Feverish? Injured? Maybe You SHOULDN'T Work Out

Transcription:

RadioMD Presents: Train Your Body  |  Original Air Date: Tuesday, January 13, 2015
Host: Melanie Cole, MS
Guest: Dr. Jordon Metzl, MD

Melanie: When is not the right time to work out?  If you’ve got a cold and the sniffles should you be going to the gym and working out?  If you have an old sports injury or your plantar fasciitis is kicking up or your shin splints hurt or your old knee is hurting you? How about if you didn’t sleep the night before?  Should you take a nap, or should you go to the gym and work out?  Which is going to be the best for you? My guest today is Dr. Jordan Metzl.  You can read more about Dr. Metzl at www.DrJordanMetzl.com. He’s a sports medicine physician at Hospital for Special Surgery.  He is also regularly voted among the top sports medicine doctors by New York magazine. Welcome to the show.  Dr. Metzl, let’s talk about when not to exercise.  So you didn’t get a good night’s sleep last night, let’s start with that one. When you’re really tired, do you go to the gym and try to work it out or do you take a nap?

Dr. Metzl: How did you know I didn’t get a good night’s sleep last night, Melanie?  Here’s the story on this.  First of all, I’m coming at it like this; I’m a sports medicine doctor, but I’m also quite active.  Every year I do one Iron Man and at least one marathon. This year will be my 32nd marathon and 13th Iron Man and I figure that I’ll keep going as long as I can.  I love activity every single day.  I love activity every single month, every single year, and I love setting goals to help me do that.  These are things I deal with, not only as a doctor, but very much as an athlete myself. So, the first thing is sleep.  Most of us don’t get enough sleep: Life, commitments, whatever.  Ideally you need somewhere between 6 and 8 hours, everyone is different.  To me the sleep question becomes the following. Generally speaking, for all this stuff, I’m a big believer in listening to your body.  Forcing yourself to do something because you feel like you have to is never good.  Not listening to your body’s cues can cause a lot of problems. So with sleep, if you feel like you want to go out there and do a slow slog, even if you’re super tired, I have no problem with that at all.  It tends to be, if you’re sleep deficient, trying to do high intensity work outs is a much bigger problem than just doing a low, steady, slog.  What I would say is: If you’re sleep deprived and you want to get out there and move I totally recommend doing it, but I don’t recommend doing a high-intensity kind of work out.  I recommend more of a slow slog.

Melanie: Okay.  What about if your back hurts?  My back goes out sometimes. I get these low back pains from a disk I bulged working at a health club 25 years ago.  Do you work out when you feel that back pain?  Does that help it, or do you give it a rest?

Dr. Metzl: Let me give you the rule on injuries that I have in my Athletes Book of Home Remedies, which is the book I did about how to put up with all of your injuries.  In that book I tell what I do in my practice, and here is my rule on this:  If pain changes your mechanic of movement, don’t do that movement.  Meaning, if your back is changing the way you serve your tennis ball, if it’s changing the way you swim, if it’s changing the way you run, if the pain is changing your mechanic of motion, don’t do it. If it’s achy, but you can keep doing it in the normal way, I generally think that’s okay.  That’s my rule. With back pain, there are all sorts of things that make people’s backs hurt.  You can have back pain from muscle spasms.  You can have back pain from a herniated disk.  You can have back pain from arthritis.  There are a bunch of categories of things that can make your back hurt.  I don’t expect people, necessarily, to diagnose their own injuries, but in my home remedies book I have a lot about how to diagnose injuries on your own.  You don’t have to diagnose yourself, but I think you have to be receptive to the kind of pain you’re having.  So it depends on the kind of back pain you’re having and also what activity you are trying to do.  If you’re trying to hit a golf ball, that’s a lot more loading force on your back than if you want to go swimming.  You have to have some common sense, too.

Melanie: Okay, what about your old sports injury?  It’s bothering you, and your knees are starting to hurt.  Maybe it doesn’t change your gait but as you go on the treadmill or the bike you’re starting to feel that old pain again and you say: “Geeze, I thought I fixed that.”

