PHOTO S BY JOHN M. DISC HER

Through
rrhepa m
•

ftft4W.:7',N,

Exercise
Stop Signs

Everyone recognizes the benefits of exercise.
But do we recognize when to stop?

The following warning

signals tell people who
exercise or work out to
stop and consult a physi-
cian:

SUZANNE CHESSLER SPECIAL TO THE JEWISH NEWS

G

reg, 32, suffered with
intense back pain af-
ter repeated lifting
caused one of his discs
to herniate six months ago.
Consultations with rehabili-
tation doctors and therapists at
Sinai Hospital encouraged Greg
to begin a program of exercise
therapy that includes inverted
pushups, hamstring stretches
and special back movements.
Believing that a bit more pain
now will alleviate the general-
ized pain later, Greg has kept up
with his workouts, biting his lip
through the most severe dis-
comfort. Although his pain has
diminished, some still remains.
His goal is to be well without
having to undergo back surgery.
What has worked for Greg —
exercising while experiencing
pain — will not necessarily work
for others. That's because his
routine was prescribed and mon-
itored by medical professionals.
Individuals initiating exercise
routines on their own and expe-
riencing pain as a result should
be evaluated by a doctor to make
sure that the condition causing
the pain will not be made worse
by certain movements.
"The phrase 'no pain, no gain'
is simply not true," says Dr.
Joseph Honet, head of physical
and rehabilitation medicine at
Sinai Hospital. "While it may be
true in certain situations, it's far
from true in every situation.
There's never a general rule be-
cause each episode of pain de-
pends on the individual
experiencing it as well as the lo-
cation and reason for the pain.
"Someone who is healthy and
wants to work out is going to
have discomfort, perhaps some
aching, afterwards. If there's no
underlying disease process or
medical diagnosis, the discom-
fort probably is of no conse-

quence and the person can con-
tinue at a personal level of tol-
erance.
"On the other hand, even a
normal individual who overdoes
exercise — with or without ma-
chines — can end up with prob-
lems like pinched nerves that
would require modifying or halt-
ing an exercise routine."
Dr. Honet gives the example
of a tenths buff who plays on a
regular basis. If that person be-
gins to suffer from "tennis el-
bow," the condition will worsen
with continued play. In contrast,
subtle muscle soreness between
the shoulder and elbow after a
game can be expected and
should not prohibit further par-
ticipation."Stretching exercises
can relieve pain, depending on
the problem," Dr. Honet says.
"Stretching for a frozen shoul-
der could help diminish pain, but
not the first time or two when
the pain could get worse before
it eases. "It's important to know
if there's a pinched nerve in the
lower back, since stretching the
hamstrings in this case could in-
tensify the pain."
Dr. Honet cautions about
what he considers the exercises
most likely to increase chances
for injury and pain — rowing
routines using machines because
of the position the person must
assume and weight lifting above
the head because there could be
damage to the neck and shoul-
der.
To guard against severe pain
regardless of regimen, Dr. Honet
recommends applying heat to
the body before exercise as a
muscle loosening technique and
applying ice after exercise as a
way to decrease swelling.
There is no exercise that is
perfectly safe, according to Dr.
Honet.
Dr. Honet does not believe

• Pain most of the tim
which means pain
long after the
workout is completed.

Pain strong enough to
awaken the person
from sleep.

• Pain in multiple
areas.

• Numbness and
tingling
accompanying pain or
felt independent of
pain.

• Pain which radiates
into an arm or leg.

• New bladder or bowel
symptoms (inability
to void or
incontinence) which
accompanies the pain.

there are any exercises
that are better for men
than women. But there
are exercises that are par-
ticularly good for women.
"Exercises that involve
walking and putting pres-
sure on bones lessen dif-
ficulties associated with
osteoporosis," he advises.
"If a woman wants to have
less thinning of bone mass,
walking would be a better
exercise than swimming.
Still, a woman with knee
or hip arthritis could be
made worse." While Dr.
Honet generally believes
strongly in the beneficial
results of exercise, he re-
mains cautious on an in-
dividual basis. "Just about Top: Dr. Joseph Honet supervises Robert Kaplan's lumbar functional stabilization exercises.
everybody should do some
form of exercise so long as Above: Physical therapist Michelle Labbe accepts a ball from patient Beverly Kaplan as
it's tailored to that person," Dr. Joseph Honet assists.
he says.

❑

IFi