Welcome to Stay in the Game, a monthly blog where the team from the Queen's Center for Sports Medicine shares the latest tips on the treatment and prevention of sports injuries. We want to help you play hard and be well - a winning combination that will keep you in the game all season long.

Dosing your exercise

Dosage of exercise takes into consideration the following elements in your activity:

Any quick, significant change in these categories may be enough to create an injury.

Example #1: Running for Sports

A very fit, multi-sport athlete is starting track season following soccer season. During the soccer season, the athlete is accustomed to running on a grass surface in soccer cleats five days a week, for one hour at a time, with moderate to severe intensity. After soccer ends, the same athlete starts running on the track for five days a week in track shoes, for one hour, at moderate to severe intensity. By the end of week 1 of track running, the athlete experiences significant pain in both feet strong enough to make even walking difficult. How did this happen? Why did this already fit athlete succumb to injury?

Look at the dosing:

• Frequency: how often
• Intensity: how hard
• Duration: how long
• Mode: type of activity + other factors (shoes, surfaces, equipment, etc.)

Given the athlete's activity pattern, what changed? The frequency was the same (5 days a week), the duration was the same (1 hour a day), the intensity was the same (moderate to severe), but the MODE changed drastically, from cleats on grass to shoes on the track, which led to injury, in this case bilateral plantar fasciitis. What are some things the athlete could have done to reduce risk of injury?

Example #2: Weightlifting

An athlete lifts weights to build up strength. His baseline dose is bench pressing (mode) three sets of 135 pounds (intensity) for 20 reps (duration), three times a week (frequency). After talking with a friend that has been working on building muscle mass and power, the athlete becomes motivated to do the same and increases his baseline dose to push three sets of 225 pounds for three reps. By the third set, he feels a searing pain in his left chest muscle.

What could have been done to avoid the pectoral muscle strain? The duration of bench presses was reduced from 20 to three. In this case, the SAFEST way to progress would have been to incrementally increase the weight and decrease the repetitions. The first increase should have been to add 10-20 pounds and cut reps in half. The next session should have been to add another 10 pounds and another cut in reps, by half. During the third session, (assuming there is a rest day or two in-between) he could attempt 225 pounds in one rep for three sets. From that point, he could safely build to 225 pounds in three reps for three sets by the next session.

So how do you avoid injury?

The Exercise Dosing chart can help remind athletes:
1. To avoid a large dose change in any single or multiple of the categories
2. If an increase is made in one category, a significant decrease should be made in one or two of the other categories

Athletes should understand that the body is an adaptive machine, and if you push your abilities, you will become stronger, faster and more agile. But drastic changes in frequency, intensity, duration or mode may cause you to experience an avoidable injury.

If you find yourself, or an athlete you know, experiencing a training injury, contact our experts for help at the Queen's Center for Sports Medicine at 808-691-4449 or click the button below.

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