Newest Dangers for Your Knees: Not Running, but Pickleball

Jennifer Heiner has served as the retail director of a running company in New Jersey since 2019. Active within the New York City running community, Jennifer Heiner has helped organize a number of training runs for the New York City Marathon, including the 20-mile Three Bridges Run, where she was also a pace group leader. Training for a 26.2-mile marathon requires organization, persistence, and discipline. The first training element is base mileage, which requires running three to five times per week and gradually increasing weekly mileage. Over the course of 10 to 20 weeks of training, runners should plan to build their mileage up to around 50 miles per week. Avoid increasing mileage by more than 10 percent per week. Every 7 to 10 days, runners should plan on a long run to help the body adjust to long distances. This distance should increase over time, then drop back down in order to let the body recover. These long runs should be taken at a slower pace in order to help the body adjust and learn to utilize fat for fuel. A peak run, such as the 20-mile Three Bridges Run, ensures the runner is prepared for marathon day. A marathon training schedule should also include rest days, which are essential for muscle recovery and injury prevention. Recently, Jennifer Heiner-Pisano notes that the FDA has published an article that afternoon exercise can help with certain health risks, including reducing the risk of diabetes. We've known for a while that there are numerous benefits to routine exercise, and this participar article takes a deeper look into the timing of exercise and the effect on the body. In her most recent post, Jennifer Heiner-Pisano took a look at some of the health benefits of running, which also shattered the common misperceptions that running is bad for your knees. There are studies out there, however, that suggest that the latest craze of Pickleball might actually be damaging people's knees. There is a recent article from HSS about this subject, which is reprinted below in full. Jennifer Heiner suspects that this is due to the fact that many pick up the sport of Pickleball because it is seemingly low impact compared to other activities, but you can still risk damage when you are going from the couch or inactivity to any activity at all. https://www.hss.edu/article_pickleball-knee-injuries.asp Is Pickleball Good for the Knees? Pickleball is less demanding than other racquet sports, but it can still be tough on the knees. If you’re among the growing ranks of pickleball players or are interested in taking up the fastest-growing sport in the United States, you may be wondering about the effect the game might have on your body.

The good news, says James Robinson, MD, a sports medicine specialist at HSS, is that pickleball is a relatively safe activity, even for older people and non-athletes who’ve never played a sport in their life. “Pickleball is less demanding than tennis or racquetball and doesn’t require as much running,” Dr. Robinson explains. But for older participants in particular, the sport can take a toll on the knees—especially if players have arthritis in the joints or trouble with their balance, which can lead to falls on the court. “A lot of the game is spent stooped over, which can cause challenges for knees,” he adds. One area on the court to watch out for is the “kitchen,” a small box around the net measuring at least 20 x 44 feet that designates a no-volley zone. Players often find themselves outside the kitchen, waiting for shots. “You’re squatting and not moving much at times, which can put a lot of pressure on the knee cap. That can lead to tendonitis in the joint and pain in the quadriceps muscles,” Dr. Robinson says. A Pickleball-Friendly Warm-Up As with all sports, a little preconditioning can help keep the body injury-free. “It’s always important to warm up the muscles and get ready for an activity,” Dr. Robinson says. “With pickleball, sometimes there’s a lot of standing around waiting for courts to free up, so you can take that time to do certain exercises to help yourself get ready for the games.” Some examples include: Mini squats to get the knees lubricated and the muscles in the joint moving. Calf raises help to loosen up the lower body. Hip flexion exercises to stretch the muscles, tendons and ligaments in the hip and increase flexibility. The key to these stretches, Dr. Robinson adds, is that they are dynamic, providing small movements that simulate functional action rather than stationary pulling. “You’re getting the joints and muscles used to the motion they’ll soon be performing,” he says. In addition to stretching, picklers will want to work on strengthening their lower body. That means working on the quads, core muscles and gluteus maximus. Pickleball and Arthritis: A Bad Mix? People with knee osteoarthritis should not be afraid to pickle, Dr. Robinson says. “Exercise doesn’t cause arthritis or make it worse. In fact, inactivity is probably the worst thing you can do for arthritis. But physical activity can lead to pain, so you need to listen to your body. If you’re playing and the pain gets intense, just back off.” On the other hand, a little soreness that goes away relatively quickly after playing and doesn’t interfere with daily life isn’t a problem, he adds. Try using a heating pad before playing to help loosen up the knees. Applying ice after games can help to reduce pain and minor swelling in the area. Of course, zealous players may find themselves putting their bodies (and knees) in unforgiving positions, so Dr. Robinson leaves picklers with the following advice: “If your knee gives way or becomes swollen, you definitely need to see someone and get it checked out.”

