With so much of the workday spent seated in front of a computer, sports and other outdoor activities can be a thrilling counterpoint for many adults. Though there are many health benefits from getting plenty of exercise, these can often come at a painful price: injuries.
      For adults in their 30s and older, many of these injuries include the rotator cuff in the shoulder, tennis elbow, knee pain and plantar fasciitis in the heel and foot.
     Such injuries sometimes are accidental, but usually they are a result of repetitive overuse. For those over 30 especially, it's important to recognize this risk when exercising, in order to prevent further injuries.
    According to Dr. Mike Miller, medical director of sports medicine at St. Elizabeth Hospital in Northern Kentucky, folks of that age will find their bodies beginning to break down a little, making them more susceptible to injuries.
    This age group is "a high-risk group orthopedically, and the reason they are is that they are old enough to have some wear and tear, but young enough to still be very active, so they are still placing high forces on their joints, muscles and ligaments," Miller says. "It's that combination and the fact that this age group can show signs of getting older and still be active, that's the risk."
    For those past the Big 3-0, who wish to continue staying active and healthy, preventing injuries means putting in a little extra time and effort before exercising, which may be an issue for people who don't have much time during the workweek.
     However, Miller says it's necessary to work a little harder at maintaining strength and flexibility, even if that means spending an extra 15 minutes stretching before exercising.
    Another main cause of these types of sports injuries is that people tend to not exercise during the week, but overdo it on the weekends, according to Dr. Paul Favorito, a fellowship-trained orthopedic surgeon at Wellington Orthopaedic.
    "The most common problem is that with these "¢weekend warrior' types, it's an irregular pattern of exercise," he says. "You have people who might not do anything for two or three days, and then after a nine-hour workday, go play indoor soccer at 10 at night."
     Instead, adults should opt for a more moderate exercise level, even if that means working out for shorter periods of time, but more days per week. Miller says this is much better on your body than doing it all at once.
     "The reason they get the nickname "¢weekend warriors' is that they aren't active all through the week, then they try to do too much, too quick and too soon on Saturday morning," he says. "What would be best is if they could develop better exercise habits, where they work out consistently three to five days per week. Then they'd be more flexible, they'd be stronger and they'd lower the risk of getting weekend injuries."
    Miller says it's also extremely important to be reasonable and realistic about what your body can handle.
     It's important to arrive early to warm up and do some dynamic stretching, he says. "But maybe one of the biggest things is for them to be very realistic about their goals and to make sure their goals are appropriate for their age."
     Favorito agrees.
     "What I see is people saying, "¢Yeah, I need to get into shape,' and then going out and running three miles, when in reality, they are 50 pounds overweight and have a sedentary job," he says. "Recognize when too much is too much. Realistically, you can't be a hero. Just because you could do it 20 years ago doesn't mean you can do it today."
     Favorito recalls one patient who came in with a shoulder injury as a result of doing too many push-ups.
     "You could tell he worked a lot and didn't have a lot of time to exercise," he says. "When I asked him how it happened, he said he was doing push-ups in his hotel during a business trip because that's what he used to do years ago to stay in shape. The truth is that was 50 or 40 pounds ago. You just can't do that when you want to exercise."
     While it's true that the risk of doing so may lead to injuries that are treatable with just rest, ice and lots of Advil, many injuries might take a lot more to get better.
     "I think most of us would agree if you go out and exercise, you get a little bit sore in the muscles," Miller says. "That's pretty A-OK, but if the soreness lasts more than two or three days, or it's gradually worsening rather than gradually improving, it might be a warning that you may need to be evaluated by a doctor."
     Other signs it may be time to get checked are if the injuries become associated with unbearable pain, swelling or loss of motion.
     "If you have pain that persists or if you can't sleep comfortably, that's also probably a good time to go see someone," Favorito says.
     "You've got to back off and moderate your activity for your injury to heal," Miller says. "Most of the injuries we see in our office, probably 85 to 90 percent are not going to be surgical, at least at the beginning, so you're going to try a conservative management first, if possible. You're not going to think about surgery unless you have failed with rest, time, physical therapy and medicine."
     For many, this means speeding up the recovery process through physical therapy, strengthening and conditioning, electric stem or ultrasound, taking anti-inflammatory medicine or wearing a brace. Or, this can mean going to the root of the problem and correcting your mechanics or techniques when playing sports or exercising.
     "We'll also tell them to have somebody that they respect "” a coach, a tennis pro, a swim instructor, whatever the sport "” to take a look at your mechanics when recovering and see if they can find anything about the way you're hitting the racquet or swimming," Miller says.
     "Our population is expecting to stay active longer . . . they want to continue to run and play sports, so I think that the benefits to exercising still outweigh the negative," Miller says. "However, it's important to realize that whenever we are exercising more often, and then we throw a little bit of age in there, we'll always have some negative effects. It's not just a middle-age thing anymore." -

