Advice for the Weekend Warrior

By D. Hodari Brooks, MD

As a practicing orthopaedic surgeon, a fair number of patients I see on any given day present with injuries that have been sustained during physical activity, literally performed on the weekend. The typical patient it someone who is 30-50 years of age and who does not engage in regular exercise, but who participates in various sporting events on the weekend. It is not uncommon for my patients to give a history of showing up “late” for a sport, such as tennis. Instead of taking the appropriate time to warm up and stretch, these patients simply change and run out on the court and start playing. This lack of stretching, combined with lack of regular activity, sets up the perfect storm for minor and major injuries to occur.

The Shoulder: a common injury involves strains of the rotator cuff. This is a group of four muscles that help to elevate the arm above shoulder level and are also involved with throwing. Activities such as serving in tennis and weight-lifting can commonly cause this injury. The most effective initial treatment is rest and limiting overhead activity for at least 7-10 days. In addition, anti-inflammatory medication can be helpful. When pain persists, then evaluation by an orthopaedic surgeon is recommended.

The Knee: the typical injury that I see involves the menisci, which function as shock absorbers for the knee. They can be injured particularly with twisting, non-contact injuries. For example, playing a sport such as basketball which involves running, quick stopping, and sudden changes in direction, can result in meniscal strains, partial tears and/or complete tears. Initial treatment for a knee injury involves ice, elevation and limited weight bearing. In addition, one should initially limit repetitive bending and squatting. When full tears are present, then outpatient surgery is often necessary for complete resolution of symptoms.

The Ankle: while the most common injury I see is an ankle sprain, the Achilles tendon is an area that is frequently injured and often requires surgery. The Achilles is particularly vulnerable in running, cutting sports and has an especially lengthy recovery period that often exceeds six months. Typically patients with Achilles tendon injuries feel as if they were “kicked” in the back of the leg. The Achilles is particularly vulnerable to those weekend warriors who do not stretch prior to activity. The lack of regular exercise decreases the elasticity (ability of stretching) and thus when subject to abnormal stress, rupture is often the result. While initial treatment for ankle injuries involve ice, elevation and restricted weight bearing, if you develop prolonged symptoms or pain over the Achilles tendon then evaluation by orthopedic surgeon is advised in a timely manner.

In conclusion, I would like to re-emphasize the importance of stretching for every athlete. Stretching increases the amount of stress a muscle or tendon can bear before tearing. It is important to indicate, however, that active stretching, where you stretch without assistance, is preferred to passive stretching, where someone else provides the resistance. I would also like to encourage all of us who are weekend warriors to become more active with routine exercise during the week. Even an exercise program consisting of 30 minutes of aerobic exercise three times a week can have a dramatic improvement on our over-all physical health and ability to tolerate increases in intensity.