple evidence-based messages to your patients/clients.
1. Don't be tempted to start that boot camp just yet. Simply start by getting off the couch and move most days per week. This sounds very basic I know, but if you haven’t regularly walked, cycled or swam for 45mins, 3-5x per week for the last few months, how on earth do you think you'll cope with running, jumping, boxing and doing push-ups and burpees for 45mins, 5x per week?
2. Compliment cardiovascular exercise with some simple body-weight exercises: You don't need fancy gym equipment and extra load when you're first starting out, but the increased nerve drive to the working muscles from 2-3 weeks of body-weight exercises such as chair squats, step ups, sidesteps, calf raises, bench/knee/toe push ups and side planks will put you in a good place to start some heavier lifting (if you want to) in late January. 2-3x strength sessions per week is all you need.
3. Don't shy away from strengthening exercises: Strengthening-alone has been shown in a systematic review of 26,000 participants to be far superior to stretching-alone in reducing the risk of "overuse" injuries by 50% and reduces the risk of acute injuries by 30% (1).
4. If you MUST do boot camps, or Crossfit, or F45, or other forms of high intensity interval training, do so 2x per week ONLY (non-consecutive days) for the first 2-3 weeks and increase to 3x per week, then to 4x, then to 5x slowly and progressively thereafter.
The other 2-3 days of the week can be filled with low-moderate intensity exercise (maximum 6-7/10 rate of perceived exertion) such as walking, bike riding, swimming, pilates, yoga. The reason for this is that it takes 48 hours in trained individuals for muscles to recover from a dose of high intensity exercise (2), and 72 hours for tendons to recover from a dose of high intensity exercise, and any attempt to do back-to-back days in untrained individuals will soon result in an "overuse" injury.
5. Don't forget to sleep! For all your training to take hold and for your body to adapt to the exercise that you are doing, your body needs sleep. The National Sleep Foundation recommends that adults require 7-9 hours sleep per night. For more information, including how to improve the quality of your sleep, see previous blog here.
6. Use sessional RPE (sRPE) to monitor exercise loads and use it to plan and progress future exercise plans. sRPE is an evidence-based way to measure load and predict future injury and I have previously written about this; see previous blog here. To summarise, every training session you do is measurable. Simply multiply the session time (mins) by a score out of 10 (rate of perceived exertion; 0 = asleep, 10=maximal effort). And remember, "High loads are not the problem. It is how you get to these high loads that is" - Tim Gabbett. Also, don’t progress exercise loads by more than 10-20% per week! (3)
7. Set realistic goals: If your goal is to lose 10kg in 1 month, it’s time to get a reality check. This weight loss is simply not sustainable and you will most likely get injured and end up in tears through disappointment of not achieving your goal. Be sensible; 0.5-1.0kg per week is a more realistic and sustainable way to try and lose weight.
8. Don’t forget to factor in rest days! In similar ways that less sleep equates to higher injury rates and poor physical and mental performance, studies have shown that those people who have less than 2 rest days per week, have a 5x increased risk of overuse injury than those who have 2 or more rest days per week (4).
So there you have it, my 8 big tips to safely getting started on an exercise program after a prolonged break from exercise so that you can stay on track and achieve your goals. I understand that nutrition plays a significant role in achieving your training goals, but as this is not an area of expertise of mine, I have purposely not addressed nutrition, but will gladly point anyone interested in the direction of some excellent dietitians.
In closing up, I know that I've given a very broad overview on how to avoid overuse injuries when embarking on an exercise program, and I completely understand that every person is different in regards to their exercise tolerance, so please remember to consult with your GP, physiotherapist or exercise physiologist before commencing any exercise or strength training program to make sure that it is tailored to your fitness level, but importantly, it is SAFE and SUSTAINABLE for the whole of 2020 and beyond!!
For those of you are interest in learning more about DECREASING injury risk and INCREASING athletic performance, Dr Tim Gabbett did a 2hr Masterclass for www.learn.physio!
You can watch it as often as you like, and register the Masterclass as continuing education by clicking on this link. We hope you enjoy and learn something new!
1.Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British journal of sports medicine. 2014 Jun;48(11):871-7. PubMed PMID: 24100287. Epub 2013/10/09. eng.
2. Korak JA, Green JM & O'Neal EK (2015). Resistance training recovery: Considerations for single vs multi-joint movements and upper vs lower body muscles. International Journal of Exercise Science, 81 (1), 10.
3. Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? British journal of sports medicine. 2016 Mar;50(5):273-80. PubMed PMID: 26758673. Pubmed Central PMCID: PMC4789704. Epub 2016/01/14. eng.
4. Ristolainen L, Kettunen JA, Waller B, Heinonen A, Kujala UM. Training-related risk factors in the etiology of overuse injuries in endurance sports. The Journal of sports medicine and physical fitness. 2014 Feb;54(1):78-87. PubMed PMID: 24445548. Epub 2014/01/22. eng.