Gyms and fitness centers have started to open up again in South Florida under tighter requirements involving mask wearing and social distancing. That means a return to full, all-out weight training and aerobics for many longtime fitness enthusiasts, or those who started exercising at home or outside in their neighborhood during the pandemic.

Despite the good intentions of staying fit or getting back into shape, you need to be cautious about jumping back into normal routines to avoid orthopedic injuries — whether it’s lifting weights or playing tennis, says John Uribe, M.D., chief medical executive at the Miami Orthopedics & Sports Medicine Institute, and head team physician for the Miami Dolphins.

“You’ve been locked up so long and you just want to go back to things you enjoy,” says Dr. Uribe. “And the bottom line is that our muscles and our muscle memory isn’t up to it.”

What you don’t want to do is dive back into a weight-training routine that you haven’t done in months, he said. Moreover, gym owners must require the wearing of face coverings even during strenuous indoor exercises under new government rules. So gym members should exercise caution by making sure they can breathe properly during a workout.

“You just gradually increase the weight as your training permits — as opposed to going in and just trying to see what you can do in the gym,” Dr. Uribe said. “That’s when you tear your peck and you can tear your biceps, (and) you can tear your rotator cuff.”

Dr. Uribe was featured in a recent episode of the Baptist HealthTalk podcast, Getting Back Into Training? Don’t Jump the Gun!, hosted by Jonathan Fialkow, M.D., deputy medical director, chief of cardiology and a certified lipid specialist at Miami Cardiac & Vascular Institute. Below are questions and answers from Dr. Uribe’s podcast.

You can access this and other Baptist HealthTalk podcast episodes on your computer or smartphone, or via Apple Podcasts and Google Podcasts.

Dr. Fialkow:
“So to get that started, let’s just talk about general health routines with returning to fitness. So what kind of things should someone who is getting back into that activity level be following and concerned with?”

Dr. Uribe:
“You’ve been locked up so long and you just want to go back to things you enjoy. And the bottom line is that our muscles and our muscle memory isn’t up to it … In tennis, for example, you have to be able to sprint, you have to be able to jump, you’re using your upper extremities. So there, you get into a program where you do interval stuff. You can start jogging and then sprint a little bit, or you warm up on the court and just jog around the court a few times … And then you stretch and then you stretch, and then you slowly hit. You get your strokes down a little bit and you back up. And then you hit a little more.”

Dr. Fialkow:
“So, it’s planning it, obviously, building up slowly, taking care of your body. Can you speak about being aware of your body or having your body talk to you?”

Dr. Uribe:
“You truly should listen to your body. And, again, in sports where you have multiple parts of your body working, it’s like — if you go out and ride a bike, it’s a little bit easier because you can just start pedaling — you can push it and get going. And you’re not doing any truly ballistic movements right away. But in other sports, for example basketball or tennis, or you’re going out to play some soccer or something where you stop and go, (then you can) start to feel your leg tighten up — that’s a real common thing with runners. That’s when you stop and you slow down. And you walk, you stretch, and then pick it back up. Because that’s what the muscle’s telling you — that it’s pulling on that tendon and it needs to be relaxed; it needs to be stretched.”

Dr. Fialkow:
“Now, gyms are just starting to open up. People might be going back to the gym, whether it be resistance training or lifting weights or things like that. Any particular concerns in that?

Dr. John Uribe:
“It’s interesting because with COVID-19 and the lockdown where we’ve been home, we’ve seen some very interesting injuries due to people trying to work out at home without, perhaps, the weights that they’re used to. And so they’ve trying to move appliances or do certain things like that. For example, the biceps tendon where it attaches to the elbow, we’ll maybe see in my practice three or four a year. And so far, just in this three-month period, I’ve had 12.

“It’s been very interesting. So when you go back to the gym, if you haven’t been lifting — and maybe (you’re) not even a gym rat — but that’s where you start with a good rule of thumb, which is just see how much you can do … For example, if you’re doing a leg extension or a leg press or a bench press, just see what you are comfortable with doing one time … and then cutting that in half. And that can be your base weight. And something reasonable like three sets of 10 (reps) with that is very good. And then you just gradually increase the weight as your training permits — as opposed to going in and just trying to see what you can do in the gym. That’s where you tear your peck and you can tear your biceps, you can tear your rotator cuff.”

Dr. Jonathan Fialkow:
“I presume you and doctors at the Miami Orthopedics and Sports Medicine are seeing more of these types of injuries over the last couple of weeks, certainly since the pandemic started. Can you speak to some of the other more common ones you’re seeing, both you personally and others in the group?”

Dr. Uribe:
“I think that the rotator cuff has become a very, very common injury, which wasn’t so common in the past. (That’s) because individuals are exercising to a greater extent as they age and the rotator cuff has a limited or a diminished vascular supply in certain parts of the tendon. As people get older and they’re doing more — say weightlifting or throwing a ball or doing overhead activities, exercises that really stress the rotator cuff muscles — we’re just seeing a lot more rotator cuff tears. And there are very specific exercises that you can do to maintain the health of that rotator cuff. So, yes, that’s become a very common part of our practice.”


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