Prevention:
If you have any chronic medical condition, check with a physician before beginning any exercise program.
Start slowly. If you’re out of shape, start with a 10-minute walk.
Do warm-up stretches first. Hold your stretches. Don’t bounce. Stretch for about 10 minutes.
Exercise regularly. Ten minutes a day is better than an hour on the weekend.
Increase your workout intensity and duration very slowly.

Drink fluids–water or juices–before, during, and after exercise. Electrolyte-replacement beverages such as Gatorade become advisable only during strenuous exercise that lasts longer than two hours.
If you run or do aerobics, soft surfaces–grass, carpet, or wood–are better than hard ones–asphalt or cement.

Recognizing Injuries:
One big tip-off is any sharp pain during exercise. If anything hurts, stop doing it.
Another is pain that develops slowly but persists despite home treatment.

Dull aching soreness 12 to 48 hours after exercise is usually not an injury. It means you pushed yourself too hard. Do a little less next time.

Treatment:
The most common exercise injuries are muscle aches and strains, and joint pains. Try aspirin, ibuprofen (Motrin, Advil, Nuprin), or acetaminophen (Tylenol, Panadol, Datril). However acetaminophen does not relieve inflammation, so it won’t help reduce the swelling of strains and sprains. Use these medicines according to package directions. If aspirin upsets your stomach, try an “enteric coated” brand, which dissolves in the intestine, not the stomach. Or try herbal aspirin, white willow bark.

For joint injuries, begin with R.I.C.E.-rest, ice, compression, and elevation.

Rest: Stop doing what hurts. Don’t move or place weight on the injured part. Rest prevents injury aggravation.

Ice: Place a few ice cubes in a plastic bag and wrap the ice bag in a clean cloth. Place it on the injury for 20 minutes. Remove it for 10 minutes and repeat. Icing helps control pain and reduces swelling. Do not place ice directly on the skin. Prolonged contact can cause frostbite.

Compression: Wrap the injury in an elastic bandage. This helps limit swelling.

Elevation: Raise the injured part above the level of the heart. For arm injuries, use a sling. For leg injuries, lay down and raise the leg on pillows. Elevation reduces throbbing pain.

For muscle injuries, take aspirin or ibuprofen, and use an ice pack for 12 to 24 hours to relieve pain and limit swelling. Then use heat–hot baths and showers, or a heating pad–to increase blood flow, which brings extra food and oxygen to injured muscle tissue.

If pain and swelling persist or increase after two days of the above, consult a physician.

Among the various exercise options, walking causes comparatively few problems. But walkers may develop muscle and joint injuries, blisters, calluses, corns, soreness, foot pain, and shinsplints. Most muscle and joint injuries respond to R.I.C.E. treatment.

Here’s how to deal with most of the other medical problems walkers may face:

Blisters: Blisters are fluid-filled bumps on the skin. In walkers, they’re caused by friction, typically from damaged or poorly fitted walking shoes or socks. Injured by the unnatural rubbing, the body protects its inner skin by padding it with fluid, mostly water, under the outer skin. Eventually, new skin forms beneath the blister and the fluid inside it is gradually reabsorbed.

“Don’t break blisters open or attempt to drain them,” says Anne Simons, M.D., of San Francisco. “Once opened, the sensitive skin under the fluid can become quite painful, and possibly infected.” Instead, use molefoam, a cushioning material available at shoe stores, drugstores, and shoe repair shops. Cut a hole in the molefoam and fit it around the blister. To relieve pain and inflammation, take aspirin, ibuprofen, or willow bark tea. If molefoam does not provide sufficient cushioning, or if a blister breaks, wash the area with soap and water and protect it with a think layer of antibiotic ointment and an adhesive bandage. To prevent future blisters, check the fit of your shoes and socks. If a blister does not improve significantly within two weeks, or if it becomes more painful, consult a physician. It may be infected.

Calluses: Calluses are raised bumps of dead skin that develop over time as a result of friction. Unusual rubbing first produces blisters, but then the body protects itself by building up a tough layer of dead skin. Calluses usually require no treatment. They develop for a reason, and in general should not be disturbed. “But if calluses become unsightly, or grow uncomfortably large,” Dr. Simons says, “you can usually reduce their size by applying an acidic paste of five crushed, powdered aspirin tablets (acetylsalicylic acid) and one tablespoon lemon juice (citric acid) mixed with a little water. Apply this paste generously, and cover the area with a bandage or plastic bag for 15 to 30 minutes. Then use a pumice stone or metal file to remove the outer layer of callus tissue. Repeat the process two to three times a week until the callus has been reduced to the desired size.”

Corns: Corns are yellowish, callus-like, hard, thickened areas that appear on the toes. Most corns are caused by shoes that are too small and chafe the toes. Switch to shoes with a larger toe box. Cushion the area with an adhesive foot pad. To remove corns, Dr. Simons advises: “First, soak the foot in Epsom salts for 15 minutes and apply a moisturizing cream. Then cover the corn with a moist gauze pad, and wrap the foot in plastic for 15 minutes. Remove the plastic and rub the area in a side-to-side motion with a clean, abrasive nail file or pumice stone available at pharmacies. Repeat this process daily until the corn disappears.”

Delayed-onset muscle soreness. Muscle injuries cause immediate pain, but soreness typically develops a day or two after exercise. It’s a sign that you pushed yourself beyond your current level of conditioning and caused minor, but painful, injury to overused muscles. Rest for a day or so, take aspirin or ibuprofen or willow bark tea, and drink plenty of fluids. Muscle soreness usually resolves in a day or two. Don’t stop walking. Just respect your limits, and increase the duration, speed, and distance of your walks slowly.

Heel/foot pain. If the pain occurs on rising in the morning or after resting, the cause is probably either heel spurs or plantar fasciitis (fassy-EYE-tis). The fascia is the tough sheet of connective tissue that runs from the ball of the foot to the heel. If it becomes stretched, calcified cartilage splinters or “spurs” may develop in the heel area and cause pain. Or small tears can develop in the fascia and cause pain on the bottom of the foot. Flat feet or very high arches can also contribute to plantar fasciitis.

Take a few days off from walking and treat the pain with aspirin, ibuprofen, or willow bark tea. Check your walking shoes. “You may need additional arch support,” Dr. Simons says, “or try shoes with a slightly elevated heel (one-half to one inch) and/or add foam heel pads inside your shoes to shift your weight forward and cushion the painful spot.” If pain persists, consult a podiatrist.

Shinsplints. This condition causes pain in the front of the lower leg. The cause is overuse of the shin muscles. Shinsplints are a usually sign that you’re walking beyond your conditioning level. Cut back a little. Poor walking technique can also contribute to shinsplints. “Don’t slap your feet on the surface,” racewalker Fenton says. “Go for a smooth heel-to-toe roll. And don’t take steps that are too large for you. Use a natural stride.” Treat the pain with aspirin, ibuprofen, or willow bark tea.

Back to How to Prevent, Recognize, and Treat Exercise Injuries

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