Health & Fitness

Weekend warriors: You’re not 20 anymore

Firefighter Gabe Arteaga runs along the Rickenbacker Causeway as he trains for a Navy SEALs challenge. He has recovered from ankle surgery on a severe break that normally would have meant his running days were over.
Firefighter Gabe Arteaga runs along the Rickenbacker Causeway as he trains for a Navy SEALs challenge. He has recovered from ankle surgery on a severe break that normally would have meant his running days were over. adiaz@miamiherald.com

When firefighter Gabe Arteaga severely fractured his ankle three years ago, doctors said he would never run again. He told the doctors, “I’m not going to just run, I’m going to race.”

It took intense physical therapy, a second surgery to repair scar tissue and loads of willpower, but in March, the 43-year-old ran the Miami Beach Half Marathon and placed 14th in his age group, 66th overall. Now he’s running with a 50-pound backpack to train for a Navy SEALs-inspired 24-hour endurance race in the Georgia mountains.

Part of his success is that he “has excelled with training techniques which will prevent future injury,” said Dr. Thomas San Giovanni, a foot and ankle specialist with Miami Orthopedics & Sports Medicine Institute with Baptist Health.

Proper techniques are crucial for anyone wanting to get back in shape without injury.

This is particularly true for weekend warriors, whom sports medicine physiatrist Dr. Ivor Nugent defines as “athletes or former athletes over 30 whose lifestyle doesn’t allow them to exercise regularly.”

“They kind of pack it all in in a weekend. Their memories are too good. They remember what they could do, and try to exercise at that level without the proper preparation,” said Nugent, a board-certified sports medicine rehabilitation doctor with Memorial Healthcare System in Hollywood.

Common injuries

The most common injuries are “any type of sprain or strain of the ankle, knee, elbow or shoulders,” said Dr. Clifton Page, primary care sports medicine physician at UHealth — University of Miami Health System. “All of these can occur when the body’s not properly warmed up or properly conditioned,” Page said.

“The general rule is to get a little bit of sweat, whether that’s 10 minutes on a bike, jumping rope, jogging in place or jumping jacks” to get your muscles warmed up and your heart rate elevated before you start exercise or playing your sport, Page added.

For people getting back into shape, Page said: “A big injury is stress fractures. The one we see is a tibial (shin) stress fracture, then you have hip and lower back [stress fractures], that leads to the next injury — lower back pain.”

Aerobic exercise, flexibility training and muscle strength are the three types of conditioning for getting in shape, Page said.

“If you were an athlete, you may know the proper training techniques. If you were not an athlete, I recommend that you be supervised for one session or two so that you learn the proper way to lift weights,” Nugent said.

If you don’t want to go to a gym, you can use your body as a weight, sitting against a wall and doing dips, or using a chair and pushing your body up with your hands, or using a chin-up bar.

A strong core is key

Both Page and Nugent stress the importance of a strong core in avoiding injury.

“I think the [body’s] core is an essential link connecting the upper and lower body. You can consider that the trunk is in the middle between the arms and legs. Watch professional runners. The arms and legs are moving and the trunks are rock solid,” Page said.

You can strengthen your core by strengthening your abdominal and back muscles simultaneously. Some exercises would be push-ups, planks or the Spider-Man walk, in which you get down on all fours, then walk with your hands and feet.

Having a good core, Page said, “improves sports performance, posture, helps prevent low back pain, helps you breathe better and trims down your waistline.”

“If your core is not strong, it puts more stress on the lower back, knees and ankles.” Page said.

A lot of injuries are sports specific. With basketball, it’s ankle sprains; with tennis, tennis elbow. Runners tend to get shin splints, stress fractures, ankle sprains and knee injuries.

While an ACL injury — tearing of a knee ligament — is more common in athletes paying contact sports, it can plague weekend warriors. “Most commonly there’s no contact, but your foot gets stuck or you land awkwardly and you have a twisting injury to the knee,” Nugent said. Proper landing techniques, with your knees bent, and a strong core can help prevent knee injuries.

Runners, start slowly

San Giovanni, co-medical director of the Miami Marathon, said 50 to 60 percent of new runners will be sidelined with injury, often because they try to do too much, too fast, too soon.

For beginners, Page suggests running for a minute, then walking for a minute until your cardiovascular fitness is such that you can run for 15 minutes.

San Giovanni recommends running every other day at first, keeping mileage low and mixing it up with lower-impact exercise. “Take some days where you’re swimming or biking,” Giovanni said.

Runners can get plantar fasciitis, an inflammation of the tissue that connects the heel bone to the toes, from using very minimalist shoes or running on uneven surfaces, San Giovanni said.

Miami-Dade County Commissioner Xavier Suarez aggravated a condition called hammertoe by running barefoot in the sand.

“When I run, I tend to do jumping exercises as well, making one of my toes into a bit of a mess. Where the toe meets the foot, it was rubbing bone against bone,” Suarez recalled.

Since surgery to correct the condition, Suarez said he runs with properly cushioned shoes on smooth surfaces.

“The really ideal thing I do is the elliptical. There is no impact on the joints at all,” Suarez added.

Even people with prior injuries or bad knees can be active, as long as they check first with their doctors. The elliptical is good for people with bad knees, as are low-impact sports such as swimming and biking. “Biking is the single best exercise for your knee,” Nugent said.

As Arteaga, the firefighter, advises, “I tell people you need to stay active. If you stop, your body will stop.”

Top sports injuries in adults

▪ Ankle sprain

▪ Groin pull

▪ Hamstring strain

▪ Shin splints

▪ ACL tear

▪ Runner’s knee, pain in kneecap

▪ Tennis elbow

▪ Rotator cuff

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