Dear Lauren & Lithers,
I've been noticing a recent trend in my practice: active women presenting with wrist, hand and elbow pain. This may not seem like anything out of the ordinary in my line of work, except that these patients all seem to blame a common culprit: EXERCISE.
In the past I've been mostly taking care of active yogis, but now I’m hearing a lot more complaints from women doing “total body work outs” such as boot camp, cross fit etc. I’m thinking this may be related to people ditching the gym elliptical and getting out there to exercise more effectively.
Some of my newer patients are active “Lithers”. Interestingly enough, most of the problems I'm seeing are not related to push ups, burpees etc. The “new” pain is primarily due to old, forgotten about injuries of the hand, wrist and elbow. An old sprain, fracture etc. is exacerbated as a result of new activity, sometimes improper technique. As an active Lither myself, I can say that the work out method is extremely ergonomic and will not cause new problems if done appropriately.
I’ve sustained three wrist fractures in my teens. For somebody like me, there needs to be an awareness that a childhood injury will most likely manifest itself in our 30’s and 40’s and 50’s. Having no symptoms from old injuries now is great and we want to keep it that way! I constantly remind myself of this and always do your modifications in class. Sometimes I will skip the more wrist “pressure point” exercises and lift my 5lbs weights, while the LITHE ladies in the room “wipe the floor” with their gliders or sleeves.
What is OK for most lithers, will not work for my wrist, even if I have no pain doing the exercise. Because of my old injuries, some stuff is off limits if I want to continue being able to move my wrist in 20 years. NO WORK OUT IS TO BLAME FOR THIS! The 14 year old me is to blame for this!
It’s not the downward dog, the mountain climbers or side planks that did it. There is no need to STOP doing your beloved activity believing that it causes you to fall apart. Please don’t grow to have a love/ hate relationship with exercising and don’t think of it as your enemy. It’s what I tell my patients and myself.
Giving yourself a day off, stopping when it hurts, not pushing yourself beyond your limitations can be very helpful, but will not always solve the problem. Sometimes treatment of underlying conditions may be necessary. Also, keeping in mind that certain exercises may be forever off limits (this part is extremely difficult to accept for a Type A personality, I personally struggle with this every day).
All of this seems fairly intuitive, however most of us can’t pay attention to our bodies when we are working out. This phenomena is caused by a rush of endorphins, which block the pain receptors in our body. They are very similar to opiates. Working out is similar to physical dependence. It can cloud judgment.
This is why it’s important to think of what hurt you in the previous class and try to avoid similar activity in the present, never push yourself through the work out. Pain is one of our best defense mechanisms to prevent injury. Believe it or not, pain is good!
Being able to stop and nurse your old injuries is not a weakness, it’s what will keep us doing the things we love for years to come. I’m thinking competing in a “LITHELON” may be a hot trend for 2023!
Julia Mayberry M.D.
Main Line Hand Surgery PC