HEALTH & FITNESS : Keeping Yourself in the Game

In pursuit of a fit and healthy lifestyle, North County residents have pursued all the usual routes--walking, cycling, running--and quite a few of the unusual routes, too. They climb rocks, chase trails marked with flour and ride their bicycles in circles.

For every variation in taste, schedule and physique, there seems to be a route to fitness out there. Some folks have charted their own way, others have connected with an established program. Whatever your own program or lack thereof, fitness starts--or ends--with a good night’s sleep. And whether you exercise occasionally or often you’ll feel a whole lot better if you do it without injury.

If you’re ready to get up and get going, still just thinking about it, or looking for new ways to put yourself through your paces, we offer these suggestions for getting the lead out:

It’s possible to carry athletic hero worship just a little too far. Wearing Air Jordan basketball shoes, Tony Gwynn batting gloves and Steve Timmons volleyball shorts is one thing.

But how about Nolan Ryan rotator cuff swelling? Or an Alberto Tomba meniscus tear? Maybe a little Jimmy Conners tendinitis? Yes, you too can suffer the same sports injuries the great ones suffer.

The best prevention say physical therapists and doctors is to stay in shape and do not overextend your abilities. Always warm up. Cardiovascular fitness helps prevent injuries by keeping athletes alert and in control for the duration of their workouts or games. Good fitness also enables those who do suffer an injury to recover faster.

Dr. Richard Parker, a primary care sports medicine specialist, said most common sports injuries can be treated by what he called RICE: rest, ice, compression and elevation. Never aggravate an injury by dismissing it and continuing to use the injured joint or muscle as usual.

Many doctors now favor some continued, but limited, use of swollen areas after evaluation by a physician. Complete immobilization allows fluids to accumulate, whereas limited movement helps eliminate these fluids.

North County residents enjoy a variety of recreational sports, but sometimes end up suffering some painful consequences. Here are some of the most common sports-related injuries seen by area sports therapists and physicians:

Softball

An increase in softball injuries is a pretty sure sign of spring. One common injury is a ligament sprain around the ankle and knee from sliding, Parker said. Most weekend softball players do not know how to slide safely. Poor technique sometimes results in sprains or torn ligaments.

According to Poway orthopedist Dr. James Bried, rotator cuff damage, the same injury that bedevils Major League pitchers, also visits softball players. Constant repetitive motion, especially on an out-of-shape shoulder, can cause the cartilage of the shoulder joint--called the rotator cuff--to become inflamed.

“In softball, you run into a situation where you can play until you are 65 years old or more,” Encinitas physical therapist Tom Simmons said. “Most people do not have the opportunity to tune the body up prior to playing. And if they are already at risk because of other factors, it does not take much to put you over the edge.”

Volleyball

Rotator cuff problems also take a big toll on the shoulders of volleyball players. According to Karen Stolp de Peralta, a physical therapist with Scripps Clinic and Research Foundation, volleyball players often visit the clinic for rotator cuff therapy.

Even healthy, fit people can fall victim, De Peralta said. “People do not think about rotation,” she said. “They lift weights for their pecs or lats but do nothing for the back of their shoulder.”

According to De Peralta, rotator cuff injuries can often be prevented by strengthening the back of the shoulder with dumbbell or pulley workouts and extensive warm-up periods before a workout or volleyball game.

Volleyball players also sees their share of hand injuries, such as jammed fingers.

Another sore spot is the knee, where a common injury is meniscus cartilage tears. This happens when the knee, made to bend forward, is forced to twist sideways, as when a volleyball player turns suddenly. If the tear is serious enough, it will require surgery.

Running

Running puts joints under enormous pressure--about four times the body weight of the runner.

One common condition that runners face is excessive subtalar pronation, often confused with flat feet. This condition forces the foot to land improperly so connective tissue like ligaments and tendons are placed under abnormal stress in the hips, back and legs. The result can be stress fractures, tendinitis and softening of the knee cartilage.

It is essential for runners to have shoes in good condition. Shoes should be replaced every 300 to 500 miles. Broken down shoes can lead to tendon swelling or even ankle sprains. As the sides of the shoes wear, they may allow the foot to roll over slightly on impact. If this becomes serious, runners may wind up with a sprain.

Insufficient stretching and warm-up exercises can result in running injuries. Runners often suffer pulled, strained or torn muscles. The Achilles tendon can become strained, or even torn, if it is not stretched before running.

Surfing

Surfers suffer a variety of injuries to knees, backs and necks. Wipeouts on waves account for most of the damage. Sometimes surfers will hit the bottom of the sea floor on the backs of their heads, straining neck muscles. Shoulder separations and knee strains, the result of being pounded by tons of water, also put surfers out of commission.

One condition unique to surfers is called otostenosis. This is a bony growth that narrows the outer ear canal when it is exposed to cold winds and cold water, the environment along North County beaches. If the condition becomes aggravated enough, surgery will be performed to reopen the canal.

Recently, surfers have been suffering from a variety of skin diseases and ear infections called otitis externa from surfing in polluted waters. Some surfers have gone so far as to ask for hepatitis shots so they can continue to surf in areas where the water has become contaminated by sewage spills.

Skiing

Although the ski season is winding down, some skiers will be licking their wounds for months. That’s because skiing has a high rate of injury--it is considered more dangerous than professional boxing. The reason is speed. Average skiers can reach speeds of 30 or 40 m.p.h., and when an out-of-shape weekend skier collides with another skier, a tree, or even takes a flying leap and winds up in the snow, a crippling injury could result.

One factor is the equipment itself. “Skiing is where we see the most severe types of injuries,” Simmons said. “With fast speeds and this long lever arm on your foot, you can do something pretty severe.” Boots both help and hurt. Newer boots have been successful in preventing so-called boot-top fractures, breaking the leg just over the top of the boots. But, Parker said, the next vulnerable spot up the leg is the knee, which is not meant to be subjected to the tremendous rotational stresses a fall can inflict.

A serious knee injury that Bried sees is anterior cruciate ligament damage. Until several years ago, an injury to the ligament was considered a permanent injury. Surgery for this hidden knee ligament is now possible, though, and athletes can return to form.

Also . . .

Other sports that physicians and therapists cite as commonly producing injuries include pick-up basketball games (sprained ankles) and tennis (rotator cuff, meniscus tears).

Athletes are susceptible to illness from both heat and cold. Heat stroke and hypothermia are both dangerous and potentially deadly. But they are easy to prevent--just don’t exercise vigorously when it is extremely hot, and dress warmly when it’s cold.

Tinea versicular is another condition suffered by a variety of athletes. This is a fungal skin disease spread by sweat. It causes pale mottling of the skin and is especially visible on a tan person. It is easily cured by using a solution prescribed by dermatologists. A variety of over-the-counter medications are available to treat the relatively minor--but irritating and very common--fungal infection known as athlete’s foot.

All athletes, but especially endurance athletes, can overtrain. A heavy schedule of physical exercise stresses all body functions, including the immune system. If the immune system is compromised, athletes can begin to suffer chronic viral and bacterial infections in what Parker called “overtraining syndrome.”

What’s the safest sport?

Most experts agree it is probably swimming. Although ear infections are common and some swimmers suffer overuse injuries like rotator cuff problems, the biggest advantage is that musculo-skeletal stresses are greatly reduced in the water.