After an injury, ease into exercise, expert says

A man runs along the water near North Avenue Beach in Chicago July 20, 2011. The heat index is expected to exceed 110 degrees Fahrenheit or 43 degrees Celsius. REUTERS/Jim Young (UNITED STATES - Tags: ENVIRONMENT) (Reuters)

It’s not uncommon for athletes and weekend warriors to struggle with recurring injuries. “People think once the pain goes away they can jump back into their routine,” says Lyle Micheli, director of sports medicine at Boston Children’s Hospital. “They end up progressing too rapidly in terms of workout volume and intensity.”

Dr. Micheli likes to invoke what he calls the 10 percent rule with patients coming back from injury. “If someone is coming back from a pulled hamstring and can run 20 minutes three times per week then it’s safe to say they can probably run 22 minutes three times a week the following week,” he says. “But many people say I can run around this pond once, so tomorrow I’m going to run around it twice. That’s a 100 percent increase.”

He says he takes the same approach to strength training. “If you’re doing repetitive exercises like dumbbell flies and doing 10 repetitions of 10 pounds, then you want to increase the weight and the reps no more than 10 percent a week.”

Dr. Micheli says one way to prevent common overuse injuries like a torn anterior cruciate ligament, or ACL, is by maintaining muscle balance across the joint.

“The joints in front of and behind the ACL must both be trained,” he says. “So if you are lifting 100 pounds with your quads on the leg extension, then you want to be able to lift at least 50 pounds with your hamstrings. The problem is most people only do quad exercises.”

He says the same balanced approach helps people avoid elbow injury. “So if you do biceps curls, you want to also do triceps extensions so you get the opposite motion,” he says.