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Screened & Examined: Advice for Weekend Warriors: Warm Up, Cross-Train, Run Barefoot (and Don't Forget the Insoles)

Ballard, Dustin MD

doi: 10.1097/01.EEM.0000399687.28256.1b
Screened & Examined
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My Sunday hoops game is a testament to the limitations of the human body; athletic tape is more plentiful than cartilage in this crowd. But it's also a tribute to perseverance. Why else would these blacktop veterans continue to play a game that takes such a toll on the body? Good question!

The following commencement address on recreation-related trauma is shamelessly modeled after an old Chicago Tribune column popularly known as “Wear Sunscreen.” My aim is to provide some flecks of wisdom for readers who, like me, are graduates of their competitive prime.

Fellow aging athletes, if I could offer you only one tip for your athletic future, a pair of shoe insoles would be it. The benefits of insoles are self-evident; well, at the very least, the benefit of having feet is self-evΩident. And if you are going to have feet and use them for activities that make them hurt, you should try insoles. They just might help.

Now, like insoles, the rest of my advice to weekend warriors and middle-aged rec league contestants has an inconsistent basis in medical science, and is to a large degree a product of my own experience.

Enjoy the pain and hardship of your sport. Actually, that's bull; you cannot possibly appreciate how much the pain and hardship of your sport pounds your joints into submission. But trust me, 20 years from now you will look back with the ache of nostalgia at the way you used to move.

Warm up before the game. Hopefully your P.E. teacher taught you that. And realize that stretching alone doesn't count; calisthenics in the sauna most definitely do.

Stop and collect your gear. Sometimes you need the knee brace. Sometimes you need the ankle wrap. The risk of re-injury is always there, so in the end you might as well wear both.

Cross-train or cross-fit. Even if you prefer not to. The best way to limit the repetitive strain of the tennis court is to balance it with time on the yoga mat. And if you succeed in doing this, please tell me how.

Swim. It is good for you, as long as the lapping of monotony against your head doesn't drive you crazy.

Try running barefoot. But not all the time, and definitely not on gravel. If you need convincing, pick up a copy of Born to Run.

Don't be reckless with recovery time. Middle-aged athletes are like leftovers from the Olive Garden: not so good on the third consecutive day.

Don't worry about taking supplements; most of them won't help unless they are steroids, EPO, or HGH, and I'm not going there. Do worry about taking over-the-counter painkillers. They do help, at least temporarily. But realize that taking too much ibuprofen is about as good for your stomach as pounding a pint of bleach. The real troubles, though, will come from the nagging pains that you ignore, like the twinge in your calf that warns that your Achilles tendon is about to snap.

Try acetaminophen first, but please don't exceed recommended doses: A liver is a good thing to keep. Teeth are also nice to have, so if you play a contact sport, wear a mouthguard. If you knew how much a dental implant costs (I speak from experience), you wouldn't ignore this accessory. It is clinically proven to decrease visits to the oral surgeon.

Pay attention to your diet, especially before and after strength workouts. Lowfat chocolate milk is probably just as good as a protein shake, and it tastes better, too.

Understand that many therapies — massage therapy, hydrotherapy, even aromatherapy — may be pleasant and relieve pain, but they do not improve performance. If you find one that does, hold on to it, for it is precious.

Take it slow with new sports. They will make your muscles ache. Like facing your property tax bill, the best way to limit shock to the system is by giving yourself time to adapt.

Most lower back pain will eventually get better, and for pain alone, surgery probably won't help. Weight loss, core muscle strength, and physical therapy probably will. I like to prescribe myself daily backrubs from my honey.

Don't feel guilty about not wanting to move on. So what if you are playing hoops against men half your age? Some of the greatest days on the court are those when you unexpectedly feel young.

Know when to ice it (right away), know when to heat it (a couple days later), and know when to walk away (consult Brett Favre on this one).

Maybe you run a quadruple marathon for kicks, or maybe you power walk a few laps on the weekends. Maybe you ride single track unicycle, or perhaps you stick to the straight, flat, and paved. Maybe you can surf 20-footers before a tsunami, or perhaps you wait for the two-foot swell. Whatever your passion and your skill, take care of your body, and get plenty of sleep, too.

Accept certain inalienable truths: All athletes will get injured, and the older you are the longer the recovery. You, too, will retire one day. And when you do, you may fantasize that you were as springy as LeBron or as shifty as Pelé. I know I will.

Be careful with the advice you heed. But be patient with those who supply it. And realize that some physicians may be better at giving advice than following their own.

But trust me on the insoles. Occasionally, I even wear them myself.

Comments about this article? Write to EMN atemn@lww.com.

Dr. Ballard is an associate emergency physician at Kaiser-Permanente in San Rafael, CA, and the chair of the CREST ED Research Network. His writing credits include co-authorship with Angela Ballard of the award-winning travel narrative A Blistered Kind of Love: One Couple's Trial by Trail (Mountaineers Books, 2003) and authorship of The Bullet's Yaw (IUniverse, 2007). Dr. Ballard writes a biweekly-medical column for the Marin Independent Journal, which he posts on his blog:http://incisionanddrainage.blogspot.com.

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