Sports and exercise can put the hurt on

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Sports and exercise can put the hurt on

By Sal Ruibal, USA TODAY 5-12-2005

Americans love to run, bike, golf and hit home runs

for their rec softball teams, but all that sports

activity accounts for a big chunk of the nation's

pain.

Dr. Freddie Fu, left, tests the stability of Barrett

Woods' right knee at the University of Pittsburgh

Medical Center for Sports Medicine in Pittsburgh, Pa.

By Eileen Blass, USA TODAY

According to a USA TODAY/ABC News/Stanford University

Medical Center poll, of the people who said their last

experience with pain was the result of a specific

condition or injury, one in five blamed a sports

injury.

The National Institutes of Health estimates that

adults age 25 and older sustained 2.29 million sports

and recreational injuries annually from 1997 through

1999, the most recent years they've conducted surveys.

Few people in America have more experience dealing

with that avalanche of ache than Carmichael and

Freddie Fu.

Fu, one of the world's leading sports orthopedic

surgeons and a medical adviser to the Pittsburgh

Steelers, spends his days rebuilding the battered

bodies of both NFL warriors and weekend wannabes at

the University of Pittsburgh Medical Center.

At the recreational level, Fu says, many of the

injuries are a result of the " too " syndrome.

" People run too much or play too long and then come

back too soon after an injury, " he says.

Carmichael is a former Tour de France rider who is now

coach to Lance Armstrong and a host of other top

endurance athletes. He has ample experience with every

shade of pain, from simple workout weariness to the

searing agony of a high-speed crash that rips muscle

from bone.

Carmichael rejects the " No pain, no gain " philosophy

of old-school coaches and trainers.

Four steps to stay on the move

For minor pain from sports injuries, most experts

recommend the R.I.C.E. method to relieve aches and

inflammation.

REST: Take a break from your sport and cut back on

daily activities as needed.

ICE: Apply an ice pack to the injured area for 20

minutes at a time, four to eight times a day. A bag of

frozen peas or other small vegetable works well and

molds to the shape of the injured body part. Reuse the

bag when needed, but don't eat the food, because it

will have been thawed and refrozen. Carmichael

says any injury that needs icing after every workout

should be checked by a doctor.

COMPRESSION: Compression of the area can help reduce

swelling. Compression can be achieved with elastic

wraps available at most drugstores or special gear

recommended by your doctor. Heat can be applied at

this stage, but not immediately after an injury.

ELEVATION: Raise the injured body part above the level

of the heart to help decrease swelling. Carmichael has

his cycling athletes elevate their legs for at least

five minutes after every workout ride or race.

Source: National Institutes of Health and Carmichael

Training Systems

" The best way is less pain, more gain, " he says. " But

to do that you have to understand exactly what type of

pain you are experiencing. Then you can take care of

it in the proper way. "

At the simplest level, sports pain can be divided into

two categories: acute and chronic.

" Acute is when you step into a hole, " Carmichael says.

" It is traumatic and immediate, with loss of mobility

in the affected area. "

Chronic pain is harder to define, Fu says.

" It is usually the result of overuse, or a significant

change in the amount of training one is doing, " he

says. " You'll get pain while doing the activity and

some swelling later. It can even manifest itself as

pain in a different part of the body; some knee pain

is actually related to back injuries. "

If you suffer from those symptoms, you should probably

consult your physician.

But there is good pain, or at least aches that come

from normal athletic activity.

" Many athletes develop what is called DOMS, delayed

onset muscle soreness, " Carmichael says. " It is an

ache that can last from 10 to 24 hours after a

workout. "

He has his athletes take part in " active recovery " to

help reduce muscle inflammation.

" Some light stretching after a workout is good,

especially if you sip a carbohydrate drink to

replenish the energy stores in your muscles, " he says.

" There's a 30- to 60-minute window after a workout in

which your muscles maximize their ability to replace

fuel burned during activity. "

Lance Armstrong follows that routine after racing a

stage in the Tour de France, Carmichael says. The

six-time Tour winner takes recovery even further with

nightly massage and chiropractic sessions.

" Even a weekly massage can do a lot of good for

recreational athletes, " Carmichael says.

Fu suggests that athletes do some fast walking or easy

jogging, followed by stretching, before they hit the

tennis court or softball field.

" Never go out cold, " he says.

There is a danger to overusing over-the-counter

medications. " Follow the dosage levels carefully, " Fu

says. " You can cause kidney damage by taking too much

ibuprofen. "

The worst thing, both agree, is pretending that the

pain will just go away.

" It is important to back off from your sports activity

when injured, " Fu says. " Playing through acute pain is

dangerous, and ignoring chronic pain can make a simple

injury much worse. "

Dr. DeSiena, D.C.

Washington Street Chiropractic Center, L.L.C.

771 Washington Street

Eugene, OR 97401

(541) 686-BACK (2225)

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