“The most recent data reported says that more than 50,000 exercisers landed in the ER after run-ins with workout equipment, including flying off treadmills, getting snapped in the face by resistance bands, dropping heavy weights on their toes, etc.,” says Dr. Leon E. Popovitz, an orthopedic surgeon at New York Bone & Joint Specialists, an orthopedic practice based in New York City.

“In addition, injuries caused by exercise and exercise equipment increased almost 45% between 2007 and 2010! Moreover, injuries can be insidious, as seen in shoulder labral tears where symptoms often do not present themselves until weeks after the injury.”

With this in mind, here are Popovitz’s recommendations on how to safely approach the top three exercises that tend to cause more harm than good at the gym:

1. Aim for Balance for a Better Back:  The overhead standing lift When executed properly this exercise distributes weight evenly across the shoulders and spine and is great for toning the shoulders. However, many people add too much weight to the bar, and that causes them to hold the bar slightly in front of their body. When this happens, the weight distribution is altered and can place a tremendous amount of force on the spine, especially the lower back.

2. Lighten Up on Leg Day: Weighted leg extensions are an essential machine for any serious “leg day” regimen. When executed properly, it is a great way to strengthen the quadriceps muscles in the leg. However, many people believe that more weight and reps will lead to better results. Unfortunately, the opposite can be true; excess weight and repetitions can lead to inflammation of the cartilage behind the kneecap. This inflammation results in pain known as patella-femoral pain, which can make it difficult to walk, stand from a seated position, or kneel.
3. Avoid These Treadmill Hazards: There’s a reason to most over-utilized machine is jokingly referred to as “the dreadmill.” For many people, jogging or running on a treadmill forces them to change their gait to compensate for the narrow path or fast pace of the treadmill. When the gait is altered, the IT band and hip flexors can become strained due to muscular imbalances in the knees and hips. This excessive strain can cause inflammation of the joints in the hip as well as tendonitis or bursitis of the hip. Work up to your desired speed over the course of at least a few days and practice your form while you run.

But while it’s a common problem, it doesn’t have a simple answer. The NIH says it could be a strained muscle or a problem with a disc, or a bone problem that could be due to a fracture or tumor.

“We rarely find out exactly what it is,” Dr. Gunnar Andersson, an orthopedic surgeon at Rush University Medical Center in Chicago, told the NIH newsletter NIH News in Health. “As long as it stays as back pain, we are typically not that concerned.”

The center of the back is the spin, the NIH says, which consists of 33 bones called vertebrae. The spinal-cord nerves run in a tunnel through the middle of the bones. Spongy discs between the vertebrae act as cushions, and ligaments and tendons hold it all together.

The back, like many other parts of our body, changes with age. Discs can degenerate and it’s possible to get arthritis in the small joints of the back. The NIH says those changes can show up on an MRI or other scans, but the same changes can show up on people who don’t have back pain. Risk factors for back pain include obesity, smoking or inactivity with irregular bursts of exercise.

The good news, the NIH says, is that most back pain goes away by itself. For a new pain in the back, Andersson told NIH News in Health, he usually advises taking over-the-counter medications for the pain and staying away from activity that is hard on the back—lifting, carrying, bending, and twisting. “Then, wait for the problem to disappear, which it will in the great majority of people over a few weeks,” he says.

However, if your back hurts most of the time for more than 3 months, you have chronic back pain. Treatments for that vary and depend on the source of the pain. If the pain comes from a fracture or tumor, those problems can be treated, the NIH says.  Surgery can help if the pain is due to a ruptured (herniated) or conditions such as spinal stenosis (narrowing of the spinal column, which can put pressure on the nerves) or degenerative spondylolisthesis (when one vertebra slips over another).

But, the NIH explains, surgery isn’t the right choice for everyone. Talk to your health care provider about which is right for you. For most people, even chronic pain eventually clears up without surgery, the NIH says. It’s important, Andersson says, to stop the pain from taking over. Research has shown that patients who stay active are better off. Just be sure to avoid activities that might strain the back. “It’s important not to succumb to the pain and become afraid of moving,” Andersson says. “It doesn’t seem to make much difference what you do, as long as you stay active.”

Dance to music on the radio or a CD

Lift hand weights, soup cans, water bottles while watching TV. You can also use resistance bands.

Do floor exercises like thigh stretches and hip stretches

Do leg lifts while holding on to a sturdy chair, counter or wall for support (Watch the video to see this exercise performed.)

