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Prevention of Athletic Injuries

If you want to increase your endurance and prevent injuries, make your muscles as strong as possible. For example, hamstring tears are very common soccer injuries, and preseason strength training for the hamstring muscles helps to prevent these injuries. Players from two of the best soccer teams in Sweden were divided into two groups; one group received ten weeks of specific hamstring training twice a week, using a special device to overload the hamstrings eccentrically. The trained group had less than one third the hamstring injuries and also had greater improvement in hamstring strength and running speed. Resistance training makes muscles stronger so that they can withstand greater forces and this helps to prevent injuries.

You will increase your endurance far more by running, walking or cycling very fast once a week than by covering long distances very slowly all the time. In the 18th to 25th mile of a marathon, many runners "hit the wall;" their legs stiffen and hurt and they have to work much harder to lift their legs. "Hitting the wall" is caused by damage to the fibrous connective tissue that surrounds muscles, as a result of the repeated stretching and tearing of the leg muscle fibers each time the feet hit the ground. Doctors used to think that "hitting the wall' meant that the leg muscles ran out of their stored glycogen. However, after two hours of hard riding, bicycle racers use up their muscle glycogen but they do not "hit the wall" because their muscles use the smooth rotary motion of pedaling and are not stretched and torn by constant shocks of the foot hitting the ground. Exercising intensely helps to prevent injury and increases endurance by strengthening your muscles.


Dear Dr. Mirkin: I’m a cyclist who would like to enter a triathalon, but my shins hurt when I try to run. Should I stick to riding?

You’re not alone; some very good bicycle racers have developed painful shin splints on the front inside of the lower legs when they tried to train for triathlons. In a triathlon, you compete in three events: running, cycling and swimming. Posterior shin splints occur when you damage the posterior tibial muscles in the inside back of your lower leg. They have to stop running until they can run without feeling pain.

Bicycle riding develops very strong upper leg muscles because you pedal with your knees and hips. It does not stress your lower leg muscles much. Running stresses mostly your lower leg muscles. When you run, you land on your heels and raise yourself up on your toes with the calf muscles in the back and the posterior tibial muscles on the inside back part of your lower leg. So your upper leg muscles can handle the stress of running very easily, but your lower leg muscles are not strong enough and you tore them.

Once a runner develops shin splints, he or she has to stop running to let the muscle and tendon injury heal. A bicycle rider has to go back to the bike. When he can run without hurting, he should try to run on one day and cycle on the next and stop running immediately when he feels pain in his lower leg. When he can run for 30 minutes without feeling pain, he can start training again by adding fast runs. In the future, he should not run very fast more often than every other day or twice a week.


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Dear Dr. Mirkin: Will I recover faster from a hard tennis match by resting or by doing light exercise?

Most experienced athletes find that they recover faster by taking the next day off, but they become better athletes if they exercise at low intensity. On the day after you exercise vigorously, your muscles feel sore because they are damaged, and running fast with sore muscles can cause injuries. Several studies have shown that athletes who exercise at a leisurely pace on the day after hard workouts are less likely to be injured than those who recover by taking the day off. Exercising during recovery causes muscles to grow more fibrous tissue, which helps to protect them from injury.

You can adapt these findings to any sport or exercise program. Play your hard match and the next day take it easy by hitting balls against a wall. Run or ride hard one day and then go at an easy pace on the next day. Scrimmage hard in basketball for several hours, and on the next day, practice your shooting and set up plays. If you work out more than once a day, follow each hard workout with at least three easy ones.


Recipe of the Week:
Marge’s Lentil "Pasta" Sauce
(use it on your favorite whole grains!)

If you have a healthful recipe you’d like to share, please send it to

List of Diana's Healthful Recipes

June 26th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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