New Year's Resolution: A Trip to the ER?

Intense exercise regimens could land fitness newbies in the emergency room.

December 30, 2008, 5:09 PM

Dec. 31, 2008 — -- As millions of Americans raise their glasses on Dec. 31, many will toast to a new beginning and the ways they plan to reinvent themselves in the new year.

Improving personal health and fitness is a mainstay among resolutions people make each year -- evidenced by a customer poll by time management firm Franklin Covey showing that losing weight and exercising were among the top three resolutions for 2008 and 2009.

But emergency physicians and fitness experts caution that health and fitness goals must be approached correctly. Otherwise, a new fitness regimen could land a newbie in the emergency room.

"We see it throughout the year, and certainly at the beginning of the year," said Dr. Corey Slovis, professor and chairman of emergency medicine at the Vanderbilt University Medical Center, who noted that the first two days of January tend to be particularly busy days at his center for exercise-related injury. "Years of doing nothing can push you to do something really bad."

The problem with diving into a new fitness regimen seems to be that people do not know their own fitness levels. Without a proper assessment from a physician or a trainer, a gym-rat wannabe could burn himself or herself out within a few days of starting intense workouts.

"I do see a lot of people who tend to be pretty overzealous at the new year," said Jan Schmidt, director of the Kirmayer fitness center at the University of Kansas Medical Center. "You can tell they are just hammering away at themselves."

In addition, following six weeks of holiday festivities and the accompanying poundage with a heavy dose of running or weight lifting could be demoralizing, if not outright dangerous.

"People attack it and think they're going to get back their lost vigor and vitality in a few days," said Dr. Linn Goldberg, professor of medicine and head of the Division of Health Promotion and Sports Medicine at Oregon Health and Sciences University. "In reality, it takes six weeks to enhance your aerobic capacity."

New Year's Workouts Bring Injury, Pain

Slovis said some of the more common exercise-related injuries seen in the beginning of the year are musculoskeletal -- including pulled muscles, tendons and pain in the shoulders, legs and feet from running too hard and long or lifting heavy weights. Dehydration, hyperventilation and tachycardia, or rapid heartbeat, can also be a problem.

But other experts are not seeing the same trend. Dr. Paul Pepe, professor and chair of emergency medicine at the University of Texas Southwestern Medical Center at Dallas, noted that while there may be an intuitive bump in exercise-related injuries in the beginning of the year, they may be difficult to track because they are not as noticeable as other annual trends, such as burns during the holidays, firecracker injuries around the Fourth of July or carbon monoxide poisonings in the fall from bad heating systems.

While exercise-related injuries are not always serious enough to send patients to the emergency room, they can force a new fitness freak to take a few days off, which can throw a wrench into the fitness plan.

"If they're in a lot of pain, they're not going to want to do that again," Goldberg said. "[Exercise] needs to be done very carefully ... so they are disinhibited from coming back to the gym again."

One roadblock can derail further plans for a healthier lifestyle for some. About one-third of the people who make these resolutions will not keep them through January, and more than half will break them within three months, according to the Franklin Covey survey.

Even if people do continue with their strenuous fitness regimens without having to go to the emergency room, damage can accrue over time. Goldberg said he does see exercise-related injuries heavily weighted at the beginning of the year.

Nearly 2 million Americans went to emergency rooms in 2006 due to "overexertion and strenuous movements," according to a report from the U.S. Centers for Disease Control and Prevention, and winter is the busiest time for emergency departments in general.

Part of the problem with New Year's resolutions to get in better shape may be cultural.

"America wants the quick fix -- with their body, with their mind with everything," Slovis said. "If people have taken off 10 years, they need to think in months rather than hours and days."

Slovis said people with exercise or diet-related injuries come to him apologetic, sheepish and disgusted with themselves.

To combat a bad exercise trip and prevent starting the new year in the emergency room, experts recommend that exercise regimens start slowly, carefully and with guidance, noting that good fitness in one area may not translate to equal fitness in another. For example, just because someone can run for a full hour does not mean the person is in any shape to lift heavy weights for an hour.

"People should begin new programs with the idea that it's a lifelong or more permanent change rather than a quick fix," Slovis said. "Start slower, do it longer."

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