March in place or walk around the room while talking on the telephone

Take a few extra trips up and down the steps at home to strengthen your legs and build endurance

Work out with an exercise DVD. Get “Everyday Exercises,” the free exercise DVD from the National Institute on Aging (NIA). (Click here for ordering information.)

While putting your groceries away, strengthen your arms by lifting the milk carton or a 1-pound can a few times

Walk on the treadmill, ride the stationary bike, or use the rowing machine that’s gathering dust in your bedroom or basement

Vacuum, mop, sweep, or dust those hard-to-reach areas

Play ping pong with the grandkids

Take advantage of small bits of “down time” to do an exercise or two. For example, while you’re waiting for the coffee to brew or for your spouse to get ready to go out, do a few wall push-ups or calf stretches.

For more information on other health issues, visit the Senior Health website.

A release from ACS reports that the researchers performed an analysis using the 2012 National Trauma Data Bank (NTDB) of the American College of Surgeons, analyzing records of 6,267 patients who had a traumatic brain injury after a bicycle related accident. Among the group of patients, just over 25 percent were wearing helmets.

The release quotes said Ansab Haider, MD, one of the study coauthors, as saying, “We know for a fact that helmets help you prevent head bleeds in case you get into a bicycle-related accident. But the real question was, if you get into a bicycle-related accident and end up with a head bleed, does helmet use somehow protect you?”

The researchers found that among this group of patients–those who sustained traumatic brain injury after a bicycle related accident–the ones wearing helmets had a 58 percent reduced odds of severe traumatic brain injury and a 59 percent reduced odds of death. Further, the use of helmets reduced by 61 percent the odds of craniotomy (an operation to remove part of the bone from the skull to expose the brain) and facial fractures by 26 percent.

“If you are severely injured and you were wearing a helmet, you are going to fare better than if you were not,” said Bellal Joseph, MD, FACS, lead study author. “When you hone in on that severe group of people who actually developed a brain injury, and then look at how they did, the helmet really made a difference.”

The researchers also looked at the impact of age and gender on bicycle accidents where a traumatic brain injury occurred.

“We tried to see how the pattern of helmet use varied over different age groups,” Dr. Haider said. “The lowest incidence of helmet use was seen in the age group of 10-20 years of age. But as we went up every 10 years, the likelihood of helmet use went up.”

Drs. Joseph and Haider said that the trend of helmet use increasing with age continued to rise with each decade of life, until the age of 70, when the rate went back down for the first time. They also found that females are more likely to wear helmets than males.

The researchers also found that in the patients they studied, the likelihood of facial fractures was higher for those who weren’t wearing a helmet at the time of the accident. Dr. Haider said that helmet use helped prevent fractures to the upper part of the face, including the area around the eyes, the orbital lobe. However, helmet use wasn’t as effective at preventing fractures to the lower part of the face, such as mandibular jaw or nasal fractures.

As a result of their findings, Drs. Haider and Joseph said that the next step is to create injury prevention programs to increase helmet use among bicyclists, to manufacture better helmets, and to develop and enforce stricter laws for helmet use. They said that they already participate in many prevention programs in Tucson, which is a very bike-friendly city.

“That’s where future efforts need to focus in on–making helmets that really make a difference,” Dr. Joseph said. “Ultimately, the important message is patient care and how we can make our patients safer and more protected. We need to take this data and take it to the next level and move forward with policy and injury prevention, especially for the younger age groups.”

The researchers used a national injury surveillance database to study trends in bicycle injuries from 1998 to 2013. They found that the rate of hospital admissions associated with bicycle injuries more than doubled during that timeframe, especially with head and torso injuries.

And many serious injuries happened to riders over 45: Altogether, the proportion of injuries occurring to riders above age 45 rose 81 percent, from 23 percent to 42 percent, the authors said, and similarly the proportion of hospital admissions to older riders increased 66 percent, from 39 percent to 65 percent.

The results, based on the National Electronic Injury Surveillance System, were published in the Journal of the American Medical Association.

“These injuries were not only bad enough to bring riders to the emergency room, but the patients had to be admitted for further care,” said senior author Benjamin Breyer, MD, MAS, associate professor of urology at UCSF and chief of urology at UCSF partner hospital San Francisco General Hospital and Trauma Center. “If you take typical 25-year-olds and 60-year-olds, if they have a similar crash, it’s more likely the older person will have more severe injuries.”

According to a news release from UCSF, urban cycling has become increasingly popular in recent years and this trend has occurred while the U.S. shifts to an older demographic.

In the new study, the researchers found that the percentage of injured cyclists with head injuries rose from 10 percent to 16 percent. Approximately two thirds of the total injuries occurred among men, the authors said, and there was “no significant change in sex ratio over time.”

