Sidestepping Summer's Ills

May 2, 2004
Outside Magazine
Outside magazine, July 1996

Sidestepping Summer's Ills

Active antidotes to keep an injured body in motion
By Gretchen Reynolds

It's the ri-i-iping sound as the achilles tendon ruptures that's so gruesome," says Jim Allivato, athletic trainer of the sports medicine center at Chicago's tony East Bank Club, as he leans back in his office chair. He shakes his head over the fate of such unfortunate souls and sights down the gun barrel of his finger. "Pop!" he says, pulling the trigger. "It's like being shot in the ankle." The thought makes him brighten. "We'll get our hands on you then. It's the same every summer. They start coming to us in waves."

Early summer is hell on the bodies of ambitious athletes, most of whom have spent long months indoors while their muscles tighten and their joints stiffen, impatiently enduring a state of enforced sloth.

Yet even the worst of winters must end--at which point Allivato's work begins. "The first nice day of the year, everyone rushes outside and throws themselves into the same activities they were doing back in October," he says. "The day after that, they're all lined up at our doors, looking for help."

But summer's short, and who has time to wait to get better--especially when there is an abundance of alternative open-air pursuits to keep the injured body in motion. It's all a matter of working around the affliction. So here's a guide to the ailments that can sideline the summer athlete, and suggestions for active antidotes. They may not keep you sharp in your preferred pursuit, but they'll certainly open the door to a more enjoyable summer.

Sprains and Strains
The most prevalent early-season injuries involve the lower body, which bears the brunt of sudden, out-of-practice muscular pounding. This rude awakening can pull dormant muscles in odd directions, causing a strain, or stretch and tear tight ligaments, creating a sprain. Strains are less serious and heal quickly--unless a stubborn athlete further taxes the injured muscle. Groin muscles are vulnerable for mountain bikers, who are prone to making impromptu leaps off the bike, and in-line skaters, who are bound to execute an awkward thrust of the leg early season. Upper-body strains--shoulders, neck, and back--are common for tennis players and surfers.

In the unpleasant realm of sprains, ankles are popular candidates for injury. They're lousy with ligaments, and springtime athletes, in switching from smooth indoor surfaces to uncertain footing outdoors, have no trouble distressing them.

For lower-body sprains and strains, think "nonweight-bearing," meaning choose activities that don't put your full weight on the injured leg or foot. Runners can safely switch to cycling, but only on the road. Swimming is an excellent alternative--if you stay away from the breaststroke and take it easy on the freestyle kick. Or take out a sea kayak on calm waters.

With upper-body strains, gently move the injured area to keep it from tightening more, so long as you avoid directly loading the tender muscle. In other words, if you strain a shoulder, Frisbee golf is fine, but bow out of the Ultimate league. Or, if you want a more invigorating outing, finagle an invitation onto a sailboat--but don't offer to rig the sail. "Keeping active is good when you've strained a muscle," Allivato says. "Just make sure the affected muscle isn't used too directly. One suggestion is to walk through 18 holes of golf. You get a decent outdoor workout and you save on cart rental--so you can afford the services of a certified athletic trainer, such as myself."

Perhaps the most dreaded of early-season injuries, tendinitis is an inflammation of a tendon, a fibrous band that connects muscle to bone, caused by overuse of a particular joint. Tendinitis of the elbow or knee fells hoards of recreational kayakers and tennis players, while Achilles tendon flare-ups have been the bane of many a runner. Unlike strains and sprains, which happen instantly in a moment of misuse, tendinitis develops slowly. It begins with mild soreness, and then the affected arm, leg, or heel will begin to hurt like hell.

A joint afflicted with tendinitis should be used directly but gently. Cycling is good for runners who develop Achilles tendon problems, since it stretches the calf muscles with each pedal stroke. It also helps those with tendinitis in the knee.

Or try rock climbing, which will work the joints without repeating a particular motion. "Any sport that stretches the muscles and uses the affected joints is good," Allivato says. Paddlers and tennis players with aching shoulders could adopt a more mellow pursuit: fly-fishing. "With tendinitis," Allivato says, "the closer the new activity recreates the range of movement of the old, the better--so long as they're not identical. Slightly different but similar movements can help to overcome the condition."

Finally, shinsplints, marked by annoying yet rarely incapacitating pains around the shins, are perhaps the most common early-season injury. The problem is widespread among runners and hikers whose leg muscles have tightened in the off-season. (Shinsplints can mask a more serious problem: a stress fracture of the tibia. To distinguish the two, push gently at the shin. If the pain radiates horizontally--rather than vertically, which indeed indicates shinsplints--your next outing should be a trip to the doctor. The same goes if the pain from your "shinsplints" persists for several weeks.)

Shinsplints can often be remedied simply by ratcheting down from running to a gentler walking or hiking program. For a more adventuresome prescription, try boardsailing, which stretches calf muscles without pounding them. "But if it were me," Allivato says, "I'd opt for in-line skating: It's easy on the shins, it's fun, it's a good workout, and it gets you outside." And that, of course, is the point of finding a substitute sport: If you can't pursue the outdoor activity you love, learn to love whatever activity you can pursue. After all, winter returns in just five months.

Gretchen Reynolds, a frequent contributor to Outside, mountain bikes in Chicago, weather willing.

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