Dr. Raj on Risks for Distance-Training Weekend Warriors

By Wendy Bumgardner, About.com Guide

Updated September 14, 2010

About.com Health’s Disease and Condition content is reviewed by our Medical Review Board

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* walking injuries

* marathon training

* half marathon training

“Dr. Bal Rajagopalan – Dr. Raj”

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Are you a “Weekend Warrior” who does intense exercise, such as distance training, on the weekend, while doing little the rest of the week? Many people want to train for a half marathon or marathon walk or run/walk. But they are time-crunched and try to fit it all in on the weekend. Even worse, rather than gradually increasing their weekend mileage, they may try to get in a few long workouts just in the month before the event.

Dr. Bal Rajagopalan, aka “Dr. Raj,” is an orthopedic surgeon specializing in hip and knee surgery. He provides his insight into Weekend Warrior Syndrome for distance walkers.

Q: What sort of injuries would a walking or run/walk “Weekend Warrior” risk by doing long mileage (10 miles or more) without gradually training up to that distance?

Dr. Raj: There are a lot of potential injuries. On the orthopedic front, having good posture is extremely important as this pertains to your back. When you are walking, or running, and carry your weight towards the front, it can lead to abnormal, increased stress on your back – leading to a potential injury.

Also, the knees are at risk, as when fatigue comes on, there is more of a chance for injury as the muscles are not as protective to the joint itself. On top of that, if there is a lack of muscle conditioning – there can be spasms and possible tendon tears. There can also be risks with the heart as well. Is there is abnormal stress to a de-conditioned heart, it could lead to cardiac arrest, especially if you are dehydrated and your electrolytes change.

Q: Do older “Weekend Warriors” face a different set of injury risks?

Dr. Raj:Yes, older people are more prone to injury due to hormonal changes, and age-related issues such as arthritic joints and tight muscles. So, they are more likely to have pain, and possibly have tendon ruptures and stress fractures from osteoporosis.

Q: How is being overweight a factor in “Weekend Warrior” injury risks?

Dr. Raj:Weight is crucial, as each extra pound is seven pounds of joint reactive force on your knees. So really, if you are ten pounds overweight, that is an extra 70 pounds of force on your joints. Something to keep in mind and be very aware of when working out or running, or even just walking.

Q: What precautions should people with Type 2 Diabetes take in training for a long distance walk or run/walk?

Dr. Raj: Proper hydration is key here. I also recommend that they stretch before and after walking and/or running, and take it slow. I would give that advice to anyone, with or without Type 2 Diabetes.

Drinking Right for Walkers

Q: Are there gender differences you have seen in Weekend Warrior syndrome?

Dr. Raj: Yes. Women have smaller tendons and joints, so they are more likely to get an injury, however men tend to be more aggressive and push themselves harder, so the end result is pretty much equal.

Q: How might proper shoes or other gear help prevent injury?

Dr. Raj: Having a good pair of walking or running shoes with arches that will support the foot will prevent abnormal loading and protect the ankle from sprains. Having a good cushion in the shoe can also decrease loads on the foot bones, leading to less incidences of stress fractures. It is well worth the money to have a great pair of shoes for exercise; it can help prevent injury.

How to Choose the Right Walking Shoes

Q: Do you recommend any kind of cross-training (strength, flexibility, etc.) as a way to prevent being a Weekend Warrior or help reduce the risk of injury?

Dr. Raj: Absolutely, it is mandatory. It is important to stretch to increase flexibility, and if you are working out, having stronger muscles and tone can also help reduce potential injuries.

Stretches for Walkers

Strength Training for Beginners

Q: How can Weekend Warriors be motivated to do within-week training as well, and to gradually build distance endurance rather than procrastinating?

Dr. Raj: It is very important to build distance endurance and do training within the week — being a “weekend warrior” and going all-out for one weekend is where the injuries are most likely to happen. A change in your overall lifestyle is the answer. You can’t wake up one day and decide you are going to go on a ten mile hike with no preparation, and expect to see long term results, or not get injured. An overall lifestyle change, eating well, stretching, doing weekly work outs, and gradually working your way up to that ten mile hike is key!

About Dr. Raj: Dr. Raj is a Double Board Certified (American and Canadian) Orthopedic Surgeon based in Beverly Hills, California, specializing in hip, knee, and joint replacements, arthritis pain, sports injuries, fractures, and additional focuses on providing top alternative, conservative, and surgical options for any joint, bone, or muscle pain. He has been seen in the series “The Doctors” on SPIKE TV. Dr. Raj has also made the America’s Top Orthopedics List in 2007, 2009 and 2010.