“These injury trends likely reflect the trends in overall bicycle ridership in the United States in which multiple sources show an increase in ridership in adults older than 45 years,” the authors said. “Other possible factors … include an increase in street accidents and an increase in sport cycling associated with faster speeds.”

The investigators emphasized that safer riding practices are needed, as well as better infrastructure. They urged cyclists to use appropriate safety gear, including helmets, and to follow the rules of the road.”

A release from the publishers notes that walkers regularly text on a mobile phone while navigating city sidewalks, but little research has been done to examine how the walkers’ gait may change when texting. The authors of this study examined the effect of texting and walking while being cognitively distracted and negotiating curbs and other common pedestrian obstacles. Thirty participants, 18-50 years-old, completed three randomized, walking tasks through an obstacle course while: (1) walking normally, (2) texting and walking, and (3) texting and walking while being cognitively distracted with a math test. The researchers analyzed the walkers gait using a 3-dimensional motion analysis system and modeled each task to assess differences between each trial.

The authors found that participants took significantly longer to complete the course while texting and being cognitively distracted compared to just walking. Texting while being cognitively distracted also increased obstacle clearance, step frequency, and decreased ability to walk in a straight line. The authors of the study suggest participants when faced with cognitive challenges decrease their walking speed to avoid accidents. The authors suggest this study group may be more familiar with walking while interacting with mobile phones and that further research may be needed to examine older participants, who may be at a greater risk of tripping with such walking deviations.

What Is the Difference Between a Sprain and a Strain?

A sprain is a stretch and/or tear of a ligament (a band of fibrous tissue that connects two or more bones at a joint). One or more ligaments can be injured at the same time. The severity of the injury will depend on the extent of injury (whether a tear is partial or complete) and the number of ligaments involved.

A strain is an injury to either a muscle or a tendon (fibrous cords of tissue that connect muscle to bone). Depending on the severity of the injury, a strain may be a simple overstretch of the muscle or tendon, or it can result from a partial or complete tear.

A sprain can result from a fall, a sudden twist, or a blow to the body that forces a joint out of its normal position and stretches or tears the ligament supporting that joint. Typically, sprains occur when people fall and land on an outstretched arm, slide into a baseball base, land on the side of their foot, or twist a knee with the foot planted firmly on the ground.

Although sprains can occur in both the upper and lower parts of the body, the most common site is the ankle. It is estimated that more than 628,000 ankle sprains occur in the United States each year.

The ankle joint is supported by several lateral (outside) ligaments and medial (inside) ligaments. Most ankle sprains happen when the foot turns inward as a person runs, turns, falls, or lands on the ankle after a jump. This type of sprain is called an inversion injury. The knee is another common site for a sprain. A blow to the knee or a fall is often the cause; sudden twisting can also result in a sprain

Sprains frequently occur at the wrist, typically when people fall and land on an outstretched hand. A sprain to the thumb is common in skiing and other sports. This injury often occurs when a ligament near the base of the thumb is torn

The usual signs and symptoms include pain, swelling, bruising, instability, and loss of the ability to move and use the joint (called functional ability). However, these signs and symptoms can vary in intensity, depending on the severity of the sprain. Sometimes people feel a pop or tear when the injury happens.

Doctors closely observe an injured site and ask questions to obtain information to diagnose the severity of a sprain. In general, a grade I or mild sprain is caused by overstretching or slight tearing of the ligaments with no joint instability. A person with a mild sprain usually experiences minimal pain, swelling, and little or no loss of functional ability. Bruising is absent or slight, and the person is usually able to put weight on the affected joint.

See a health care provider for a sprain if:

You have severe pain and cannot put any weight on the injured joint.

The injured area looks crooked or has lumps and bumps (other than swelling) that you do not see on the uninjured joint.

You cannot move the injured joint.

You cannot walk more than four steps without significant pain.

Your limb buckles or gives way when you try to use the joint.

You have numbness in any part of the injured area.

You see redness or red streaks spreading out from the injury.

You injure an area that has been injured several times before.

You have pain, swelling, or redness over a bony part of your foot.

You are in doubt about the seriousness of the injury or how to care for it.

A grade II or moderate sprain is caused by further, but still incomplete, tearing of the ligament and is characterized by bruising, moderate pain, and swelling. A person with a moderate sprain usually has more difficulty putting weight on the affected joint and experiences some loss of function. An x ray may be needed to help the health care provider determine if a fracture is causing the pain and swelling. Magnetic resonance imaging is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament, or can be recommended to rule out other injuries.

