"Take time to listen to your body and its aches and pains." -- Christopher Mazoué, M.D.

Reducing The Risk Of Men's Overuse Injuries
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They’re all over Columbia: lifting weights in the gym, working up a sweat on the racquetball court, and jogging miles through neighborhood streets. A look around town will find an abundance of middle-aged men exercising in a variety of ways.

And while pursuing an active lifestyle has obvious health benefits for men, it doesn’t come without risk. Taking on a new sport or increasing the frequency or duration of a sport can take its toll on the body if not done properly. The result? Overuse injuries. Unlike acute injuries, these are subtler and usually develop over a period of time. They result when the middle-aged athlete causes ongoing trauma to the tendons, bones and joints through a repetitive force such as a golfer’s downswing or a tennis player’s backhand. As a man continues to exercise, despite mild discomfort or even nagging pain, the injury becomes chronic.

Overuse injuries can occur when exercise is undertaken in a manner that is too much, too quick for the middle-age man. Adequate time isn’t allowed for the body to recover between outings. Such can be the case with the increasing number of 40 and 50-year-old men who have started training for marathons and can end up in the doctor’s office with runner’s knee or another running injury. “You can be a recreational runner who’s accustomed to doing three miles a couple of times a week. Then you decide to prepare for a marathon and increase the distance of your runs and how often you do them. That’s a lot of stress on the body and oftentimes the body can’t handle that,” Dr. Christopher Mazoué, an assistant professor in the Department of Orthopaedic Surgery.

It’s not unusual for men to show up in Dr. Mazoué’s office suffering from rotator cuff tendonitis and impingement syndrome, two overuse injuries that affect the shoulder. “In the course of common activities like softball and tennis, there is a lot of stress put on the rotator cuff muscles,” said Dr Mazoué. “We see this all the time,” he added.

Poor technique can play a role in an overuse injury, with beginners not taking adequate time to learn their new sport. “The problem with men is that we tend to be very competitive and tend to jump into things and not necessarily think about the consequences,” said Dr. Mazoué. He added, “Not taking the time with the proper technique and not warming up before and after an activity contributes to the risk of injury.” With knee injuries, a man’s particular body structure and genetics can also factor in. “The alignment we are born with certainly plays a role such as having a flat foot or a high arch,” Dr. Mazoué said.

Dr. Mazoué often finds that men tend to cope with an overuse injury, such as golfer’s elbow or tennis elbow, for a number of months before they consult a doctor. “By going to the doctor, men are forced to acknowledge that they are not as young as they used to be and that their injuries are not healing as quickly as they used to,” he said. After a full history and physical for a new patient, Dr. Mazoué orders any necessary x-rays to rule out other possible causes of pain such as tumors or fracture. Then he initially talks with the patient about non-operative ways to treat the injury, such as using anti-inflammatory medications, modifying activity for a period of time, and physical therapy. “We typically talk about a gradual progression back into activity,” he said. Sometimes additional intervention is necessary. With rotator cuff injuries and impingement syndrome, for example, that could mean steroid injections or even surgery. “Yet the vast majority of men will improve without requiring surgery for these conditions,” Dr. Mazoué interjects.

Concerned by the rising rate of obesity, Dr. Mazoué wants to see men continue to choose to exercise. “The more weight you carry, the more stress on your body. For long term health it’s very important that we control our weight and our percentage of body fat,” he said. He stresses that approaching exercise correctly is the key. “Take your time and listen to your body and its aches and pains. While the common expression is ‘no pain, no gain,’ at this age and stage of life, a lot of times that doesn’t necessarily hold up.”

Reprinted from Connections newsletter, October 2006.

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