When injuries interrupt exercise: Readers weigh in

I got some great feedback on my Jan. 27 column about the sudden interruption to my running regimen, "Coping with an out-of-the-routine injury." Here are edited excerpts of what two readers had to say, followed by excerpts from an online Q&A nutritional biochemist Shawn Talbott and I did with readers.

Using an elliptical machine

I also have been dealing with an injury that has sidelined me from running, but I'm 75 percent healed. It sounds like you already understand that you need to just do something to keep up your cardio and put you in a better place mentally.

I have been using an elliptical machine as 85 percent of my cardio workout and 15 percent easy jogging/walking on a treadmill. But I've also been doing core, balance and upper-body work since I know these things will help with my running when I'm healed.

One thing you wrote about that I would clear with a doctor first: You are "stretching a lot more." Muscles are similar to rubber bands, and when a rubber band has a weak point, it can rip. I tend to do more massage and very, very light stretching. And even then, I make sure the muscle is warmed up first and do active instead of static stretches.

- online comment from jdoe1

Massage therapy

Lenny, I was so sorry to read about your injury. I was wondering if you have looked for a massage therapist with training in sports-related injuries. Because nothing was found on your various tests, it is possible a muscle spasm is involved. Stretching is always good, but it sounds like you need serious massage therapy a few times a week for a while. Good luck.

- online comment from donnalmt

When someone stops lifting weights after doing it frequently, what happens to their muscles? I know that they atrophy, but I was wondering to what extent. What are some ways to prevent this without going to the gym as much?

Talbott: This is one of the major problems with being forced to take some time off from your workouts. Muscles start to atrophy within a few days of being sidelined, which makes it extremely important to come back slowly when you're able to resume workouts. Studies show that we can maintain our levels of fitness with short, high-intensity workouts, so that can help when you're pressed for time but still is a problem if you're injured and can't exercise.

For eight to nine months after a groin pull, I couldn't play tennis or walk fast. I've had painful cramps in that area, usually in summer. I was recently diagnosed with very low Vitamin B12 and high uric acid. Any connections?

Shawn Talbott: If you've been diagnosed with low B12, then your doctor will probably recommend a course of Vitamin B12 injections to help bring your levels back up to normal. This will probably be followed by a daily supplement of B12 to maintain your levels. Low B12 can be associated with nerve damage, depression and general fatigue, but not typically with muscle cramps.

For cramps, you'll want to look at your electrolyte intake (sodium, potassium, etc.) and perhaps consider taking a sports drink like Gatorade along for your tennis and walking workouts.

You don't realize how much gets taken away from you when you can't exercise. I am 36 and a runner and I had to spend last year undergoing treatment for breast cancer. I went back to running as soon as I could, and I actually started crying when I took those first steps jogging because it marked a time of feeling back in control. However, since I let myself have so many sweets during treatment, it's hard to break the sugar habit. Any suggestions?

Talbott: It is often said that "exercise is medicine" because it can help with so many physical and psychological ailments. A great deal of emotional eating is driven by changes in stress hormones such as cortisol, but sugar cravings can also be caused by flucuations in blood-sugar levels. A few ways to break the sugar habit are:

1. Getting as much sleep as you can.

2. Combine protein and fat with any carbohydrates you eat. Example: Put peanut butter on a slice of bread. The protein and fat will slow the absorption of the carb and help maintain blood-sugar levels longer.

3. The carbs you eat should come mostly from "whole" sources, such as fresh fruits and veggies and whole grain breads.

View the original article here

Can't judge an exercise book by its cover

"We're all humans. We're basically the same," says Adam Campbell, the fitness director for Men's Health and author of both books. There aren't any exercises only men should be doing, or vice versa, so he saw no reason to alter the content of the books.

But he's aware of the importance of presenting information in a way that's palatable to each sex. So for a male audience, he uses such words as "define," "carve" and "build." When he switches to addressing women, it's "shape," "firm" and "tone."

