Most at risk for what often is called weekend warrior syndrome are those who remain primarily sedentary during the week and then use the weekends to “catch up” by engaging in high-stress activities for which their bodies are ill-prepared, says Dr. Chang. “This lack of preparedness puts them at much greater risk for exercise-induced injury, including back and spinal injuries.”
Experts concur. Authors of a study published in the Canadian Journal of Surgery report more than 35 percent of 351 patients who sustained “major trauma from recreational sporting activities on weekends versus weekdays” experienced back and spinal injuries. The scientists write “many people compress their weekly exercise volume into lengthy periods of physical activity on the weekend,” citing a lack of time for exercise on weekdays. “Long periods of intense physical activity on weekends [are] physically demanding, especially among unfit individuals, [which is why] weekend warriors may be at an increased risk of injury.”
Of course, “weekend warriors” not only applies to sports enthusiasts. The term also refers to the do-it-yourselfers and homeowners who use the weekends to climb ladders, cut bushes, clean out garages, get into awkward positions to paint ceilings and railings, wash windows, and undertake other home projects.
In a paper headlined The Dangers of Being a ‘Weekend Warrior’ and published in the Journal of Trauma and Acute Care Surgery, investigators indicate weekend warriors attempting “high-risk” home maintenance projects such as roof repairs or tree trimming are at greater exposure for sustaining serious injury.
“We must prepare for maintenance projects as we would for sports – with pre-activity warm-ups for muscles, ligaments, and joints; sufficient knowledge of proper techniques; and an honest evaluation of our physical capabilities,” says Dr. Chang. “Injuries affecting the spine can be far more serious and life-altering than other kinds of trauma, and it is these high-risk activities, with their potential for falls, that are particularly dangerous to the spine.”
He emphasizes “too few of us understand what being fit means. Simply having big biceps, strong legs, and some stamina does not make one ready to rise from a desk chair and engage in physically taxing weekend action. The spine, for example, depends on a well-conditioned anatomical core for support. The core includes those interconnected muscles, tendons, ligaments, and joints of the hips, pelvis, and body trunk. It is the area of the body that delivers needed energy to the arm, leg and shoulder joints and muscles and helps stabilize the spine.”
“Unfortunately, the core is also the part of the anatomy most neglected in preparatory exercise regimens and weekend warrior activities,” Dr. Chang says.
He calls the spine a “complicated structure of tendons, muscles, overlapping ligaments holding vertebrae in place, and an array of nerves emanating from the spinal column.” Back injuries take the form of strains, muscle and tendon pulls, spinal disc failure and herniation, compression of nerves, and destruction of bone and soft tissue. “Spinal trauma often creates significant and painful repercussions,” he says.
But lack of physical preparation is not the sole factor underlying the risks involved in weekend warrior syndrome, Dr. Chang adds. “Aging, obesity, history of smoking, and other lifestyle and environmental factors increase one’s risk profile during strenuous exercise.”
In persons over age 50, the spine is more subject to deteriorating forces like osteoarthritis and degenerative spondylolisthesis.
Spondylolisthesis develops when spinal discs or the paired facet joints behind the discs lose the ability to absorb spinal stress or control the forward-bending of the spine, thereby allowing one vertebra to slip onto another. Aging also tends to dry out the spine’s intervertebral discs, making them more brittle and subject to rupture or herniation when stressed.
Of course, excess body weight produces hundreds of pounds more impact on the spine. When this stress is coupled with weekend warrior syndrome, results can prove disastrous for the spine and back, Dr. Chang suggests.
Even if job or family commitments interfere with achieving the 30 minutes of daily exercise recommended by the Centers for Disease Control and Prevention, Dr. Chang says weekend warriors can take steps to cut injury risks both to spine and other body structures.
· Spend at least five minutes stretching before and after an activity to warm up and cool down muscles.
· Hydrate, hydrate, hydrate, and maintain as healthy a diet as possibility.
· Engage in low-impact aerobics and activities, such as stationary biking, swimming, and walking. Walking increases blood flow to the spine.
· Be hardcore about your body core. Talk to a physical therapist, exercise physiologist, or exercise trainer about at-home exercises to strengthen it.
· Use common sense. You have been sedentary much of the week, so not everything in your body immediately performs at peak efficiency when you pull on jogging shorts or pick up a basketball or tennis racquet. Ratchet down the intensity and take breaks.
· Up in years? Be even more cautious. You may think like a 30-year-old, but your body knows differently. Its parts break more readily with age. Understand your physical limits.
“Finally, if your belly hangs over your belt and you can no longer zip up last year’s pair of new pants, shed the weight regardless of whether you spend weekends gardening, jogging, or simply sitting and watching sports. Your spine will thank you,” Dr. Chang says.
Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery and pain management with several locations in NJ and NYC. (www.atlanticspinecenter.com, www.atlanticspinecenter.nyc)
Kaliq Chang, MD, is an interventional pain management specialist at Atlantic Spine Center. He is board-certified in anesthesiology.