St. Elizabeth Healthcare
Sports Medicine
Providing a variety of services for active individuals and athletes, St. E's combines the expertise of sports medicine specialist Dr. Michael J. Miller, with physical therapy and athletic training services. They have three locations: Edgewood, Florence and Southgate.
Specialties include orthopaedic injuries to the foot/heel, ankle, knee, back and neck, elbow and shoulder.
Medical evaluations available at Florence and Edgewood offices.
Sports concussion program features ImPACT testing.
On-site X-ray facilities, operated by registered radiological technicians (available at Florence and Edgewood offices).
Physical therapy services provided by experienced therapists and athletic trainers who deliver individualized attention to every patient.
A full line of orthopaedic bracing to assist recovery.
830 Thomas More Parkway, Suite 101,
(859) 301-5600 or www.stelizabeth.com/sportsmedicine.
4900 Houston Road, (859) 212-5200.
525 Alexandria Pike, (859) 291-7800.

     When docs say "warm up" to the 50-Plus set, they're not talking about throwing on a sweater and sitting by the fire. They're talking about the best way to stay in shape without feeling like Methuselah.
     Warm-up is the key, especially for this group, says Dr. Glen McClung of Beacon Orthopaedics & Sports Medicine.
     Though aging tissues tend to lose elasticity, boomers can still be part of the game, especially those who've been exercising regularly for 15 to 20 years.
     "Those who tend to get injuries are those who haven't exercised in a month and go out on the basketball court and injure themselves," says McClung.
     "In people 50 and older, one of the problems is that they're out of shape if they only exercise weekends. If you can find time weekdays to do something, it makes a difference in stamina, then they don't depend so much on ligaments, and that takes the stress off the joints," says Dr. R. Scott Jolson of Freiberg Orthopaedics & Sports Medicine, part of The Christ Hospital Orthopaedic Associates.
Hotspots for the 50-plus crowd include:
Knee meniscus injury, especially the inside meniscus. The menisci are fibrous cartilage that distribute your body weight across the knee joint. They become stiffer and easier to tear.
Shoulders in aging athletes are prone to rotator cuff tears and tendonitis from overuse. Tennis elbow is very common from overuse, especially in anybody doing repetitive upper extremity activities. "Different sports have different problems. Basketball and tennis players often rupture their Achilles tendon where overhead sports like tennis, handball, softball can lead to ripped rotator cuffs," says Jolson.
Achilles tendon ruptures are a common risk in the lower calf heel area because of elasticity loss.
Worn joints is another big issue in the aging crowd, especially in those who were very active in younger years. "They find they are developing arthritis "” old injuries come back to haunt you as you age," says Jolson.
     To combat the aches and pains, both doctors prescribe more warm-up and stretching "” before and after exercising "” than the simple toe-touch of youth.
     "It doesn't have to be a full 15 to 20 minutes before exercise and after," says McClung, "but an extended warm-up pre-conditions muscle to work."
     And choose a program with a cardio component and a weight-bearing activity to build bones, especially important for women prone to osteoporosis
     "Pick something you like, that's fun, so it's not like a job," says McClung. "Then you'll be much more prone to do it.""” Joy W. Kraft


