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Tell patients to forget "no pain, no gain"

Starting an exercise program slowly is key to avoiding injury and making physical activity a routine part of life.

By Susan J. Landers, amednews staff. Jan. 24, 2005.

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Washington -- Many people who resolve to embark on fitness programs at the start of the new year abandon such healthy thoughts when aching knees and backs bring them into their physician's offices after just a few weeks.

But it doesn't have to be that way.

As rising levels of obesity threaten to undermine the health of young and old, increased exercise could provide a route, though not an easy one, out of this morass. Physicians can help patients develop programs that avoid some common pitfalls and could spell the difference between success and failure, say those who see the damage wrought by imprudent exercisers.

"It is key to remind people that the adage 'no pain, no gain' is wrong," said Clarence L. Shields Jr., MD, an orthopedic surgeon at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. "They should not try to push through with a painful swollen knee or increasing back pain."

He also sees patients who, despite having mild arthritis, embark on a running program when a low-impact exercise would have been a better choice. They should start off on an elliptical trainer, bicycle or perhaps swimming, Dr. Shields suggests.

X-rays might come in handy to determine the extent of a knee injury before any exercising is begun, he said. Patients should also be warned not to take pain medications and then continue to exercise.

They often think, " 'I'm out of shape, that's why my knees are sore,' " said Dr. Shields. They press on, causing greater damage. Dr. Shields recommends ice and, if that doesn't help alleviate pain, a medical evaluation is needed.