Language can have a huge impact on how readers digest information, explains Women's Health Executive Editor Lesley Rotchford. "We want to speak to goals they have. A 'six-pack' isn't relatable," she says. (The flip side is also true: "You're not going to tell a guy to work out to fit into skinny jeans.") By using more female-friendly terms, the magazine is able to promote resistance exercises in a way that makes women more interested in doing them.

For the same reason, Campbell insisted on doing two books, one with images of men and the other with images of women. "Presentation matters. Seeing a woman doing a barbell squat looks very different than seeing a man doing the same thing," he says. "It's less intimidating."

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How men and women exercise differently

No one wants to think she's a cliche. But it's time for me to recognize that when it comes to my gym behavior, that's exactly what I am: a cardio-loving woman who has to be forced to hoist a dumbbell.

I would feel worse about this revelation if it weren't for the fact that my husband is just as stereotypical. Every workout is a chance to outdo himself, which inevitably results in soreness, shin splints and other woes. A few months ago, at a boot camp class, he generated so much heat that his head - no joke - started to steam. I can guarantee that I'll never work that hard.

Luckily, we can both blame it on biology, according to research by Weight Watchers. The organization is best known for counting points, but behind the scenes, staffers are sorting through a lot more complicated data. And some of the most fascinating stuff stems from contrasting male and female attitudes toward weight loss and activity, says chief scientist Karen Miller-Kovach.

For starters, a much higher percentage of the men surveyed believe that exercise is enough to slim down, whereas the women tend to embrace a smarter combination of eating healthier and moving more. "You rarely hear guys say, 'I'm going on a diet.' Instead it's, 'I need to hit the gym,' " Miller-Kovach notes. (That may also explain why men make up just 10 percent of Weight Watchers' membership.)

But the Weight Watchers surveys show men top women when it comes to actually enjoying exercise. "That doesn't mean women don't know they need to be physically active or don't do it," Miller-Kovach says. "But if you're a woman, you're looking at being active as a means to have wine with dinner. For guys, to sweat is a badge of honor."

Then, there's the approach: Women are likely to take small steps toward a goal while men are quick to make sweeping changes, according to the research. "It's the Hundred Years' War versus the Battle of Normandy," Miller-Kovach says. And where we choose to have that fight also differs. For men, it's the weight room. For women, it's anywhere else.

These are all generalizations, and, of course, there are plenty of outliers for both sexes. (Weight Watchers' research is proprietary, so exact figures are not available.) But you can witness these opposing strategies - and their accompanying weaknesses - if you look around almost any gym. Women clump by the cardio machines, regularly reading magazines and talking, thus lessening the effectiveness of their workouts. Men congregate around the largest of weights, which they proceed to pick up even if that requires heinous form.

Heavy, dude, but . . .

Lynda Espada, fitness director of the D.C. Jewish Community Center, says that, from her observations, "Women never want to push it. Men want to push it too much."

Partly, that's because women tend to worry about bulking up no matter how many times they've been told that they'd need to grab some steroids along with that heavier dumbbell to make it happen. For guys, it's the opposite. "They think the more weight, the bigger they will be and the better that is," says Espada, who notes that in reality, more weight than you're ready to handle leads to injuries rather than bulging muscles. "You can't be grunting and groaning and throwing weight around."

It's possible that men and women would get these messages more easily if they weren't so hung up on preconceived notions of what kind of exercise is appropriate for them. "Guys are thinking about high school even though what they learned doesn't apply to a 40-year-old," says Robert Sherman, the group fitness manager for Equinox's Washington area clubs. If Sherman had his way? He'd make sure every man made time for yoga and that every woman put strength classes on her schedule.

Change comes slowly

Over the past few years, that's started to happen more as older exercisers have been warned by their doctors to change up their routines and younger ones have brought their evolving attitudes to the gym.

But there's still an intimidation factor when it comes to the unknown. Espada understands when new female clients tell her they've shied away from weights because they've never been fully introduced to what to do with them. She felt the same way 20 years ago when she first breached the boys' club. "I start slowly so they get comfortable," she says. "And when they see they can do it, they realize it's fine."

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