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Pain-Free Guide: The Fit Girl's Guide to Common Exercise Pains
Common Problems for Runners
Lance Armstrong might not let a shattered collarbone keep him from his Tour de France training, but most of us are slower to bounce back when injury strikes. The trick is knowing the right way to rehab. "Too often, a minor injury becomes a major bump in women's fitness routines," says Vonda Wright, MD, a sports medicine surgeon at the University of Pittsburgh and a FITNESS advisory board member. What's the best way to get back in the game? (Hint: It isn't always about speed-dialing your doc.) We asked the experts for tips on how to tackle the most common exercise aches and pains yourself.
Common Problem for Runners: Heel and Sole Tightness
The sole of your foot and heel are tight and tender.
Here's why: With overuse, the connective tissue that runs the length of your sole can become inflamed or suffer microscopic tears. Known as plantar fasciitis, it usually feels worse early in the morning, better during exercise, and painful once you stop.
Feel better: Sit in a chair and place a cold can of soda on its side on the floor in front of you, says Christopher John Anselmi Jr., a chiropractor at the Hospital for Special Surgery in New York City. Put your foot on top of the can and, applying medium pressure, roll it back and forth. The cold will reduce swelling while the massage eases the pain.
Your new game plan: Buy shoes with arch support; women with high arches are especially prone to this injury. And cut down the mileage until your foot feels better (try a nonimpact cardio activity, like swimming, instead).
Always stroke in the direction of the heart to prevent blood from being pushed against closed valves, which could damage blood vessels, says Kimberly Mitchell, a licensed massage therapist in New York City.
Common Problem for Runners: Sore Shins
Your shin area is sore.
Here's why: You have shin splints, caused by doing too much too soon. When you run, your legs absorb a force three or four times your weight. Piling on miles too quickly can cause the tissue surrounding your shins to become inflamed.
Feel better: Wrap an ice cube in a thin rag and firmly rub it up and down your leg, on either side of your shinbone, for 15 minutes at a time.
Your new game plan: Hard surfaces exacerbate the pain, so in addition to curtailing mileage, swap in a few runs on the treadmill or a dirt path. Buy shoes with extra cushioning, and replace them every 300 to 500 miles.
Common Problem for Runners: Upper Leg Pain
You feel a sudden twinge in the back of your upper leg, followed by tightness.
Here's why: The muscles that run down the back of your leg are delicate. Hamstring pulls happen when you add a burst of speed or quickly change direction, especially if the muscles aren't warmed up.
Feel better: For severe pain, see your doc. Mild to medium? "Sit on the floor with your injured leg bent and your other leg straight for support," says Mitchell. "Using the fingers of both hands, reach behind your leg and apply pressure while stroking upward from your knee toward your glutes for several minutes."
Your new game plan: Strengthen your hamstrings by adding one minute of jogging backward to the end of your regular run.
Common Problem for Cyclists: Tingling
You walk out of Spinning class and realize that your hands are tingling.
Here's why: Tingling hands and sore forearms can be caused by weak abs. "If your abs are strong, you lightly rest your arms on the handlebars while your core holds you up," says Dr. Wright. "But weak abs make you bear down on the handlebars for all the support you can get." An hour later, hello, ouch!
Feel better: Tingling goes away once you stop leaning; soreness usually takes about a day.
Your new game plan: Strengthen obliques with bicycle crunches. Lie on your back, upper torso raised off the floor; twist to bring left elbow to right knee, then right elbow to left knee, cycling legs in the air. Do 2 sets of 20.
Common Problem for Cyclists: Knee Pain
You feel a grinding in your knees as you pedal; later, they swell and ache.
Here's why: Overuse, improper motion while pedaling, and incorrect seat height all can cause inflammation of your knees.
Feel better: The key to knee health is strong quads. Strengthen these muscles by doing wall squats with your knees bent 60 degrees or leg presses on a machine. Also, dial back your workouts by 20 percent; if you're Spinning, use a lower gear and higher rpm.
Your new game plan: Check your form. Your foot should pedal pointing forward; rotating inward can aggravate the band of tissue on the side of your leg by causing it to rub against the outside of the knee joint.
Common Problems for Swimmers: Upper Back Pinch
As you pass your arm overhead during your pool session, you feel a sharp pinch in your upper back.
Here's why: Repetitive motion can irritate the nerves in your neck and back as your muscles contract.
Feel better: "Place your opposite hand on the sore side of your neck, on the fleshy portion between the base and your shoulder," says Dr. Anselmi. "Press until you feel the tender spot. Turn your head away from the tight area while applying pressure." Relax, then repeat, until the pain eases.
Your new game plan: Looser muscles equals fewer injuries. Face a closed door and grab the knob with both hands. Lean back from your hips, keeping legs straight (don't lock knees). Let your head hang; feel the stretch in your upper body as you twist your head from side to side to work out neck stiffness.
Common Problem for Swimmers: Leg Cramps
Mid-kick, your calf (or foot, quad. or hamstring) gets a nasty cramp.