Dr. Metzl: I’m a big believer in helping people learn how to manage their kinetic chain, first of all. Everything from functional strength training, which I’m a huge fan of not only doing but teaching, in addition to getting on their roller and loosening up their muscles. This maximizes the muscular strength and flexibility around their joints which reduces things like aching knees.  Sometime that alone is all we have to do.  If that alone is not helping, then you have to talk to your doctor and see what some of the other things you can do are.  Maybe you have some arthritis in your knees and doing things like lubricant shots may help reduce your symptoms, so you can be active. It’s never quite as simple as: “It hurts, don’t do it.” We try to figure out what we can do to make it hurt less, or not at all, so you can keep doing it.  As far as I’m concerned, achy knees become a health issue in a broader sense.  You’re not active if your knees hurt.  If you’re not active, you get depressed, your blood pressure goes up, your cholesterol goes up, and you have a higher risk for a heart attack or a stroke, for all kinds of stuff.  It becomes a major health issue.  I want you to get off your couch and move every single day.  That’s how I think about those things.

Melanie: It’s flu season, colds and flu. If your nose is really stuffed up and you can’t taste anything, which in my opinion is like torture, when you work out does that stuff you up more if you’ve got a cold?  Sometimes you like to picture it as flushing it out, shooting it out.  Does that work, or is that a myth?

Dr. Metzl: It works for me; I’ve got to tell you.  I tell my patients, if it’s above the neck, if it’s neck and up and you can do it, get out there and do it.  I think getting out there and getting moving and going, being outside, it definitely cleans everything out for a while.  I think it’s terrific.  I would recommend doing it.  Plus, it gets your immune system going.  I think it’s only helpful.  If it’s down below the neck, if it’s in your chest, if it’s in your lungs, if you’re coughing up nasty stuff, or if you have a fever over 101 then it’s time to kind of back off.  In general, I think listening to your body is the best advice I can give you on that.  

Melanie: This is a good one because I have a lot of people ask me about this.  The last time someone worked out, they felt a sharp pain.  Maybe it was in their chest, maybe it was in their back, maybe in their calf. They get worried that it’s a blood clot or that it’s a heart condition.  When you feel that sharp pain, even if it goes away right away, do you stop exercising and rush off to doctor?  What do you do when you feel that sharp pain?

Dr. Metzl: It’s tough as a health care practitioner, I’ve got to say.  I used to play soccer all the time.  Then I’m in my office and I see people with injured knees from playing soccer, tearing their ACLs from playing soccer.  “Crud, I’m not going to keep playing soccer.”  Fortunately the people that come see me are a skewed population.  They come to see me because they hurt their knee, not because they had no problem playing soccer. It definitely affects me.  I’m very sensitive to these issues because I’ve had people come in that have had heart attacks pushing through pain or they’ve had other problems pushing through pain.  I generally think that if it’s a pain that comes and it goes away and it’s not causing any symptoms, generally, it’s probably okay.  If it’s something that comes up repeatedly: “Every time I run, my chest starts to hurt.” I start to lean to getting it checked out.  Blood clots, not as much, but it certainly can be. Definitely heart conditions, for sure. Everything from dizziness to chest pains, those things can be worrisome, obviously, if you do have that or have a history of that.  Most people with athletic related heart conditions are fully asymptomatic until they have a big event, so unfortunately there are no warning signs.  If you are lucky enough to get a warning sign and the things I look for are dizziness, chest pains, that kind of stuff, you definitely want to get it checked out.  

Melanie: Really great information and great advice. You can read more about Dr. Jordan Metzl at www.DrJordanMetzl.com.  He’s got a lot of great information and great books out there, so check him out.  You can kind of help diagnose some of these things yourself.  Of course, if you have any issues see your doctor.  If you get any kinds of pains from exercise, that’s our disclaimer, you know we always have it here on RadioMD.  Thank you so much for listening.

You’re listening to Train Your Body.  Motivate and perform with the American College of Sports Medicine, right here on RadioMD.  You can share these shows with your friends on Facebook, you can follow us on Twitter @RadioMD, and you can even listen to these shows on IHeartRadio and iTunes.  There are lots of ways to go.  You can listen anytime, on demand or on the go, on your tablets or on your phones.  Share these shows, because this is great information.  This is Melanie Cole.  Thanks so much for listening and stay well.