Starting an Exercise Program the Smart Way

SAN DIEGO (KUSI) – Starting an exercise routine – or resuming one after not exercising for a while – can be difficult, especially after an injury. Vigorous physical activity is a must for cardiovascular and overall health. But muscles and tendons can't go from zero to 60 overnight. Good conditioning is a gradual process.

"The most important thing to remember is to start slowly and gradually increase intensity and duration," said Jan Fronek, M.D., an orthopedic surgeon with Scripps Clinic and longtime team physician for the San Diego Padres.

Workouts generally fall into three categories, based on the degree of impact-loading – that is, the amount of stress that is applied to weight-bearing joints (feet, ankles, knees, hips, back).  

The highest impact level includes running, ball and racquet sports, martial arts, water skiing and competitive running. The moderate level features walking, hiking and low-impact aerobics. The low-impact activities are biking, working on an elliptical trainer, or swimming. It is this latter, low-impact category that would be recommended to begin a fitness program.

While these categories help people sort through appropriate choices when resuming a workout routine, they also highlight another important factor: cross training or simply alternating different activities. A good cross-training program might consist of the elliptical trainer on Monday, bike on Tuesday and swimming on Wednesday. Different activities allow stressed muscles, tendons and joints to rest while still maintaining fitness. Perhaps even more importantly, changing the workout makes the activity fresher and more interesting. 

Next, establish the duration and level of intensity, checking with a physician to ensure the appropriate level based on age and medical status. For example, many cardiologists recommend cardio five to seven times a week (though four to five may be more realistic). Two to three resistance (strength) workouts should also be incorporated.

Also, while gradual is good, a workout should be just that—work. Many people like to exercise with a friend, which may alleviate some of the monotony. However, if you are able to hold a nice, easy discussion with an exercise partner while working out, it probably means the workout should be more strenuous.

Many people wonder how to respond to the occasional, painful twinge during a workout. This is where the natural desire to push through the pain runs up against the pragmatic consequences of sustaining an injury. A good guideline is to use the one-to-10 scale. If the pain is at the low end, say a two or three, and goes away when the activity stops, it's probably nothing to worry about. 

However, if the pain is a six or seven and continues the next day, it's a good idea to suspend the activity for a while. Here's where cross training is especially handy, working other muscle groups while the painful area heals. If the pain continues, or there is a noticeable loss of function, it's time to visit a doctor.

For the most part, people reinjure themselves when they do too much too soon. For people who appreciate or would like additional guidance, it makes sense to consult with a physical therapist or fitness trainer. These professionals can outline a healthy routine that can restore good fitness without incurring further injury.

Much like adults, younger athletes and their parents are keenly interested in continuing sports activities while minimizing the risk of injury.  With this goal in mind, Major League Baseball recently created guidelines for youth baseball players. Because of his extensive experience treating elite athletes, Dr. Fronek was recently asked by MLB to join an advisory committee, which created the “Pitch Smart” program.

Available on the MLB website, the PitchSmart program establishes guidelines for pitch counts and rest periods for youth baseball pitchers, based on their age range. A wide range of baseball organizations follow the guidelines, including Little League Baseball and USA Baseball. The program was formed in light of a recent spike in the number of “Tommy John” (or elbow reconstruction) surgeries among MLB pitchers. 

For more information, visit or call 858-240-5075.

Categories: Health