Avoiding Walking Injuries

* Stretches for Walkers

* Drinking Guidelines for Distance Walkers

* How to Choose the Right Walking Shoes

Distance Training

* Marathon Training for Walkers

* Half Marathon Training for Walkers

* 10K Training for Beginners

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* Walking Injuries – Prevention of Shin Splints and Plantar Fasciitis

* How to Lift Weights Safely – Tips for Safe Weight Training

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* Shoulder Injuries and Prevention Tips

The famed actress and socialite and her eighth husband, Frederic von Anhalt, 67, are in dire financial straits after losing $10 million to con man Bernie Madoff in his multibillion-dollar Ponzi scheme, the sources add.

As Gabor, 93, bravely struggles to recover from a risky hip replacement surgery, she and von Anhalt face losing their $14 million Bel Air, Calif., mansion plus luxury cars, jewelry and a fabulous art collection.

“It’s terribly sad,” says an insider. “To have such a fabulous life come down to possibly being booted into the street just brings you to tears.

Relied on advice

“If she hadn’t gotten caught up in Madoff’s scheme, Zsa Zsa could go out in the style to which she has been accustomed. Now, she’s in the same boat as others who bet their life savings on the silver-tongued sales pitches of con men.”

Von Anhalt admits he blew it by relying on the advice of investment experts who led him to Madoff.

“I feel really bad because Zsa Zsa shouldn’t have to worry about the financial mess I’ve gotten us into,” he says.

Von Anhalt adds that he is trying to recover some of the money through legal action. Without it, he fears they are facing “financial ruin”.

As GLOBE reported in our Nov.30 issue, records show the Internal Revenue Service has already filed a lien against Gabor seeking $118,000 in delinquent taxes.

“We might be forced to sell our home, cars, artwork and jewelry because of this sick man,” von Anhalt says about Madoff. “He should be dragged through the streets and flogged!”

Madoff, 72, was sentenced to 150 years in prison after swinding a whopping $50 billion from hopeful investors, but his punishment isn’t likely to help Gabor’s bottom line.

And her money woes only add to the health problems she has endured in recent years, including a crippling car wreck in 2002 and devastating stroke in 2005. Now, friends fear her latest ordeal, the July 19 hip replacement surgery she needed after breaking bones when she fell out of bed could be her last.

“We all fear the end is near for Zsa Zsa,” says a source. “She’s always had a lot of fight in her, but the years and her health problems have taken a terrible toll. She just might not have the strength to fight on.”

And Beverly Hills orthopedic surgeon Dr. Bal Rajagopalan tells GLOBE, “At Zsa Zsa’s age there is an increased risk of death after hip replacement surgery because it’s unlikely she’ll ever walk again.”

Now, friends are heartbroken that Gabor-the great-aunt of scandal-plagued Paris Hilton by her three-year marriage to hotel magnate Conrad Hilton-faces taking her final bow as a pauper rather than a Hollywood princess.

“The thought of Zsa ZSa Gabor going out penniless is tragic,” says a pal. “It’s a sad final act in a life that she lived to the fullest.”

JIM NELSON and LYNN ALLISON
jnelson@globefl.com

Former U.S. House of Representatives Republican Majority Leader Tom Delay, 62, was forced to quit the show after suffering stress fractures in both feet. And Entourage star Debi Mazar, 45, landed in the hospital after tearing a muscle in her neck. Even pro dancer Lacey Schwimmer, 21, was feeling the pain after severely straining the hip flexors and abductor muscles in her upper legs around the groin area. She needed physical therapy for at least three weeks. “I’m doing OK, “she says. “I’m in a lot of pain but hey, that’s a dancer’s life!”

Dance-related injuries are on the rise across the country and most can be prevented, says Dr. Bal Rajagopalan, a Beverly Hills orthopedic surgeon. “The problem with Dancing with the Stars is that the contestants become overachievers,” he says. “They vie for the prize and don’t take the time to prepare their bodies properly.”

