Eager Covid-19 Pandemic Exercisers are Racking Up Injuries

Covid exercise Injuries and prevention, Foot and ankle institute


Some patients with more free time and fewer exercise options during the Covid-19 pandemic have been overzealous, at times, in adopting new exercise programs.

Unfortunately, this has led to overuse injuries, which have become the painful downside of “quarantoning” (the new name for getting toned and working out for weight loss during quarantine).

Calls began coming in during late March as our newly homebound patients without gyms to go to started taking up new exercise routines online and on their own. Some include:

  • A grandfather who pumped up the tires on his long-neglected bike and pedaled for just an hour and called reporting calf soreness and pain so bad that he couldn’t walk.
  • A patient who took up running but wore shoes that were worn out and came to see us thinking that he had a sprained ankle which turned out to be stress fractures.
  • Lots of new runners complaining of ankle pain, shin splints, plantar fasciitis (sharp pain in the arch of the foot or the heel), back pain, knee injuries, and other unhappy body parts.
  • The desk jockey who started hiking in the wrong shoes and came in with a bad case of Achilles tendinitis. 

Our colleagues are reporting similar stories all over the country.

We’re seeing two types of “over-doers” — the “overzealous new sport adopters” and the “more is better” over-doers

About the “over-zealous new sport adopters”

Some people looking for an exercise they can do during confinement make the mistake of thinking that fitness in one activity transfers to fitness in another activity, especially when the activities seem similar. When the tennis courts closed, a patient picked up a mean game of ping-pong and ended up hurting their ankles since their tennis footwork was not as helpful in table tennis. When another patient could no longer attend spinning classes, she took up running and, after over-doing it, presented with an inflamed knee and swollen ankle.

Unfortunately, not all activities that appear similar challenge your body in the same way. Eager exercisers adopting a new sport discipline often overlook the fact that cross-training may be needed to handle their new sport.

About the “more is better” over-doers

We’ve also seen some folks who, after eating (and drinking) more during their confinement, have panicked and turned into exercise freaks, doing online HIIT classes for several hours per day.  Then there are those who decided to pick up a sport they used to dominate but haven’t practiced in a long while and thought they could go back to playing at their former level.

While their cardiovascular system could handle the cardio demand, their bones, joints, and connective tissues weren’t ready for the onslaught. And thus, the new exercise injuries cropped up.

Going from 0 to 60 too quickly is a recipe for foot and ankle disasters

Large population studies of sports-related injuries have demonstrated that the risks of harm skyrocket when people suddenly increase the amount or intensity of their workouts.

As gyms, studios, and personal trainers start (or begin, depending on where you live) to reopen and folks return after months away, we are expecting to see a lot more people presenting with muscle overuse symptoms. While we love seeing our patients, we’re not as in love with them being hurt, so we implore you to NOT attempt to pick up your exercise routine at the same level of intensity as where you left off.

We anticipate also hearing from folks who led a relatively sedentary life since March and picked up a few extra pounds who have recently decided to make a major lifestyle change by joining a gym. But during the early days of their new workout regimen, they launched with a little too much enthusiasm and ended up injured.

Please, please cut yourself some slack and take your time getting back to your workout routine.  Whether starting from scratch or resuming an exercise regimen after a couple of month hiatus, you need to gradually work your way up in the intensity and duration of your activity in order to avoid injury. It is really that simple.

Running injuries are the most common seen during the Covid-19 quarantine

We’ve noticed a large uptick in running injuries. This is because running (along with walking) has been one of the few feasible options for many sheltering in place. For bodies that aren’t used to it, running can be very taxing because it causes tissue breakdown resulting from the same motion being performed over and over again.

Whereas it takes your heart and lungs from three to six weeks to adapt to running, because of the tissue breakdown resulting from the repetitive foot pounding, your bones, joints, muscles and connective tissues require eight to twelve weeks of conditioning before they develop the strength to support that kind of impact. As with other high impact sports, running requires a gradual buildup in order to avoid injury.

Tips on how to return to exercise injury free

Start low and go slow

Prevent foot and ankle injuries with warmups, University Foot and Ankle Institue

The key thing to remember if you want to start a new activity or take up one that you haven’t done in a while is to ease into your new routine. Begin with a five-minute warm-up of gentle stretching and 30 minutes of light activity such as walking, Pilates floor exercises, gentle yoga, sit-ups, or wall slides to build up your leg and back muscles. As you get used to this and start to see results, you can start gradually ratcheting up the intensity and duration of your workout.

