Dr. Mark Schillinger is the director of Schillinger Chiropractic & Wellness Group. The clinic specializes in stress management care utilizing chiropractic adjustments and a complete physical therapy department.

By Dr. Mark Schillinger, D.C.

It's no secret that cardiovascular exercises have become the favorite workout activity of this decade. It is estimated that over
18 million people are enrolled in aerobic dance classes! Combine this with the number of people participating in running, cycling, dance and swimming, and it becomes very clear that Americans are on the move.

There are unquestionable benefits to the heart and circulatory system, lungs and musculo-skeletal system. Overall, the increased stimulus to the nervous system is the most beneficial feature. After all, it is the nervous system which controls all other bodily functions. As a chiropractor who treats a wide variety of sports injuries, it is easy for me to state that the patients involved in aerobic-type exercises tend to be healthier than those who are involved in non-aerobic sports (golf, bowling, etc.) Unfortunately, along with the many benefits have come a wave of injuries caused by the repetitive impact and shock that most aerobic exercises tend to cause. I will focus on Aerobic Dance, as a case in point. A recent medical study revealed that 760/0 of aerobic dance instructors and 46% of their students suffered an injury of some kind, directly due to their classes. How often do you hear that statistic mentioned in your spa? The three most common injuries listed were ankle sprains, twisted knees, and low back pain.

It is not my purpose to reduce or eliminate your participation in aerobics classes. On the contrary, I encourage all of my patients to engage in some sort of exercise. As a matter of fact, an integral part of my treatment program includes rehabilitative resistance exercises. Movement (physical, mental and spiritual) is the key to life! No one can guarantee you will never suffer an exercise-related injury; but there are some things you can do to reduce the chances. Here are my five steps to a safer workout:

1. Set realistic goals for what you wish to accomplish daily, weekly and monthly. Visualize yourself completing those goals successfully.
   
   
2. Warm up gradually: Gentle stretching without bouncing allows for increased flexibility of the muscles and joints. This prevents the strains and sprains commonly responsible for injuries. (The best book on this is Stretching, by Bob Anderson, Random House, 1980.)
   
   
3. Participate in the exercise only to the extent of which you are physically and mentally capable.
   
   
4. Stretch down after exercise - come back gradually to your more ordinary level of movement. After a workout, muscles are tight due to a buildup of lactic acid, which is a by-product of muscle metabolism. Gentle stretching, following the workout, relaxes the muscles and contributes to improved muscle tone. For example, if a horse is put away in a comfortable stall immediately after being exercised, it will become crippled with stiffness and pain; it must first be walked for ten minutes or more to bring its temperature down to normal, before returning to a state of comparative inactivity.
   
   The same principle applies with people.
   
   
5. Evaluation. After the workout, visually see yourself as if watching an instant reply in your mind, per-forming your workout. Critique your performance; then change the negative aspects of your workout and enhance the positive. This allows you to (re) set realistic goals.

These five steps should be preceded by a comprehensive physical examination. Discovering any predisposing physical or mental factors that may lead to unnecessary injuries is a truly preventative approach. Chiropractors are specialists working with the musculo-skeletal system, and are most qualified to perform this type of evaluation. However, a properly trained medical doctor, trained respect to sports injury, can provide this service.

The evaluation should include: heart and lung exam, blood pressure check, range of motion of the joints of the spine and extremities, muscle groups, and specific orthopedic and neurological tests.

Most injuries occurring during exercise are of the sprain / strain variety. When muscles and ligaments are overstretched or torn, the joints under this soft tissue may become misaligned. This accounts for the continuing pain and instability in the particular area.

I have found the most effective treatment to be a combination of chiropractic adjustments and physiotherapy modalities (hot! cold packs, ultrasound, electro-muscle stimulator, diathermy, etc.) At the proper phase of healing, a rehabilitative program of resistance exercises must be implemented. (If the weakened muscles or ligaments are not strengthened, reinjury is very likely to occur.) In addition, I share with patients simple, effective relaxation and concentration techniques designed to increase their physical and mental agility.

Remember to follow the Five Steps to a safer workout - so that the next time you stop exercising, it is to head for the showers, not the sidelines!

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Schillinger Chiropractic & Wellness Group
(415) 491-0959
1050 Northgate Drive, Suite 1
San Rafael, CA 94903