“Dancing is a very demanding sport that pushes the body way beyond the normal movement we experience in our daily lives. “Dr.Raj says that too often, folks throw themselves onto dance floors, trying to copy what they see on TV. It’s vital, he says to take care before hitting the ballroom. To reduce the risk of injury, take the following steps:

1. Always stretch the body totally before and after dancing. This will help the muscles and tendons get back to normal after being pulled and pushed.
2. Wear proper shoes with arch support to help avoid fractures. “You put so much weight on your heel and toes during a fast dance move that it’s easy to overload the bone,” says Dr. Raj.
3. Check with a professional therapist before beginning an intense dance program to see if you’re in good enough condition for the stress and strain of demanding dance routines. “Very often we have imbalance in our front and back legs which can lead to serious knee and ankle injuries,” says Dr. Raj. “You can help prevent future injury by strengthening the muscles around these joints.”
4. Drink a glass of milk daily to help maintain bone density and strength.
5. Finally, choose an age-appropriate dance.
6. “Our tendons and muscles deteriorate as our age,” says Dr. Raj.

“If you are over 40, you may want to concentrate on learning how to waltz rather than quick step!”

LYNN ALLISON
lynnallison@globefl.com

Music legend Prince appears to be wasting away from anorexia, contends a top medical expert-and pals are terrified about his weight.

As these ENQUIRER photos reveal, the “Purple Rain”singer’s weight looks like it has plummeted dangerously low. The diminutive entertainer, who stands just 5-foot-3, has dropped from 125 to a shocking 110 pounds, shocking 110 pounds, one expert estimates.

“He’s living in pain and not eating much, “a concerned friend told The ENQUIRER.” He looks awful, and some of the people around him are seriously worried.”

“Prince eats so little that I don’t think he’s getting enough nourishment,” divulged another source.

Dr. Aaron Tabor, a weight-loss specialist from North Carolina who has not treated the singer, says Prince shows some symptoms of anorexia.

“His Adam’s apple is protruding, his head appears much larger in proportion to his body, and his arms and legs are scarily thin,” said Dr.Tabor. “He appears to weigh little more than 100 pounds.”

“ALTHOUGH ANOREXIA MAY BE CAUSED BY certain illnesses, it is more commonly a psychological disorder in which the sufferer has an unhealthy desire to be thin and has a distorted sense of body image.”

After years of onstage acrobatics and dancing in stilettos, Prince is struggling with joint problems, While surgery may be able to alleviate his acute pain, the 51-year-old has balked at the suggestion because his faith does not allow medical procedures that may need blood transfusions. Prince is a devout Jehovah’s Witness.

Orthopedic surgeon Dr.Bal Rajagopalan of Beverly Hills, who specializes in hip and knee replacement, says dancing in high heels may have contributed to deterioration of his joints.

“Eventually, that abnormal wear and tear breaks down the ball and socket joint in the hips, necessitating surgery.” Dr. Rajagopalan explained, “If he doesn’t have surgery, he will have to ‘unload’ the hips another way with the use of a cane, crutches, a walker and eventually a wheelchair.”

by MICHAEL GLYNN

mglynn@nationalenquirer.com
PATRICIA SHIPP and LYNN ALLISON

The 56-year-old talk queen doesn’t want to be confined to a wheelchair,but experts say the operation involves weeks of grueling recovery and requires dramatic weight loss-but she’s vowed never to diet again!

“Oprah’s caught in a Catch-22 regarding her health and future!”a source tells GLOBE.”Her face are so bad,it looks like she has a sixth toe!” “She can barely walk,and is in constant pain.She MUST have surgery to keep from being permanently crippled.” And,the souce says the gab guru could already be facing future hip and knee replacements due to being overweight for so long

Currently,Oprah is tipping the scales at about 210 pounds,but since 1988 she’s yo-yoed from a svelte 130 pounds to a whopping 275 pounds,say sources. After 20 years of failing to permanently slim down despite trying “every weight loss plan known to man,”the insider says,”she’s just decided to accept she’s never going to weight 150 or even 160 pounds.” “But that goes against what her docs have told her.” Oprah has been warned every extra pound she carries adds more debilitating stress to her feet,knees and hips-and her age also increases the chance of developing bonedepleting osteoporosis.

“All in all,Oprah is facing a medical nightmare,”says the insider.”If she doesn’t find a way to lose weight and keep it off,she could end up in a wheelchair!” Oprah even admitted on a 2008 episode of her show she’s been “living in pain almost every single day for 21 years” because of her feet.But she still hasn’t gone under the knife to correct the problems,say sources.

She suffers from agonizing bunions,hammertoes and fallen arches,mostly brought on by her insistence on wearing fashionable,but highly impractical high-heeled shoes-which cause an unnatural walk. “This abnormal gait is overloading her knees and they will deteriorate faster,”Dr. Bal Rajagopalan of Beverly Hills tells GLOBE.”Eventually she’ll need surgery to repair or replace her knees and possibly her hips.If she doesn’t,she’ll end up in a wheelchair or using a cane. “Surgery to correct her feet needs to be done but it is extremely painful and she’ll need months to recover.And she needs to lose weight to save her joints.”

