Bone and Joint Health

Exercise Frequency and Guidelines for Maintaining Healthy Bones and Joints

Exercise is the time-tested elixir for looking good and feeling healthy. However, if done improperly, it may lead to joint aches and pains. When planning your exercise frequency, routine, or prescription, always consider form, stability, speed, and intensity. Here's why:

Form Matters

Anybody who has competed in an athletic event or participated in resistance training likely recognizes the importance of employing proper form. The reason is obvious in Olympic lifts, such as the power clean, which are near impossible to complete without proper technique. So let's consider something a bit simpler, like an air squat. When performing a squat, we're always told to keep our butt down and get our knees to 90 degrees. Well, a common problem when squatting is that the knees tend to fall inward during the descent. This results in improper knee position and overpronation at the foot.

Let's translate the concept of squatting into the most common form of exercise in the world: running. When we run, our legs act like springs; we impact the ground with every foot strike, our knees bend as we absorb impact, and we actively and forcefully push upward. In essence, running is a series of single-leg squats, and if our knees are falling inward, it hurts after a while — think of doing 100 squats a day or running a 5K like that! That overload can result in breakdown of the menisci (cartilage of the knees), leading to painful bone-on-bone impacts.

Let's say you take this advice and try to utilize proper form, but for whatever reason, you just can't manage it. This is the point where you proverbially look at yourself in the mirror: If something is moving wrong, that means there's a problem. Before trying to get big or fast, you need to focus on stability. In this case, strengthen the hip abductors (in layman's terms, the side butt muscles) so they can prevent the knees from falling inward. Similarly, if your shoulder feels weak or has a tendency to separate, don't keep doing shoulder presses. Rather, use controlled movements to develop the small shoulder-stabilizer muscles. Also, be sure to balance out your exercise routine, as improper movement mechanics are usually attributed to a lack of flexibility or imbalances in strength.

Quality Over Quantity

Now that you're exercising with proper form and with stable joints, here's a suggestion: Stop defining your workout solely by the amount of reps you achieve. Instead, think about the quality with which you complete them. Speed and control matter a lot! Think of a simple bicep curl. When you lift the weight up, the biceps muscle shortens; this is called a concentric contraction. When you slowly lower the weight, the biceps muscle lengthens; this is called an eccentric contraction. Now, if you lift the weight up and just drop it quickly, you lose out on the eccentric portion of the contraction. By taking it slow, you're focusing on eccentric training, which overloads the muscle in a healthy way and leads not only to quicker strength gains, but also changes in muscle properties (e.g., greater strength at longer muscle lengths).

Consistent Training

To further ensure bone and joint health, develop a personalized exercise routine that you can commit to. As recommended by the American College of Sports Medicine (ACSM), attempt to balance your training across cardiorespiratory, resistance, flexibility, and neuromotor (or functional) exercises. If you desire strength gains, focus on higher weights and lower repetitions. Conversely, if you desire to develop muscular endurance, aim for lower weights and higher repetitions. Because of delayed onset muscle soreness (DOMS), peak muscle soreness will occur 24–72 hours after exercise. Thus, make sure to provide ample time for recovery (24–48 hours is typically sufficient for weight-trained muscles). With regard to exercise frequency, the ACSM suggests that novice individuals train 2–3 days per week, whereas intermediate and advanced lifters can train 3–4 days a week and 4–6 days a week, respectively.

By employing proper form, performing exercises with appropriate speed and control, and following previously established guidelines, you will put yourself in the best position to maintain long-term health.

Posted in Bone and Joint Health

Dr. Rami Hashish achieved his doctorate of physical therapy from the University of Washington School of Medicine and holds a doctorate in biokinesiology from the University of Southern California. Following his Ph.D. work, Dr. Hashish cofounded a footwear technology startup, JavanScience, which develops customizable footwear to help relieve and prevent foot and leg problems. Dr. Hashish is also active in the clinic, serving as the director of physical therapy for Regenerative Medicine - Pacific Pain & Wellness Group, at Urban Med in downtown Los Angeles.

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*This information is for educational purposes only and does not constitute health care advice. You should always seek the advice of your doctor or physician before making health care decisions.