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Dear Doctor: How Do I (Safely) Re-Start My Exercise Routine?

Dr. Steven Andelman, Sports Medicine and Orthopedic Surgery

March 2, 2021

Dear Doctor: How Do I (Safely) Re-Start My Exercise Routine?

Avoid a common exercise injury with these expert tips.


I am over 45 and am ready to get back to exercise after taking a much longer than anticipated “break” during COVID-19. What should I know about avoiding injury before I lace up my running shoes again this spring?

Dear Reader:

Trust me, you are not alone! Many people were sidelined from the gym or sports during COVID-19, and with the weather now improving, it’s a great time to think about getting back on track with physical activity. You are right to proceed with caution. Many athletes suffer more injuries in the preseason than they do during competition as they try to get back into game shape. Some of the most common orthopedic sports injuries are tendon and ligament strains and sprains, caused by overstretching or tearing from either a sudden movement or overuse. In fact, about half of the 33 million musculoskeletal injuries in the US every year involve tendons and ligaments. Add in a lack of conditioning, especially after a period of inactivity, and the risk of injury goes way up.

Some of the most common sprains and strains occur to the:

  • Achilles tendon
  • Quadriceps tendon
  • Biceps tendon
  • Anterior cruciate ligament

Unlike muscles which heal very quickly, our tendons and ligaments are more fibrous and take longer to repair and heal – sometimes as long as 6 to 9 months before you feel ready to go back to sports or exercise class. To compound that further, if you end up on crutches for a month your muscles will get even weaker, making your bounce-back to sports that much more difficult. 

How to get yourself game ready again

Make strengthening exercises a part of your own preseason program. Start with low weights and high repetitions. Avoid jumping back into your activity at the same level you may have been at prior to COVID-19. For example, if you are a runner, start out doing one mile a few days a week for the first week. In the second week, you can increase the mileage as long as you aren’t feeling any pain or stress on your legs and ankles. It’s important to build up slowly over the course of the month to allow your body’s structures to reacclimate to the stress, especially those parts of the body at higher risk such as the knee and ankle.

Overhead athletes such as swimmers, tennis players, and baseball or softball players should follow a similar gradual return to activity in order to protect their shoulders and elbows.
Dynamic warmups, where you stretch and move at the same time, are a great way to get your entire musculoskeletal and cardiovascular system moving, boosting circulation to the muscles, tendons, and ligaments. Some good examples are bodyweight squats, walking lunges, frog jumps, running in place, and jumping jacks.

The best Rx for healing

If you do end up with a sprain or strain – rest, ice, compression, and elevation, with some ibuprofen or acetaminophen is the first line of treatment. For lingering pain, or if you are unable to get back to activities after few days, it’s worth making an appointment with an orthopedist for evaluation. Patients frequently ask me if there’s a particular food or diet that will speed healing from an orthopedic injury. Unfortunately, there is no data to back that up, but one essential I recommend is vitamin D, which plays an important role in calcium absorption for bone and soft tissue health.

The bottom line: Take it slow! Start by improving your strength and endurance and go from there. You’ll get back to where you left off in no time.

Dr. Steven Andelman

Dr. Steven Andelman is an orthopedic surgeon at White Plains Hospital Physician Associates who specializes in adult and pediatric sports medicine. For an appointment, call 914-849-7897.

Similar Topics: sports injuries, stretching,