Let’s say you want to run. Try walking briskly for 30 minutes six days a week for the first two weeks. Once this becomes comfortable, then incorporate one- or two-minute spurts of running alternating with walking briskly, and then gradually increase the amount of running time according to your comfort level.

This gradual build-up will add a controlled amount of stress to your joints, muscles, and cardiovascular system, strengthening them without injuring them. If you’re a runner who took several weeks off during lockdown, start at no more than 50 percent of what you were doing before COVID. If you previously ran 5 miles, start with two and a half-mile runs at a slower pace than you ran before and gradually work your way up.

If you want to do strength training, do a variety of weight exercises, with each one targeting a different muscle group instead of doing lots of exercises that put all the stress on just one muscle group. Start with 15 reps using a lightweight and build up your reps before increasing in weight. If you were doing weightlifting prior to COVID and are starting to go back to weights after several weeks off, start at no more than 50 percent of the weight and reps you were doing before COVID and gradually scale up.

Adopt one change at a time

Let’s say that you’ve been considering getting a Peloton bike, trying out yoga, and wanting to dust off your running shoes. Nooooo! Pick one and take that one activity on for a while.  The key here is to get your body used to a sport before taking on another sport that will tax your body in different ways. Patience, Grasshopper (and reduced muscle soreness too).

Do the ¨Talk Test”

This is an easy way to gauge whether you’re pushing yourself too hard while performing your cardio exercise. The premise here is that you should work at a pace that allows you to hold a conversation while doing your cardio. If you are huffing and puffing and can only spit out two words at a time, then you need to slow your pace down. By the way, using the talk test is a great excuse to invite a buddy to walk or run with you (keeping safe distancing, of course). Running with a partner can be more fun than running alone and each of you can hold the other accountable to your daily exercise commitment.

If you can’t run, walk!

Walking for exercise, walking and your feet

Before you say it, I know that weightlifting, resistance, and core training burn fat and provide cardiovascular benefits.

But research has also shown that walking can be a perfect whole-body exercise that allows you to get regular exercise that is lower impact and much less hazardous. Not to mention that it can be done anywhere, most any time and cheaply.

Before you turn up your nose to walking, consider that it has been shown to yield long-term mental and emotional health benefits, lower the risk of stroke, cognitive decline, and cardiovascular disease. Nothing to sneeze at, if you’ll forgive my analogy 😉

Listen to your body

When you take up a new exercise routine, you might be surprised to notice a little boost in your mood because aerobic exercise triggers the release of endorphins (feel-good chemicals produced by the brain). This “high” can last for a few hours after your workout and can be addictive.

While endorphins are great for motivation, be careful of overdoing it, particularly when you first begin exercising. If you’re feeling pain in a joint or muscle, it could be a warning sign of an injury. Do not ignore pain! Get some rest and switch to a less demanding activity for a few days to rest your sore area. Don’t hesitate to call your foot and ankle specialist if you experience any concerning new symptoms.

Invest in appropriate footwear

If engaging in high-impact sports, look for shoes that provide maximum protection. For runners, this means choosing stiff soles that don’t bend easily in the mid-arch. Orthotic insoles can also offer great arch support, correct overpronation and under pronation, and reduce unwanted foot mobility. In addition, they can provide extra cushioning and distribute your body weight more evenly across the bottom of your foot.

It’s also important to remember to replace your running shoes when they start to look worn out, or every 300-500 miles. When running shoes get too old, they can no longer adequately support your foot and may leave you vulnerable to injury. Is it worth getting injured to save the price of a good pair of running shoes?

When in doubt, call a Specialist!

We know that this is a stressful time and that you might have concerns about going to a doctor’s office right now, but we’d like you to know that we have put in place measures to maintain appropriate social distancing and rigorous sanitation protocols in order to keep our patients and staff safe during the Coronavirus pandemic. Our patients have always come first – that’s a promise that has always been, and will continue to be, the cornerstone of our practice.

Why choose University Foot and Ankle Institute to cure your foot and ankle pain?

If you’re experiencing any foot conditions, we’re here to help. Our nationally recognized foot and ankle specialists offer the most advanced podiatric care and the highest success rates in the nation. We are leaders in researching, diagnosing, and treating metatarsalgia. For more information or to schedule a consultation, please call (877) 736-6001 or make your online appointment now.

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