Chicago orthopedic surgeon Dr.Richard Berger says it’s too late for Oprah to avoid pain and suffering.”She needs surgery.”he says.

-JIM NELSON and LYNN ALLISON

The doctor in the story have not examined Oprah.

It looked like five and out for golden girl Dara Torres when she was stuck down with a debilitating knee injury. The 42-year-old mom from Florida set a record in 2008 when she competed at her fifth OLympic Games in beijing. During a glittering swimming career, she has amassed an incredible 12 Olympic medals, including four golds. But in recent months she’s had to face up to the very real threat of a career-ending injury. Her knees have been bowing to the pressure of age-related deterioration that plagues millions of Amercians.

She has been suffering from extreme pain in her left knee, the result of wear and tear on her cartilage. “Some days it hurts to walk”, admits Dara , who has a 3-year-old daughter, Tessa. “Going up and down stairs-forget it.”

“I would like to be able to go to the London Olympics in 2012 and to chase my daughter around without any pain in my knees.” In a bid to end her pain-and realize her Olympics dream-the bombshell opted for a revolutionary new procedure called an Autologous Chondrocyte Implantation(ACI). It was performed by Dr.Tom Minas of Brigham and Women’s Hospital in Boston. Instead of invasive surgery,he used biotechnology to strengthen her knees by implanting them with her own cartilage cells. First the doc removed 10,000 cartilage cells-the size of three tic tac mints-from Dara’s knee. These were then sent to a lab and grown for several weeks until they numbered close to 50 million cells. Dara’s knee was then opened up and the cells implanted into the hole directly where the cartilage was missing.Now the swimmer has to wait while,hopefully,the cells regenerate into healthy cartilage. However, Dr.Bal Rajagopalan,the famous Beverly Hills orthopedic surgeon known as Dr.Raj to his patients,tells GLOBE that the procedure isn’t for everyone.

“while the results have been encouraging,they are not 100 percent effective,”he says.”We can do partial or full knee-replacement surgery that can take care of the problem and relieve the pain immediately. “It’s important to get several opinions before taking any route.” For Torres, it appears that her innovative treatment is working. “My knee is doing great,”she says.”They did an MRI scan that showed the cartilage is growing.”

-LYNN ALLISON

“My back and neck were locked up, reveals the 41-year-old dancer,choreographer. “I wasn’t able to move pretty much the whole time.”

She was suffering from spinal stenosis, a painful arthritic condition whereby the spinal canal narrows and compresses the spinal cord and nerves. It is usually caused by age-related degeneration,but sometimes by spinal disc herniation,osteoporosis or a tumor.About 400,000 Amercians suffer from the condition. Having struggled through her DWTS judging duties, Carrie Ann went under the knife after the show’s run ended in November. And,amazingly, she was back dancing five days later!

“It’s nice to have my motion back,” says the Hawaiian-born beauty after surgery to relieve the pressure and stiffness in her neck. “I have dance class Monday, Wednesday and Friday. I’m back to my normal schedule and I can’t wait!”

Dr.Bal Rajagopalan, a board certified Beverly Hills-based orthopedic surgeon known to his patients as “Dr. Raj” tells GLOBE: “Carrie Ann is very very young to be going through surgery to repair this condition,but as a dancer she has had much more wear and tear on her joints and spinal column than the average person.

“Dancers are often over the hill way before their time when it comes to joint damage. “The most common surgical procedure is called cervical laminaplasty in which a small ‘door’ is cut into the back of the spine to decompress the nerves and relieve her pain. Small artificial wedges are placed between the spine and the door to create more space.”

The procedure takes about an hour under general anesthesia. Carrie Ann’s recovery was incredibly quick. Typically following surgery,patients are put in a brace for two weeks and then must have about two months of physical therapy.

“It should successfully relieve Carrie Ann’s acute pain, but she will probably always have dull, chronic pain from over use injuries in her joints after all the years of dancing, Dr.Raj says.”

While the ‘dancing’judge needed surgery, some sufferers can control their pain with medication or steroid injections along with physical therapy.

Carrie Ann hinted that she may have to face more surgery in the future, but experts say that with today’s minimally invasive techniques she should be fine.
-LYNN ALLISON