Unlike bears which were designed to hibernate, the human body needs to stay active year round to optimize health in all age groups.
The short days of winter create a tempting scenario of curling up on the couch in front of the fire with a good book and a cup of hot chocolate. "As comforting as this sounds, a season-long diet of cozy restfulness leads to cardio and musculoskeletal deconditioning and other maladies," says Jamie Peters, MD, sports medicine physician at Sports & Orthopaedic Specialists.
Exercise as medicine
It has been proven beyond any doubt that exercise is a powerful treatment and a successful preventive for many conditions including diabetes, depression/anxiety and other mental health conditions, osteoporosis, cardiac-related conditions of hypertension, coronary artery disease, congestive heart disease and many others.
The US recommendations are 150 of moderate intensity aerobic exercise or 75 minutes of vigorous intensity exercise as well as muscle strengthening two or more days a week using all major muscles.
Younger age groups: Joint injury prevention
In addition to the aforementioned benefits of year round exercise, maintaining core strength – abdominal and, especially, hip core strength – is extremely important to preventing ACL and other knee and ankle injuries, which have become commonplace occurrences in sports involving turning and cutting.
Currently, there are 250,000 ACL ruptures in the US annually with an annual direct cost of approximately $1.7 billion. Even after an ACL is surgically reconstructed, a very high percent of these patients will develop knee arthritis within 12-20 years. The saying “an ounce of prevention is worth a pound of cure” is extremely appropriate with this condition.
Women are especially prone to ACL injury at a rate of 3:1 female to male ratio. Several reasons for this gender difference have been attributed to women having wider hips, weaker hamstring strength and menstrual cycle estrogen's effect on ligament strength. A sports medicine professional can evaluate individuals for predisposing factors and recommend specific programs taught by physical therapists and/or athletic trainers (or online). Many preventive exercises are designed to enhance gluteus and other hip core muscle strength and balance with improvement in the control of abnormal knee motion; and therefore, decrease the risk of ACL and other “downstream” joint injuries.
ACL prevention programs also address proper landing and proprioceptive training, improving the ability of the brain to sense the position of joints in space. Also helpful is year-round cross training in which different muscles are used for a mix of activities such as cross country skiing, skating or inside sports in addition to the treadmill, elliptical and stationary bike, which are excellent for cardiac training.
Yoga, Pilates and similar strengthening activities are also helpful for maintaining core strength and balance, which can reduce the risk of lower extremity injury; however, as any good instructor will tell you, listen to your body. If something hurts during a specific pose or position, avoid it and practice an alternative pose.
By maintaining these activities throughout the winter, you are much more likely to enter your spring and summer sports season with less risk for these types of injuries. Keep in mind that any level and type of exercise is better than no exercise. Access to a club or gym may be a challenge for some people, so keep in mind that bundling up for a brisk walk on these winter days also has significant benefits.
For older athletes: Maintain an active lifestyle
Regular cardio exercise at the Center for Disease Control and Prevention (CDC) recommended levels has been shown to help maintain the overall efficiency of the heart and lungs (measured scientifically as “VO2 max”). As we age, we lose ten percent of our VO2 max level every decade of life. Active cardio-type activities can significantly stem this loss, but a sedentary lifestyle, even for a season, can eliminate this benefit.
Sarcopenia is the term used to describe the irreversible loss of actual muscle cells as we age leading to increased weakness and flabbiness. A successful strategy to reduce the rate of sarcopenia is regular ongoing use of our muscles in sports and/or resistance training applied year round and lifelong.
Osteoarthritis (OA) is the most common type of arthritis. It affects the weight-bearing joints, especially hips and knees, but can also commonly involve the spine, hands and shoulders. It is a deterioration of the cartilage lining of the joints with associated abnormal calcifications within the joints. From an exercise perspective, we know that regular use of our joints prolongs the life of the cartilage and it has been shown that disuse can lead to accelerated joint cartilage deterioration.
Also, weight-bearing activities can improve the amount of healthy bone calcium content and therefore reduce the risk of bone thinning (osteoporosis/osteopenia).
Regular running is an activity, which is considered weight-loading, but many have questioned potential risk of joint damage with long-term running. Several recent studies have concluded that there is no increased risk for osteoarthritis development in individuals pursuing regular running.
For all ages: What we eat matters
As humans, we gravitate to comfort foods and increase our food intake as the days shorten and the temperature drops. Unfortunately, many of the foods in this category are high in fat and lead to weight gain, which we know can increase joint stress, type II diabetes risk and other maladies. Current nutritional scientific information encourages a reasonable calorie content diet rich in vegetables and fruits and adequate protein. Instead of avoiding all fats, maintaining a diet with some fats rich in Omega 3 fatty acids such as olive oil is recommended (Mediterranean diet). This is in contrast to the previously recommended weight control diet of low fat and higher carbohydrates.
Also, adequate levels of vitamin D in our bodies have been shown to have a significant impact on the maintenance of bone health, muscle function and general health. Given that the most common source of vitamin D is associated with exposure to sunshine, inhabitants living in northern climates are especially at risk for low vitamin D levels. For that reason, supplementation of vitamin D3 at 1000 units per day is a current recommendation; however, discuss specific recommendations with your health care provider.
Maintaining regular exercise year round, even in the depths of winter, will payoff in a stronger and healthier you in the seasons to come.