Q: I love to run, but it seems like one problem after another. I developed anterior knee pain first, then plantar fasciitis, now shin splints. I have had to cut down on my mileage, and sometimes take long breaks to recover so I’m getting out of shape. I’ve tried taping, bracing, ibuprofen, ice and physical therapy, what can I do next?

A: It sounds like you should be cross training instead of just running.

Athletes who only do one form of exercise are more prone to overuse injuries like you’re having. Especially if you’re older than 30.

Listen to your body. It’s best to stay in shape with multiple kinds of exercise and rotate so you don’t do the same thing too many days in a row. Work different muscles on different days and give your body a chance to recover. Ideally, choose a combination of cardiovascular fitness exercises, strength training and flexibility. Consider long and short days of cardiovascular exercise, with interval training. For example, instead of jogging at a steady pace for an hour, try walking at a brisk pace for three minutes, then run for two minutes, alternating for 15 minutes one day and 45 minutes on another day when you have more time. You’ll save time and burn more calories doing interval training.

For example, Tabata training or plyometrics are popular classes that include interval training. Right now you shouldn’t be running at all with all the injuries you’re suffering from. You can do intervals on a stationary bike or try a spinning class, but don’t overdo anything when you’re injured. Avoid anything that is painful during exercise or that causes increased pain after exercise.

In the case of weight training, serious weight lifters will push themselves to the point of muscle fatigue and will be sore the next day as part of their muscle building program. It is best to have a professional trainer supervise you if you choose to try this to make sure you are doing it correctly and don’t injure yourself in the process. Strength training can also be accomplished with lighter weights (more repetitions), pilates (especially on the reformer) or power yoga, among others. Pilates and yoga also have the benefit of flexibility training included in the workout. Stretching is an important part of injury prevention and I recommend doing it before and after exercise of all types for best results.

In the case of injury, a physical therapist is the best person to show you which exercises you can safely do to rehabilitate your body and avoid reinjury. You can ask them for an evaluation and to give you a home exercise program to add to your workouts. For example, adding 20 minutes of stationary biking to your weekly workouts in place of running will help with your anterior knee pain. Quadriceps stretching and strengthening exercises should also be done daily to help your kneecaps track properly.

It is important to choose a variety of exercises that are fun for you to do so you will stay with it for life. Keep trying new things and keep your workouts fresh and fun as well as good for you. You’ll want to do five days of at least 20-30 minutes of cardio and three days of strength training. Remember, this is good for you even in old age but your doctor should clear you for vigorous exercise, especially if you are starting a new exercise program. Ask your doctor what heart rate is a healthy range for you and consider using a heart rate monitor to make sure you stay in this range during workouts for maximum benefits. Exercise is good for you even if you are overweight or obese. Losing weight reduces stress on the knees and feet, so dropping even dropping 10 pounds can help. Download a fitness app on your phone to keep track of how many steps you take per day, the intensity and length of your workouts, and even the calories you ingest.

Marian J. Wymore, M.D. is a practicing physician and a freelance writer. She is a regular contributor to the Peninsula News. To send a health question for Extraordinary Health column, send an email to drmarian@hotmail.com.

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