Wellington Orthopaedics & Sports Medicine
4701 Creek Road, Cincinnati, OH 45242
(513) 232-2663
Top Doctor: Dr. James Plettner, MD "” Board President
Focus area(s) or specialty: Orthopaedics and Sports Medicine
Local Hospital Affiliations: Mercy Anderson, Mercy Clermont, Mercy Fairfield, Christ, Bethesda, Good Samaritan, Children's
Professional Memberships: MGMA

     With 27 physicians and seven locations throughout the Greater Cincinnati area, Wellington Orthopaedic and Sports Medicine is the largest and most experienced musculoskeletal health care provider in the region. Wellington is committed to providing its patients with superb, state-of-the-art care. Whether you see one of Wellington's providers in the office, operating room or physical therapy, you will receive the compassionate, personalized care you deserve. Wellington's goal is to make your experience exceptional and to make Wellington Orthopaedic and Sports Medicine the preferred destination for comprehensive orthopaedic care!

UC Health Sports Medicine
222 Piedmont Ave., Suite 2200,
Cincinnati, OH 45219
(513) 475-8690
Top Doctor: Angelo Colosimo, MD, Director of Sports Medicine
Focus area(s) or specialty: Sports Medicine, complex knee injuries, knee and shoulder reconstruction, ligament repair, cartilage repair, meniscus repair
Post-Graduate Training
     Undergrad: Colgate University
     Medical School: New York University
     Residency: Duke University
     Fellowship: Kentucky Sports Medicine Clinic
Local Hospital Affiliations: UC Health University Hospital and UC Health Holmes Hospita
Professional Memberships: American Board of Orthopaedic Surgery
     UC Health Orthopaedics & Sports Medicine provides comprehensive care for a broad range of surgical and non-surgical orthopaedic needs. Recognized by Best Doctors in America and Top Doctors in US News & World Report, our physicians are fellowship trained and board certified in a variety of orthopaedic specialties. We provide a multidisciplinary approach for the UC Bearcats as well as professional, recreational and high school athletes.
     Our physicians are also professors and researchers at the University of Cincinnati College of Medicine.
     Office locations include Clifton, Montgomery, West Chester, Wilmington, and Florence. Surgical cases are performed at UC Health hospitals, including University Hospital, West Chester Hospital, Holmes Hospital and University Pointe Surgical Hospital in West Chester, as well as Clinton Memorial Hospital in Wilmington.
Our services include:
"¢ Adult joint reconstruction and total joint replacement
"¢ Arthroscopic and reconstructive surgery
"¢ Foot, ankle, and knee surgery
"¢ Hand surgery
"¢ Orthopaedic evaluations
"¢ Spine surgery
"¢ Trauma surgery

UC Health
234 Goodman St., Cincinnati, OH 45219
(513) 584-2214
     Athletes are at a significant risk of repeat head injuries. More than 30 states have adopted laws designed to protect students from returning to play too soon after sustaining a head injury. National legislation was introduced in January 2011.
     A study of football athletes found that a player who experienced a concussion is three times more likely to experience a second concussive injury.
     Although recurrent injury will produce greater physical and cognitive impairment, many athletes place themselves into situations where repeat hits are likely to occur. Because recurrent mild head injuries can behave like a severe traumatic brain injury, experts
     Neurotrauma Center at the University of Cincinnati Neuroscience Institute (UCNI) are pursuing research to better understand the extent of the damage that often may not become visible until later.
     UCNI, based at University Hospital, is home to the largest team of neurointensivists in the area, each with the highest level of training available. These skilled physicians helped pioneer critical care trauma-response techniques used both on the battlefield and the playing field. Results from this research could help shape return-to-play guidelines and provide non-invasive means to measure concussion, guide treatment and prevent long-term effects of repeated concussive injury.