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Rosemarie Battiato, MPT Outpatient Administrator
Summer brings a host of aches and pains caused by our desire to get outside and do something, after being cooped up all winter. Most of us come out of winter hibernation to hit the tennis courts, soft ball fields and golf courses. We are weekend warriors catching up after a dormant winter.

What this brings us is aching joints, pulled muscles, strains and sprains. All of this still doesn't outweigh the risks of not exercising. The benefits far outweigh the risks. The key is to exercise on a more regular basis versus just being a part-time athlete.

The following are common injuries caused by weekend athletics and some considerations for return to activity.

Back Pain
Our backs take a life-time of beating between poor posture and poor body mechanics. As we age, many of us develop degenerative disc disease and narrowing of our spinal canal. Slow and steady is the way to go. Physical therapists can design an exercise program to strengthen and stretch back and abdominal musculature. They can also instruct you in proper body mechanics and posture.

Knee Injuries
Knee injuries are very common as well. The knee is not a very stable joint as it bears much of the body's weight. If the position of the knee is not perfectly aligned during various recreational activities there is an increased incidence of patellar femoral problems (or knee pain).

"Runner's knee" is a very common condition often seen is the general population. It is caused by compressive forces of running and also malalignment of the thigh and knee joint. Approximately 95% of people with knee pain can be treated with a conservative approach. Supportive sneakers with good arches are very important for shock absorption. Perhaps the individual may need orthotics or arch supports to keep the foot in a neutral position. If physical therapy is warranted, after careful evaluation, the therapist may choose exercises that strengthen the muscles around the knee joint. These could include: Straight leg raises, short-arch knee extension, and standing squats. Other options could include biofeedback, electrical stimulation or bracing.

Shoulder Injuries
Another mobile but unstable joint is the shoulder. The shoulder allows for movement in multiple directions and planes and because of this, it is susceptible to injury and dislocation. Age-related changes occur in the shoulder such as decreased blood supply to the rotator cuff muscles, impingement due to poor posture and arthritic changes. Over head activities increase the likelihood of injuries. A thorough evaluation of the shoulder joint is required to determine what's wrong. Treatment could include strengthening the shoulder's internal and external rotators, stretching, ultrasound, rest or nonsteroidal anti-inflammatory medication.

Plantar Fasciitis
Plantar fasciitis is another common injury. This condition causes severe heel pain. It a classic repetitive stress injury that may occur in a normal or abnormal foot. The majority of those who suffer from plantar fasciitis have over pronated or (flat feet). An over pronated foot causes over-stretching of the plantar fascia which acts like an elastic bridge to support the foot. This inflammatory condition is associated with prolonged standing, intense walking, stepping or running. If treated early, this condition may improve, ignoring the symptoms of heal pain can lead to disabling results. The goals of therapy include controlling abnormal biomechanics of the foot, decreasing inflammation, and improving flexibility of the calf musculature. Treatment may consist of rest, fabrication of foot orthotics, iontophoreis (which is a form of electrical stimulation), stretching of the plantar fascia and strengthening of muscles that cross the ankle joint.

Tennis Elbow (Lateral Epicondylitis)
Tennis elbow or lateral epicondylitis is a disorder caused by a faulty backhand stroke involving the forearm tendons originating at the elbow. Playing tennis is not the only cause of tennis elbow. Activities such as gardening, bowling, racquetball and squash can also cause tennis elbow. Constant improper grip on a racket or tool increases the likelihood of tennis elbow. An occupational or physical therapist can provide therapeutic management to decrease or eliminate the pain associated with this condition: ice massage to the elbow, cross-fiber massage, ultrasound, strengthening wrist and elbow muscles, stretching of wrist muscles. Iontophoresis is another option to help alleviate this painful condition. Education on the use of proper equipment and proper technique is very important to prevent further injury.

Most summers bring about some sort of heat wave. Too much heat is not good for anyone and can cause hyperthermia (increased body temperature) or even heat stroke. Ways to avoid injury are to drink plenty of fluids, like water or fruit juices. A healthy amount would be about 8 glasses per day. Avoid drinks containing caffeine and alcohol as they have a tendency to cause dehydration. Don't exercise in the middle of the day; try to find times in the early morning or later in the afternoon or evening. Dress appropriately with light-weight cotton clothing not synthetics.

The message to the recreational athlete is to begin to exercise slowly and cautiously. Some aches and pains are normal and to be expected, however, if discomfort lasts for more than a week, you should consult a doctor.