Here's why: Dehydration, electrolyte imbalance, or weak kicking muscles can trigger calf cramps.
Feel better: Flip onto your back and propel yourself back toward land with your arms and unaffected leg. If the pain is too great for you to swim, try floating on your back while gently kneading the cramp with one hand.
Your new game plan: Out of the water, slowly stretch the calf muscle by lunging forward with the uninjured leg while keeping the cramped back leg straight. Drink lots of fluids. Help ward off future cramps by eating a banana (high in potassium) and having a sports drink pre- and post-swim.
Common Problem for Tennis Players: Radiating Elbow
You have pain on the outside of the elbow that radiates down your arm when you swing.
Here's why: "Over time, repeated use of the muscles in the forearm can lead to tennis elbow, which is caused by small tendon tears," says Mitchell, an avid tennis player.
Feel better: Stay off the courts for a week and ice your elbow for 15 minutes at a time to reduce inflammation. "The best self-massage for this injury is called the deep longitudinal stripping method," says Mitchell. "Start by pressing the thumb of your opposite hand firmly on top of your forearm; begin at the wrist and slide your thumb along your forearm toward the elbow." Use a lubricant, such as oil or lotion, to prevent friction.
Your new game plan: Strong forearms and wrists help stabilize your elbow. Using light weights, hold your arms straight in front of you, palms down. Flex and bend wrists up and down 10 times; then rotate wrists from palm up to palm down 10 times. Work up to three sets.
Common Problem for Weight-Lifters: Back Pain
Yesterday, you were queen of the gym — lifting, pressing, and flexing. Today you can barely stand up straight.
Here's why: Working new muscles, using too much weight, and having weak obliques are all prime causes of back pain. "Your spine is a column of bones surrounded by tiny muscles holding it in place," says Dr. Wright. "Your core is a giant sheath of muscles that stabilize the spine from the front. If your core is weak, strength training can stress the smaller muscles around the spine."
Feel better: Patience. With a few days of "active rest," the aches should disappear. This means you shouldn't strain your back, but stretching, icing, and gentle core work are okay. Cross-train by walking and swimming.
Your new game plan: The best moves for strengthening your abdominal muscles? "Standard planks and side planks," says Dr. Wright. Hold each for 30 seconds and work up to two minutes.
Helpful Tools and Tips
Learn what the pros keep on hand for exercise emergencies.
"Put these cylindrical cushions under your knees while you sleep to take pressure off your legs, help blood flow to your heart, and ease back and leg pain," says Mitchell.
"It's ideal for massaging hard-to-reach spots in your back and hips," Mitchell explains. "Lie down on the floor with the weight of your body on the tennis ball. This will apply more pressure to the achy spot. Hold for 20 to 30 seconds, or until the knot is released." (Never place the ball under your spine.)
The same idea as above, but the smaller size makes it an ideal tool to use under the soles of your feet while you sit at your desk at work.
Intense exercise can cause scar-tissue buildup, shortening and tightening your muscles, says Dr. Anselmi. Rollers help break it up. For your hamstrings, sit with legs in front of you; place roller under your knees. Using your hands for support, slowly slide legs and hips forward (roller will move toward your butt). Roll back to start.
A runner's secret weapon, the Stick ($42.50, thestick.com) is a long tube with six to 18 plastic spindles that rotate against your muscles as you roll it up and down your legs. The intensity of the self-massage is determined by how much pressure you use.
"It reduces friction," says Mitchell. "Some ointments, like Tiger Balm (tigerbalm.com) also have topical analgesics, like menthol and clove oil, which temporarily ease aches. Use a coin-size drop and massage directly into the sore spot."
Heat increases blood circulation so muscles become more pliable, allowing you to put them through a gentle range of motion that will speed recovery. "Microwave a wet hand towel for two minutes," Mitchell says. "Shake it out to make sure it's not too hot for your skin." Then roll it up lengthwise and place it on the sore area for 15 minutes.
Or active rest, as Dr. Wright says: "Just because you strained an ankle doesn't mean you can't use your other three limbs!" For some injuries, low-impact exercise, like yoga or the elliptical trainer, is ideal.
For acute injuries, like a sprain or a fall, ice for 10 to 15 minutes to reduce swelling and limit internal bleeding. Continue for 24 hours, allowing skin temperature to return to normal between treatments.
Wrap the injured area in an elastic bandage to reduce swelling. Wrap from lower to higher on the body, e.g., start at your toes and end at your calf.
Rest in a position that allows blood to flow toward your heart — lying down with two pillows under your legs, for instance.
When to See a Doctor
Signs your injury requires a trip to your doc:
- Persistent numbness or tingling in your extremities, which could mean nerve damage.
- Pain that is more than normal soreness and doesn't go away in a few days, or prolonged swelling and pain that increase with activity and don't improve with RICE.
- Pain bad enough that it wakes you up at night.
Originally published in FITNESS magazine, July/August 2009.