Trends in Marathon Running - Injuries and Health Benefits

Jennifer Heiner has served as the retail director of a running company in New Jersey since 2019. Active within the New York City running community, Jennifer Heiner has helped organize a number of training runs for the New York City Marathon, including the 20-mile Three Bridges Run, where she was also a pace group leader. Training for a 26.2-mile marathon requires organization, persistence, and discipline. The first training element is base mileage, which requires running three to five times per week and gradually increasing weekly mileage. Over the course of 10 to 20 weeks of training, runners should plan to build their mileage up to around 50 miles per week. Avoid increasing mileage by more than 10 percent per week. Every 7 to 10 days, runners should plan on a long run to help the body adjust to long distances. This distance should increase over time, then drop back down in order to let the body recover. These long runs should be taken at a slower pace in order to help the body adjust and learn to utilize fat for fuel. A peak run, such as the 20-mile Three Bridges Run, ensures the runner is prepared for marathon day. A marathon training schedule should also include rest days, which are essential for muscle recovery and injury prevention. Recently, Jennifer Heiner-Pisano notes that the FDA has published an article that afternoon exercise can help with certain health risks, including reducing the risk of diabetes. We've known for a while that there are numerous benefits to routine exercise, and this participar article takes a deeper look into the timing of exercise and the effect on the body. https://www.healio.com/news/endocrinology/20230530/afternoon-exercise-linked-to-greatest-hba1c-reduction-in-type-2-diabetes?utm_source=selligent&utm_medium=email&utm_campaign=news&M_BT=3449163138025 Jennifer Heiner notes that the article states, in full: "Physical activity performed in the afternoon could yield a greater reduction in HbA1c than physical activity during other times in the day, according to an analysis of data from the Look AHEAD trial published in Diabetes Care. “This is the first large-scale epidemiological study demonstrating that timing of unsupervised physical activity is associated with long-term improvement in blood glucose in type 2 diabetes,” Jingyi Qian, PhD, associate physiologist at Brigham and Women’s Hospital and instructor of medicine at Harvard Medical School, and Roeland J.W. Middelbeek, MD, MSc, assistant investigator and staff physician at the Joslin Diabetes Center and assistant professor of medicine at Harvard Medical School, told Healio. “Our findings highlight the potential of incorporating timing into physical activity interventions. While any amount of physical activity appears beneficial, the timing of the activity is linked to effects on blood glucose management.” People walking for exercise Afternoon exercise may confer a greater HbA1c reduction for adults with type 2 diabetes plus overweight or obesity than exercise during other times of day. Image: Adobe Stock Qian, Middelbeek and colleagues obtained data from 2,331 adults aged 45 to 76 years with type 2 diabetes and overweight or obesity who participated in Look AHEAD and had accelerometry data available at year 1 and year 4 (mean age at baseline, 59.2 years; 57% women; 72% white). An accelerometer was used to measure the number of moderate to vigorous physical activity sessions, physical activity duration and timing. Participants were assigned timing groups based on when they conducted physical activity. For year 1, morning time was defined as 5 to 10:42 a.m., midday included exercise from 10:43 a.m. to 1:42 p.m., afternoon consisted of exercise from 1:43 to 5 p.m. and evening included exercise performed from 5 p.m. to midnight. For year 4, the times shifted to 5 to 10:30 a.m. for the morning, 10:31 a.m. to 1:18 p.m. for midday, 1:19 to 4:36 p.m. for the afternoon and 4:37 p.m. to midnight for the evening. Participants who exercised at varying times were placed into a mixed group. Demographics and anthropometric factors were collected at baseline and annual follow-ups. Change in HbA1c was assessed from baseline to year 1 and from year 1 to year 4. Roeland J.W. Middelbeek There were 1,755 adults with accelerometry data available at year 1 and 2,047 with data available at year 4. Half of the study cohort was randomly assigned to lifestyle intervention in the trial. Adults who exercised in the morning at year 1 and who exercised at mixed times in year 4 had the highest amount and intensity of physical activity measured. From baseline to year 1, HbA1c changes varied across time groups. Adults exercising in the afternoon had a larger decrease in HbA1c from baseline to year 1 when compared with inactive adults (mean difference, –0.22%; 95% CI, –0.39 to –0.06). There was no difference in HbA1c change between adults in the other exercise groups and inactive adults. No difference in HbA1c from year 1 to year 4 was observed for any of the exercise timing groups. Among 1,939 adults who did not use insulin, exercising in the afternoon during year 1 was associated with a greater likelihood for discontinuing glucose-lowering medication compared with no physical activity (OR = 2.13; 95% CI, 1.29-3.52). “Why afternoon exercise is better for patients with type 2 diabetes remains to be investigated,” Qian and Middelbeek said. “Some common hypotheses are, the circadian system regulates many physiological functions in our body, which may play a role in the time-specific benefits of physical activity. Other behavioral factors, such as fasting/postprandial states and sleep-wake cycles may also contribute to the glucose-lowering effect of physical activity. For example, post-meal physical activity, which may be occurring most often after lunch in the afternoon group, is an effective strategy for managing postprandial glucose excursions in type 2 diabetes.” Qian and Middelbeek said the research team plans to test out the findings experimentally to investigate the underlying mechanisms that may explain the association between afternoon physical activity and glycemic control."