People who sustain a grade III or severe sprain completely tear or rupture a ligament. Pain, swelling, and bruising are usually severe, and the patient is unable to put weight on the joint. An x ray is usually taken to rule out a broken bone. When diagnosing any sprain, the health care provider will ask the patient to explain how the injury happened. He or she will examine the affected area and check its stability and its ability to move and bear weight.

What Causes a Strain?

A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is associated with a recent trauma or injury; it also can occur after improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse: prolonged, repetitive movement of the muscles and tendons.

Two common sites for a strain are the back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.

Typically, people with a strain experience pain, limited motion, muscle spasms, and possibly muscle weakness. They also can have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.

Treatments for sprains and strains are similar and can be thought of as having two stages. The goal during the first stage is to reduce swelling and pain. At this stage, health care providers usually advise patients to follow a formula of rest, ice, compression, and elevation (RICE) for the first 24 to 48 hours after the injury. The health care provider also may recommend an over-the-counter or prescription medication to help decrease pain and inflammation. Ask your health car provider about any possible side effects.

It is important that moderate and severe sprains and strains be evaluated by a health care provider to allow prompt, appropriate treatment to begin. This box lists some signs that should alert people to consult their health care provider. However, a person who has any concerns about the seriousness of a sprain or strain should always contact a health care provider for advice.

The second stage of treating a sprain or strain is rehabilitation, with the overall goal of improving the condition of the injured area and restoring its function. The health care provider will prescribe an exercise program designed to prevent stiffness, improve range of motion, and restore the joint’s normal flexibility and strength. Some patients may need physical therapy during this stage. When the acute pain and swelling have diminished, the health care provider will instruct the patient to do a series of exercises several times a day. These are very important because they help reduce swelling, prevent stiffness, and restore normal, pain-free range of motion. The health care provider can recommend many different types of exercises, depending on the injury. A patient with an injured knee or foot will work on weight-bearing and balancing exercises. The duration of the program depends on the extent of the injury, but the regimen commonly lasts for several weeks.

Another goal of rehabilitation is to increase strength and regain flexibility. Depending on the patient’s rate of recovery, this process begins about the second week after the injury. The health care provider will instruct the patient to do a series of exercises designed to meet these goals. During this phase of rehabilitation, patients progress to more demanding exercises as pain decreases and function improves.

The final goal is the return to full daily activities, including sports when appropriate. Patients must work closely with their health care health care provider or physical therapist to determine their readiness to return to full activity. Sometimes people are tempted to resume full activity or play sports despite pain or muscle soreness. Returning to full activity before regaining normal range of motion, flexibility, and strength increases the chance of reinjury and may lead to a chronic problem.

The amount of rehabilitation and the time needed for full recovery after a sprain or strain depend on the severity of the injury and individual rates of healing. For example, a mild ankle sprain may require 3 to 6 weeks of rehabilitation; a moderate sprain could require 2 to 3 months. With a severe sprain, it can take 8 to 12 months to return to full activities. Extra care should be taken to avoid reinjury.

Can Sprains and Strains Be Prevented?

People can do many things to help lower their risk of sprains and strains:

Avoid exercising or playing sports when tired or in pain.

Maintain a healthy, well-balanced diet to keep muscles strong.

Maintain a healthy weight.

Practice safety measures to help prevent falls. For example, keep stairways, walkways, yards, and driveways free of clutter; anchor scatter rugs; and salt or sand icy sidewalks and driveways in the winter.

Wear shoes that fit properly.

Replace athletic shoes as soon as the tread wears out or the heel wears down on one side.

Do stretching exercises daily.

Be in proper physical condition to play a sport.

Warm up and stretch before participating in any sport or exercise.

Wear protective equipment when playing.

Run on even surfaces.

Courtesy of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). For more information, click here.

A release from the society quotes lead author, Peter Millett, MD, MSc, from the Steadman Philippon Research Institute in Vail, Colorado, as saying, “Seventy-seven percent of our patients who had an arthroscopic repair of a full thickness rotator cuff tear, were able to return to their sport at a similar level of intensity.” s

The release notes that there were 33 men and 11 women involved in the study. All postoperative measures to evaluate progress demonstrated a significant amount of improvement than before surgery. Patients who simply modified their activities due to postoperative weakness were significantly less satisfied.

“The surgery we performed appears to be highly effective in reducing pain, improving function and returning our older athletes back to the activities they love,” said Millett. “Patients over 70 are typically not treated operatively for rotator cuff issues, but these results highlight that there might be significant reason to assess and treat a tear arthroscopically.”

