Dr. Tara Narula writes a women’s health column for TODAY.com. She is a cardiologist, medical correspondent for NBC News and associate professor of cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
I see many female patients who are frustrated that their injuries prevent them from exercising and, as a result, they are missing out on important mental and physical benefits. Exercise is known to be especially beneficial for women’s heart, bone health, and more.
However, there is a surprising lack of research on sports injuries in women.
“Experts say there are significant gaps in our understanding of women’s physiology in the context of physical activity and sport, and that there is not enough evidence-based research to provide specific recommendations.” The American Physiological Society points out:.
In fact, much of the instruction given to female athletes regarding training, injury prevention, and return to activity after injury is based on men, even though women’s bodies are not the same as men’s.
For example, women have higher levels of estrogen and body fat, less muscle mass, looser ligaments that make them more flexible, wider hips, thinner knees, and higher rates of calcium and vitamin D deficiencies, writes Dr. Robert H. Schmerling, former clinical director of the department of rheumatology at Beth Israel Deaconess Medical Center. Harvard Health Blog.
These characteristics may make female athletes more susceptible to certain types of injuries. According to Schmerling, these include:
- Ankle sprain
- Shoulder problems
- Knee problems
- Stress fractures
- Plantar fasciitis
- Women are two to eight times more likely to tear their ACL than men. According to the Yale School of Medicine:.
As a mother of two young daughters who have just started playing soccer, I was thinking about their future injuries and the best ways for women to exercise while staying protected.
TODAY Fitness contributor Stephanie Mansour, who leads the monthly challenge for the Start TODAY community, offers some tips from her experience as a certified personal trainer working with mostly female clients for more than 15 years.
This interview has been edited and condensed for clarity.
For a woman who never exercises, what’s the best exercise to start with?
Walking is recommended to loosen joints, increase mobility and flexibility, and strengthen the largest muscles in the body, such as the legs and buttocks. Walking is also a great cardiovascular exercise and can be done at your own pace, whether you walk slowly or briskly to get your heart rate up. It can be done easily, anywhere, anytime. It also helps develop your sense of balance.
If you only do one type of workout on a regular basis, what’s the first new exercise you’d recommend adding to your routine?
Strength training, i.e. basic exercises like squats and lunges, or leg raises if you can’t do lunges due to hip problems, as well as core strengthening exercises and upper body exercises. All of these will help you improve your posture in any activity. For example, pull your shoulders back and engage your quads, but also your abs, glutes and hamstrings. Strength training with dumbbells can be done in the gym or on your own.
Whatever your health and fitness goals are, whether you want to build muscle, speed up your metabolism, increase your energy or lose weight, strength training can help you achieve them.
What are your tips for getting started with strength training?
Start slowly. Even if you feel you have the stamina for 30-45 minutes of strength training, start with 15 minutes and repeat the same routine every other day for a week or two to let your body get used to the exercises. Don’t feel that you have to change your exercises every day; it’s better to give your muscles time to grow.
Pay attention to your breathing: breathe in when you’re not moving, breathe out when you’re moving. Synchronizing your breath with your movement becomes more of a moving meditation, allowing you to become more aware of sensations in your body.
Try doing your exercises in front of a mirror, focusing on your form. In some of my apartments, I’ve done strength training in the bathroom.
What should you do if you start to feel pain while exercising?
First, try not to beat yourself up. Don’t think, “Oh, I’m so weak,” or “What’s wrong with me?” If you feel like something’s not right, know that you can be your own trainer and expert on your body. Slow down a little bit. Don’t squat too low, use less weight, take shorter walks or cardio sessions.
I think what especially gets women down is an all-or-nothing mentality: “If I can’t walk for an hour, I shouldn’t even be walking.” Starting with five minutes trains you to prioritize your body and be aware of your sensations, so even if you feel tingling, pulling, snapping, or any other injury, just five minutes of exercise a day can help you become more in tune with your body.
If you are seeking medical attention, see a doctor or physiotherapist if you hear a popping sound and it is immediately accompanied by a sharp pain. Also, if it has been more than a week and you still feel something is wrong and it is not improving, we recommend that you see a medical professional.
What are some signs that you may be injuring yourself while exercising that shouldn’t be ignored?
The first is lower back pain. Many women start to experience lower back pain when they start doing sit-ups, planks, downward dogs, lunges, and squats because they’re not properly using the transverse abdominis, the deepest abdominal muscle.
Next is knee pain. If you do movements that your body is not used to, such as squats, lunges, or jumps, using incorrect form, your knees may hurt.
Skipping modifications can lead to injury. If you try to do a push-up and your core isn’t engaging properly and your hips are sagging, do modified push-ups on your knees. Don’t be discouraged. I’ve been certified in all of these for over 15 years and still do modifications when I feel it’s good for my body.
Finally, hip pain can be a sign that you’re not stretching enough (as can lower back pain). There are two types of stretching: dynamic stretching, which occurs when you’re moving, and static stretching, which occurs when you’re stationary. Use dynamic stretching to warm up and static stretching to cool down.
What other unique challenges do women face when it comes to exercise?
As women, we often shy away from working out. “I don’t know how to do yoga and I don’t want to look stupid at the back of the class,” or “I hate the treadmill, so I’ll never be a runner.” If that sounds like you, you could go outside and run or walk fast. Instead of getting hung up on a particular method you don’t like, find something you enjoy that meets your cardio, strength, and stretching requirements.
Also, pay attention to your schedule, your life, your body, and do what feels right. You know the difference between taking the easy way out and respecting your body and saying, “No, this is how it feels today.” Instead of feeling like you have to follow the training plan you made for yourself at the beginning of the month, be open to doing something different. It will actually help you have a better relationship with yourself too.
