5 Do’s and Don’ts of Working Out After Injury

Article featured on Hospital for Special Surgery

It can be tough to know how to safely return to exercise after you’ve been hurt.

Here’s how to get back to exercising after an injury.

1. Do check in with your doctor for a game plan.

First things first: If you have a persistent injury that you haven’t yet seen a doctor for, that’s step one. “The most important thing to do after an injury is to get the right diagnosis for treatment and a recovery plan,” Dr. Carr says. He explains that he customizes treatments and recovery programs based on his patients’ injuries and sports of choice. “Every injury is unique, and there are different demands on your body based on the activities you’re involved in. I won’t give the same advice to an equestrian that I would give to a soccer player, even for the same kind of knee injury.”

2. Don’t rush back too quickly.

If you were off for a week because of a shoulder injury, plan to take two weeks to get back to where you were before the injury,According to Dr. Carr, your recovery should last twice as long as the time that your injury kept you out of commission. “If you were off for a week because of a shoulder injury, plan to take two weeks to get back to where you were before the injury,” he says.

Keep in mind that the period in which you weren’t able to exercise or participate in sports affected more than just the injured area. “After a break, you lose strength, coordination and flexibility — not only where you were injured but also elsewhere in your body,” Dr. Carr says. That deconditioning, combined with adjusting your movements to compensate for weaker or painful areas, is how many people get hurt. “It’s common to come back from an injury and then get an injury in a different spot,” he says. “People with a hurt right knee will put more weight on their left side, for instance. That sets you up for another injury.”

3. Do start with small goals.

A journey of 1,000 miles starts with a single step — so do yourself a favor and make it a small one. “Go gradually, with the aim of slowly getting back to normal,” Dr. Carr says. Start with some easy stretching and strength training. “There are a variety of things you can do to regain flexibility and range of motion,” he adds, like Pilates or yoga. If you’re working out at home, try some flexibility training with dynamic (active) stretching.

As for strengthening, Dr. Carr advises starting with bodyweight or band exercises, cable machines or light weights. “Avoid Olympic weights and bench presses,” he says. “Increase your strength without loading your body too much. Then gradually work your way up to more weight.”

4. Don’t ignore pain.

Though we may enjoy the physical and mental challenges of being uncomfortable when we exercise, post-injury is not the time to push through pain. “Don’t be a hero,” Dr. Carr says. “Rehab is not the time to push it — don’t ignore pain, discomfort or other reactions in your body.”

Check in with your body before you exercise. “I tell patients that they need to have normal function for daily activities before they start exercising,” he says. “If you twinged your knee, and it hurts when you’re doing the dishes or walking up and down stairs, it’s going to hurt if you go for a four-mile run. Make sure you have no pain and full range of motion before loading the joint again. And if you’re feeling discomfort two days after exercise, or persisted through an activity despite pain, you’ve pushed too hard. Cut back on the effort.”

5. Do get back to what you love, once you’re ready.

Ultimately, you want to return to the exercises and activities you love — and you should! Once you’re pain-free, hit the courts or links for some limited play. “If you play tennis, for example, start with a few groundstrokes — but no serves,” Dr. Carr says. “See how you’re feeling during and after. The next time you go out, work the baseline a bit, maybe hit a couple serves. Work your way into it. Next time out, play a few points — a game or two. Then, by all means, test it out and play a match.”

Similarly, if your sport of choice is golf, start with chipping and putting. “Then play nine,” he says. “If that feels OK, go ahead and play 18 next time.”

“You want a nice, gradual return,” Dr. Carr says. “That’s how the pros do it. The skills will come back.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Guide to Hip Pain Relief & Treatment Options


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Lactic Acid Build Up: What It Means and How to Get Rid of It

Article featured on Verywell fit

Lactic acid is created when the body turns glucose into energy. The production of lactic acid occurs when oxygen levels are low, generally during high-intensity exercise. Lactic acid build-up can hinder your exercise routine, so it’s important to understand why it happens and how to prevent it.

What Lactic Acid Is

Lactic acid is produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates for glucose during exercise in certain conditions. “Lactic acid is a result of glycolysis (or the breakdown of glucose), an energy system that creates ATP energy in the absence of oxygen in muscle cells,” says Jenna Braddock, MSH, RD, CSSD, ACSM-CPT, owner of MakeHealthyEasy.com and OffSeasonAthlete.com.

Braddock also notes that there is a difference between lactic acid and lactate. Although the two words are used interchangeably, they are not technically the same.

Lactic acid has a hydrogen ion that is available to donate, while lactate is the molecule left after that hydrogen ion is cleaved from the molecule.

“This distinction helps us understand what is happening in the body; lactate is a fuel source for the body and has many important functions,” adds Braddock. During exercise, the working muscle cells can continue anaerobic energy production for one to three minutes, during which you can perform at high levels.

Why Lactic Acid Builds Up

During high-intensity exercise, muscles require more oxygen than the body can take in, causing anaerobic respiration and lactic acid build-up. When lactic acid develops depends on a person’s fitness level. The body clears lactic acid when it develops, but it may not be able to keep up when the levels start to increase rapidly.

“This is often termed “lactate threshold” for high-intensity aerobic activities (like running), but keep in mind lactate accumulation can also occur with strength training,” says Chrissy Carroll, RRCA Running Coach at Snacking in Sneakers.

When this increased acid builds, the muscles get tired and may not be able to contract as effectively. Some people may notice a burning sensation in the muscle during exercise.

“Interestingly, some experts believe the production of lactate actually helps the muscles delay fatigue during intense exercise,” says Carroll. She also notes that contrary to popular belief, the lactic acid buildup is not what’s responsible for delayed onset muscle soreness that occurs in the 24-48 hours after a workout.

