August 2002  

Beating the Monday Blues:

The Weekend Warrior’s Guide to Injury Prevention & Treatment

Bob Calabritto. MS, ATC  

It’s Monday morning and you’re sitting at your desk pondering the great time you had the past weekend during your neighborhood’s third-annual flag football game. Suddenly, your boss interrupts your thought by summoning you to his office. Problem is, your back feels like you’ve been kidney-punched by Muhammed Ali, your hamstrings have decided to shrink three inches and your ankle has grown to twice its size because on your game-winning touchdown catch, you twisted it. Hopefully, the boss can wait as you hobble down the hall because you’re suffering from the Monday blues of the weekend warrior. 

A weekend warrior is any person who participates in little or no exercise during the week and then on the weekend partakes in some kind of physical activity. In most cases, the intensity of the weekend activity is far to vigorous than that which the individual is conditioned for, resulting in injury and in almost every case, severe soreness. 

Injury, soreness and in the rare case, fatality, plaque millions of American men each year as a result of improper training prior to athletic events and physical activities. According to orthopedic surgeons nationwide, more than one million injuries related to sports occurred in the baby-boomer population alone during 1998. Sports injuries can occur in any event from bicycling or football, to badminton or basketball. Virtually any activity that requires rapid limb movement or a fast-paced walking motion can cause bodily injury to the unconditioned weekend warrior. 

According to insurance claims and medical expense data, injuries related to sports and physical activity have increased substantially from 1991 to 1998. The 33 percent increase in injuries during the eight-year-long period has accounted for nearly $120 billion dollars in medical costs. Nearly 18 billion dollars a year is spent on treating and rehabilitating injuries that may have been avoided with proper education and conditioning. 

What Ails You  

The myriad of injuries common to the weekend warrior ranges from strains and sprains, to concussions, broken bones and torn cartilage. The most common of these injuries are sprains and strains. The most common body part injured is the long leg – in particular, the knees and ankle complex. According to a panel of sports medicine physicians, in 1998, Achilles tendon tears were the number-one injury sustained by weekend warriors older than thirty years old. Not far behind were ankle sprains and severely pulled (strained) hamstrings. 

The Difference Between a Sprain and a Strain 

One of the best ways to prevent injury is to know what can happen to you while participating in sports or other physical activity. Like any other warrior, you must know your enemy and attack him before he attacks you. Knowledge of the common sports-related ailments will help you prevent them from taking you out of the game. 

One of the most common injuries suffered by weekend warriors is the strain. A strain is the stretching and in the worst case, tearing of the muscle tissue or the tissue that makes up your tendons. A tendon is a band of connective tissue that attaches your muscles to your bones. If you’ve ever been diagnosed as having a pulled muscle, you’ve suffered from a strain. The most severe strains are tears of the tissue, resulting in very painful movement, swelling and in the worst cases, subcutaneous bleeding or bruising. 

A sprain, on the other hand, is a stretching or tearing of a ligament. Your ligaments are fibrous connective tissue structures that connect one end of a bone to another. One of the most glamorized sprains among professional athletes is a tear of the anterior cruciate ligament (ACL). The ACL is one of the main stabilizers of the knee and is often injured during contact and jumping sports such as football and basketball. 

A sprain or a strain can occur during virtually any physical activity. Strains in particular can result from inactivity, deconditioning or simply from overdoing it. Most post-physical activity soreness can be categorized as a strain. It is theorized that the soreness you feel after a hard day’s work is a result of micro-muscle (or microscopic muscle) tears. Strains most often occur as a result of not being properly warmed-up or stretched prior to and after activity. 

Strains, like most other injuries, cause pain and swelling to the affected area. In most cases, you will feel the pain of a strain in the muscle belly, which is the central bulky part of the actual muscle. If you have suffered from a strained muscle or tendon, you are most likely to have a loss of or diminished function in that area. In the most severe cases, you can lose function all together. Other symptoms of a strain include muscle spasms and a dead feeling to that limb. 

A sprain is often caused by acute trauma either indirectly from a fall or bad twist or from a direct collision. Sprains are graded into one of three distinct categories. First-degree sprains are categorized by pain and discomfort to the ligament, with minimal to no joint laxity or looseness; in other words, even though there’s pain, the actual joint is still taut and stable. Second-degree sprains involve partial tears of the ligaments, increased pain, increased swelling, loss of function and difficulty with movement. Most severe are third-degree sprains. They are associated with complete tears of the ligaments, loss of stability and in some cases, dislocation. 

The most common symptoms of a sprain are pain, swelling and bruising. Unlike the strain, where the pain is felt in the belly of the muscle, pain from sprains is found on, in, or around a joint. People who sprained a ligament often report hearing or feeling a pop in their joint. That pop is the sound of ligament stretching and in the worst scenario, fully tearing apart. The most common sprain that occurs in weekend warriors is the ankle sprain, usually due to poor footwear or unconditioned musculature surrounding the ankle. Sprains are commonly referred to as twists (e.g. twisting you ankle). 