To avoid offending others, Whitmore offers this advice in honor of National Cell Phone Courtesy Month:

Be all there: When you’re in a meeting, performance, courtroom or other busy area, let calls go to voicemail to avoid a disruption. In some instances, turning your phone off may be the best solution.

Keep it private: Be aware of your surroundings and avoid discussing private or confidential information in public. You never know who may be in hearing range.

Keep your cool: Don’t display anger during a public call. Conversations that are likely to be emotional should be held where they will not embarrass or intrude on others.

Learn to vibe: Always use your wireless phone’s silent or vibration settings in public places such as business meetings, religious services, schools, restaurants, theaters or sporting events so that you do not disrupt your surroundings.

Avoid “cell yell:” Remember to use your regular conversational tone when speaking on your wireless phone. People tend to speak more loudly than normal and often don’t recognize how distracting they can be to others.

Follow the rules: Some places, such as hospitals or airplanes, restrict or prohibit the use of mobile phones, so adhere to posted signs and instructions. Some jurisdictions may also restrict mobile phone use in public places.

Excuse yourself. If you are expecting a call that can’t be postponed, alert your companions ahead of time and excuse yourself when the call comes in; the people you are with should take precedence over calls you want to make or receive.

Focus on driving: Always practice wireless responsibility while driving. Don’t make or answer calls while in heavy traffic or in hazardous driving conditions. Place calls when your vehicle is not moving, and use a hands-free device to help focus attention on safety. Always make safety your most important call.  And always check the laws of your particular state.

Please visit http://www.etiquetteexpert.com/ and http://jacquelinewhitmore.com/.

On average, about 200 people every day go to the emergency department with fireworks-related injuries around the 4th of July holiday, according to the Consumer Product Safety Commission (CPSC). More than half the injuries were burns. For example, a sparkler can burn at 2,000 degrees Fahrenheit – which is as hot as a blowtorch.

Almost half (41 percent) of fireworks injuries are to a person’s hands, fingers or arms. One-third (38 percent) of them are to a person’s eyes, head, face and ears (CPSC).

If fireworks are legal in your community, The American College of Emergency Physicians strongly suggests that you do not use fireworks at your home. If you do use them, however, these do’s and don’ts will help make it a safer experience.

• DO – Have knowledgeable supervision by an experienced adult if you choose to use fireworks.
• DO – Buy fireworks from reputable dealers.
• DO – Read warning labels and follow all instructions.
• DO – Keep a bucket of water or fire extinguisher on hand.
• DO – Light fireworks one at a time, then move back quickly.
• DO – Dispose of all fireworks properly.
• DON’T – Give any fireworks, including sparklers, to small children; older children should be supervised by a responsible adult.
• DON’T – Light fireworks indoors or near other objects.
• DON’T – Place your body over a fireworks device when trying to light the fuse and immediately back up to a safe distance after you light it.
• DON’T – Point or throw fireworks at another person, ever.
• DON’T – Try to re-light or pick up malfunctioning fireworks.
• DON’T – Wear loose clothing while using any fireworks.
• DON’T – Set off fireworks in glass or metal containers – the fragments can cause severe injury.
• DON’T – Carry fireworks in a pocket.

“The safest and only thing you should do is watch a professional fireworks display managed by experts who have proper training and experience handling these explosives,” says Dr. Cunningham.

Carol Cunningham, MD, Emergency Medicine Physician at Akron General Health System, and State Medical Director for Ohio Department of Public Safety, Division of EMS, is available for interviews.

Akron General Health System, an affiliate of Cleveland Clinic, is a not-for-profit health care organization that has been improving the health and lives of the people and communities it serves since 1914. Akron General Health System includes: Akron General Medical Center, a 532-bed teaching and research medical center, and Edwin Shaw Rehabilitation, the area’s largest provider of rehabilitation services; Akron General Partners, which includes Partners Physician Group, the Akron General Health & Wellness Centers, Lodi Community Hospital, Community Health Centers and other companies; Akron General Visiting Nurse Service and Affiliates; and Akron General Foundation. Recently, U.S. News & World Report ranked Akron General Medical Center as the fifth best hospital in Ohio for the second year running. In 2013, the American Nurses Association bestowed the prestigious “Magnet” status on the more that 1,000 nurses from Akron General Medical Center, Edwin Shaw Rehabilitation and the Health System’s Health & Wellness Centers. For more information about Akron General Health System, visit akrongeneral.org.