How to Get Rid of It

“Decreasing the exercise intensity, resting from the activity, and taking deep breaths may all be helpful ways to clear lactic acid during an exercise session,” says Carroll.

Another proven method for clearing lactic acid is engaging in active recovery after exercise. Low-intensity movements, like yoga, walking, biking, or foam rolling, may clear lactic acid from the body.

A study compared active and passive recovery in 14 downhill skiers and found that active recovery caused a greater decrease in lactic acid. Skiers who performed the active recovery were able to move faster and complete more runs.

Ways to Get Rid of Lactic Acid

  • Decreased exercise intensity
  • Resting
  • Taking deep breaths during exercise
  • Active recovery or low-intensity movements, such as yoga, walking, biking, or foam rolling

How to Prevent Lactic Acid Build-Up

“The feeling of burning and fatigue that is associated with lactic acid can be improved most significantly through training,” says Braddock. She recommends increasing volume, intensity, and duration of training gradually to prevent lactic acid buildup.

But, “you do not have to avoid lactic acid build-up completely,” according to Carroll. “It’s normal for certain training regimens to include high-intensity intervals that are completed above the lactate threshold, couched between easier training days and/or rest days, to allow for proper training adaptations and recovery,” Carroll adds.

Braddock also notes that fueling properly for a workout can positively affect lactic acid levels. “Beta-alanine3 is a supplement that can be used to delay the impacts of lactate accumulation, but it may negatively impact other areas of performance,” says Braddock.

She also urges athletes to work with an experienced sports dietitian to develop a fueling and supplement plan that’s right for them.

How to Prevent Lactic Acid Build-Up

  • Increase volume, intensity, and duration of training gradually
  • Incorporate rest days and easier training days
  • Fuel your body properly
  • Consider working with a sports dietitian to develop a custom fueling and supplement plan

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

How Can I Improve My Balance?

Article featured on Summit Ortho written by Kyle Hall, DPT

Although it is often overlooked, balance is an important part of your overall physical fitness. Poor balance increases your chance of falls or other causes of injury and can reduce your overall mobility.

“Your body relies on three things for balance: your eyes, your inner ear, and receptors in your joints — that’s the part that can decline with age or injury,” Hall said. These joint receptors contribute to balance by sending signals back to the brain to tell you that you are falling or that there is more pressure to one side or another.

How can I improve my balance?

Yoga and Pilates are excellent for improving your steadiness, and core-strengthening exercises like planks and straight leg raises can help as well. Heel raises can increase ankle strength, which can help support you if you wobble. But if you have problems with your balance, it may be smart to add specific balance-building exercises into your daily routine three to five times a week.

A typical progression of balance exercises may include:

  • Weight shifting from side to side, forward and backward, and along a diagonal. You can stand in a corner or in a doorframe so that you can use the wall to balance yourself, if needed.
  • Tandem stance — standing with your feet heel to toe, as if you’re on a balance beam. This gives you a narrow base of support, challenging your balance. To add difficulty, you can close your eyes or stand on something soft and uneven, like a pillow.
  • Standing on one foot for 30 seconds — for more challenge, close your eyes.
  • Doing the “Superman,” reaching your arms forward, with one leg out behind you.
  • Walking heel to toe (called a “tandem walk”) or doing a few grapevine steps will help with balance as you move.

If you’re an athlete who wants to attain higher levels of performance, try using a minitrampoline, plyometrics, and box jumps. You can also catch a ball thrown by someone else, with planned and unplanned changes in direction.

Should I be working on balance?

There are several easy ways to test your balance:

“Standing with your feet together and your eyes closed, you should be able to stand for about 30 seconds. If not, balance is something to work on,” Hall said.

Other balance benchmarks include:

  • Can you stand in tandem stance (heel to toe) for 30 seconds?
  • Can you reach forward about 10 inches without holding on to anything?
  • For people ages 65 and under:
    • Can you stand on one leg with eyes open for 30 seconds?
    • Can you stand on one leg with your eyes closed for 20 seconds?

There are many good balance tests available for free online. Hall suggests the Berg Balance Test, which will tell you if you’re at high risk of falling or should use a cane or walker for safety.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

Easing the Pain of Osteoarthritis of the Knee

Easing the Pain of Osteoarthritis of the Knee

Article Featured on AMTA

There’s been more than one study suggesting massage therapy helps relieve the pain associated with osteoarthritis of the knee. More recently, the results have again been affirmed by research supported by the National Center for Complementary and Alternative Medicine.

Read more

6 Do’s and Don’ts After Knee Surgery

6 Do’s and Don’ts After Knee Surgery

Article Featured on Active Implants

After knee surgery, there is no doubt you will encounter challenges and pain on the path to recovery. While it will seem difficult, and maybe even impossible at times, try to remember that what happens after your surgery is just as essential to the overall success of the procedure as the surgery itself.

Here are some do’s and don’ts to help you along the road to recovery:

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Activities After Knee Replacement

Article Featured on AAOS

After having a knee replacement, you may expect your lifestyle to be a lot like it was before surgery— but without the pain. In many ways, you are right, but returning to your everyday activities takes time. Being an active participant in the healing process can help you get there sooner and ensure a more successful outcome.

Even though you will be able to resume most activities, you may want to avoid doing things that place excessive stress on your “new” knee, such as participating in high-impact sports like jogging. The suggestions here will help you enjoy your new knee while you safely resume your daily activities.

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Care of Casts and Splints

Care of Casts and Splints

Article Featured on AAOS

Casts and splints support and protect injured bones and soft tissue. When you break a bone, your doctor will put the pieces back together in the right position. Casts and splints hold the bones in place while they heal. They also reduce pain, swelling, and muscle spasm.

Read more