Treating Sprains and Strains  

Rest, ice, compression and elevation (RICE) are four cardinal rules for injury treatment and they apply here as much as anywhere else. By immediately adhering to these rules, you can significantly reduce the pain and discomfort of your injury. Likewise, your overall healing time will be reduced. 

The rule of thumb for ice application is application of ice to the injured area immediately following the injury. You should keep the ice on for 15 minutes, remove it for 15 minutes and then reapply. Repeat that cycle as many times as possible during the next 48 hours. You can use ice in the form of cubes or shavings in a bag, pre-made ice packs or even a steak or bag of peas from your freezer. Always put a layer of tissue or cloth between your skin and the ice to avoid any negative reactions to the cold. 

If you are in doubt as to the severity of your injury or you notice that it is not getting better over a period of time, you should have your doctor examine your injury and have an x-ray taken. In some cases, particularly in sprains, there is an associated fracture of the involved bone. The most severe sprains and strains may require surgery or physical rehabilitation, so a doctor’s visit is essential. 

Other Common Injuries 

Weekend warriors are prone to other injuries besides sprains and strains. Head injuries such as concussions are also common. Head injuries occur as a result of direct trauma to the head as in the case of hitting another player or colliding with a structure. 

Lacerations and bruises are other uncomfortable problems that occur in the weekend warrior population. Black eyes and cut lips abound in many pick-up basketball games across the country. 

Though most of the traumatic collision types of injuries are unavoidable, their frequency of occurrence and the frequency of sprains and strains in particular, can be significantly decreased with proper conditioning and common sense. 

Prevention is the Best Medicine  

So you think you’re ready for that pick-up game, this Saturday all the boys in the office have been talking about all week? Well, if you haven’t done anything to tune your body before tip-off, you may very well end up stiff as a board with an ice pack somewhere on your body by Monday. 

Conditioning  

The best way to prevent injury and soreness is to condition your body by participating in some sort of physical activity a few times during the week. The best way to get ready for your weekend event is to do something fairly similar to it Monday through Friday. If your event requires running or sprinting it is a good idea to do some jogging or cardiovascular conditioning before heading into the full activity. 

By building your body’s cardiovascular endurance, you will not fatigue as fast during your activity and you will build the strength of your muscles, tendons and ligaments. Most incurred by weekend warriors comes as a secondary product of fatigue.  For example, if your quadriceps muscles are not in shape, you’re very likely to have weak and injury-prone knees that are bound to give out sooner than later. 

Stretching  

Stretch, stretch, stretch. It is a good idea to stretch your muscles on a daily basis to increase their elasticity and durability. Tight muscles are the primary causes of muscle strains. By increasing their elasticity, they are less likely to tear or cramp during your weekend event. 

Spend a few minutes each morning stretching your major muscle groups. On game day, don’t go rushing right onto the field. Spend a good ten-to-fifteen minutes stretching your legs, your shoulders, your back and all muscle groups related to your activity. To help prevent soreness the next day, it is also a good idea to do some stretching after the activity to help fresh blood and nutrients to the area. Doing so will help increase the recovery rate of your muscles and tendons. The next day you will thank yourself for performing your stretching ritual. 

Warm up  

Always warm up before participating in any physical activity. When your muscles are cold, they are less elastic and very prone to overstretching or tearing. Take a few laps around the court or field. Don’t exhaust yourself, but you should be on the verge of breaking into a slight sweat. The increased blood flow will bring the warmth to the muscle needed for your activity. 

Eat right 

Other things to remember to help prevent injury are proper eating and equipment choice. Junk food and heavy meals will only slow you down and give you insufficient energy to perform at your peak level. You should eat a good balanced meal three hours before you play and drink plenty of water before, during and after your event.

Proper footwear 

Many injuries each year are due to poorly fitted shoes or the wrong type of shoe for your activity. When making your shoe selection, keep in mind the type of surface you will be playing on and match the shoe to the surface. Make sure your shoe fits properly, and that it’s not too tight and not too loose. If you are prone to ankle sprains, it is a good idea to invest in a pair of high-top shoes for added ankle and foot support. 

Conclusion  

Finally, take it slow. If it’s your first time out, don’t try to perform in the same fashion that you did in your high school lacrosse championships. Play for a limited time your first time out and increase your participation as your body becomes better conditioned, Most of the Monday blues comes from weekend warriors going full tilt for an extended period of time – far beyond their bodies’ capabilities. You might not feel it at the time, but come Monday, you’ll be kicking yourself in the rear for overdoing it – if you can move your leg.