Tips and tricks from the pros.
When thinking about how to remain active in our mid-30s, 40s or 50s, choosing the right activities is key to balancing health and injury. At this life stage, we are usually past our peak athletic years but still enjoy working out or playing a few rec sports leagues – we have become “weekend warriors.”
Unfortunately, as we get older, injuries tend to happen more frequently, and we take longer to recover. That’s why it becomes increasingly important for us to find a balance between remaining active and preventing injuries.
Some examples:
- Lower risk: Low-impact aerobics, including classes (i.e., spin class), light to moderate weightlifting, doubles tennis, pickle ball, swimming
- Moderate risk: Boot camp (with high-impact jumping and landing exercises), singles tennis, softball, baseball, distance running
- Higher risk: CrossFit, basketball, soccer, football (and other high-impact cutting and pivoting sports)
For the more risk-averse who want to maximize their health while minimizing the risk of injury, you may want to stay in the lower or moderate risk activity ranges. This allows you to maintain a high level of health and fitness without the elevated risk of an injury that could result in pain, dysfunction or surgery and missed work or family time. For these reasons, most weekend warriors tend to gravitate toward lower and moderate-risk activities.
However, for those who live for playing basketball every morning before work or cannot imagine missing that post-work workout of the day (WOD) at your local CrossFit gym, then you should consider focusing on injury prevention techniques such as flexibility, core/low-back strengthening and agility drills to decrease your risk for injury during these high-impact activities.
It is important to maintain good cardiovascular health and to train by performing sprinting and cutting activities throughout the week. You should not be sprinting and cutting only when you play in that rec league on Tuesday night, as this will put you at higher risk for an orthopedic injury.
A proper warm-up and cool down can also help prevent injuries. This should include stretching, with a focus on Achilles/calf muscles, hamstrings and quadriceps muscles. Upper body stretching can include arm circles, starting small and getting progressively larger, gentle resistance exercises such as push-ups (on feet or knees) and elastic bands (if available). Consider finishing the warm-up with a brisk jog, ideally approximately 400m (which is equivalent to one lap around a track).
Common injuries in “weekend warriors” in their 30s to 50s include hamstring strains and tears, calf strains, Achilles tendon injuries, knee ligament and cartilage injuries, ankle sprains and shoulder/elbow tendon strains. Most muscle strains and tendon inflammation injuries can be treated with rest, ice, oral anti-inflammatories, activity modification, bracing and topical gels. Physical therapy can also be extremely helpful for muscle and tendon injuries to get you back in the game as soon as possible. Unfortunately, some tendon or muscle injuries could require surgical repair.
So how do you know which injuries may do well with conservative treatments and which may require surgery? Keep reading – we have listed some common injuries and typical treatments for our fellow mid-lifers that can help you out:
Overuse Injuries
What can you manage on your own, and when you should seek care:
Shoulder pain
If you can continue playing or working out despite minor shoulder aches or pain, you can consider a brief course of an over-the-counter anti-inflammatory (Aleve, Advil, Motrin), activity modification to avoid painful activities, and either home rehabilitation exercises or supervised physical therapy. The American Academy of Orthopaedic Surgeons (orthoinfo.aaos.org) provides outstanding home exercise programs that you can use as a guide:
Any nighttime pain or loss of function, which can include new-onset or progressive weakness or decreased range of motion, should prompt a visit to the doctor. In addition to a history and physical exam, the doctor may obtain X-rays and possibly an MRI to assess the extent of injury. Treatments include medication, physical therapy, injections and surgery.
Knee pain
Similar to shoulder pain, chronic or intermittent knee pain without swelling can often be successfully self-managed with anti-inflammatories, activity modification, and either home exercises or supervised physical therapy. If symptoms fail to improve despite these treatments, you should arrange for a visit to the doctor.
Elbow pain
This is most often tendinitis of the elbow from repetitive use such as lifting weights, playing a racquet sport or weekend honey-do lists. Tennis elbow (lateral epicondylitis) or golfer’s elbow (medial epicondylitis) are the most common causes of pain in the elbow, and affect the outside or inside part of the elbow, respectively.
Initial treatments include over-the-counter oral or topical anti-inflammatory medication (diclofenac gel), activity modification, home exercises or supervised physical therapy, and a counterforce brace that can be purchased at the pharmacy or online. Persistent pain despite a month or so of treatment should prompt a visit to the doctor.
Acute Injuries
What can you manage on your own, and when you should seek care:
Muscle strain/pull
Most muscle strains can be treated successfully without surgery. You may develop localized swelling, bruising, tenderness to touch and even the inability to use the injured muscle. These injuries are usually self-limiting and can be treated with ice, oral anti-inflammatories, rest and gradual increases in activity. However, if the pain, swelling and/or dysfunction are not improving after a few days, then it would be wise to see a sports medicine specialist.
Swollen knee
Any knee swelling should prompt a visit to the doctor. Knee swelling could indicate an injury to a structure within the joint, such as the cartilage, meniscus or a knee ligament.
In addition to a history and physical exam, X-rays and possibly an MRI will be obtained to determine the extent of the injury. After a physical exam and imaging has been completed, a treatment plan can be organized by the sports medicine specialist.
Ankle injury
If you are unable to or have great difficulty putting weight on an injured ankle, this should prompt a visit to the doctor. An X-ray will be obtained to rule out a broken bone. If you can bear weight on the injured ankle, then it can likely be treated with elevation, icing, oral anti-inflammatories and a walking boot for comfort. If the pain and swelling are not improving, then you should have it evaluated by a sports medicine specialist.
Shoulder injury
Shoulder injuries are most commonly muscular strains that occur from exercise and sports. Most acute shoulder injuries can be treated with conservative measures such as rest, ice, oral anti-inflammatories and activity modification.
Physical therapy can also be helpful in improving your shoulder pain. However, if you are having night pain, loss of range of motion or significant weakness in the shoulder, then you should be evaluated by a sports medicine physician. X-rays and sometimes MRIs are indicated for full evaluation of your shoulder injury so that a proper treatment plan can be formulated.
The purpose of this article is to provide the “weekend warrior” with practical knowledge to minimize the risk of injury with common fitness activities and sports. If you do suffer an injury, you now know when you can treat it conservatively at home or when you may need to be evaluated by a sports medicine specialist. And when injuries do happen that require a sports medicine specialist, the experts at Emory Sports Medicine can help you get back in the game.
Dr. Destin Hill
Dr. Hill is an assistant professor in the orthopaedics department at Emory University School of Medicine. He is a non-operative sports medicine physician based at the Flowery Branch office. Dr. Hill serves as a team physician for the Atlanta Falcons as well as for Atlanta-based Fan Controlled Football. He is also the head physician for Flowery Branch High School and provides sports medicine coverage for many events in Atlanta and Hall County.
Joseph Lamplot, MD
Dr. Lamplot is an assistant professor in the orthopaedics department at Emory University School of Medicine. He is a sports medicine surgeon at the Emory Orthopaedics & Spine Center in Flowery Branch. Dr. Lamplot serves as the medical director for Fan Controlled Football and is the associate team physician for the Atlanta Falcons. He is also head team physician for Cherokee Bluff High School and provides sports medicine coverage for many events in Atlanta and Hall County.
