joint problems

Exercise should prevent injuries, not cause them


 “I have a fake knee, I have a fake hip, I’ve got a lot of metal in my back – it’s a field day at the airport. My body hurts almost all the time.” ~ Jane Fonda. Jane, longtime aerobic exercise innovator, finds it hard to do yoga.1 

While heredity is a factor, years of repetitive use from aerobic exercise will eventually wear out your joints, regardless of your genes. The key is to not overdo it. As a preventative measure it would help to safely strengthen those joints that are prone to injury; one day a week substitute low-impact circuit strength training instead of high-impact aerobics. It’s more cardiovascularly demanding than most aerobic exercise, and your aches and pains will subside.

At our Austin Personal Training and New Orleans Personal Training  locations we have clients who can no longer do aerobics, but they have no problem strength training using our protocol. 

With our protocol we:

·      Eliminate high-impact jerking movements that create forces that lead to injuries.

·      Limit movement to a pain-free range of motion.

·      Sufficiently work muscles to a deep fatigue to stimulate a positive adaptation with one exercise set instead of multiple sets.  We seek to determine, no how much exercise you can withstand, but the least amount you need to continuously improve.  This lowers the probability of repetitive-use injuries.

·      Use MedX equipment with medical rehab features that are more easily tolerated by the joints.

Done correctly, low-impact circuit strength training will give you a measure of protection from injuries and bring relief from chronic pain.  Your body doesn’t have to “hurt almost all the time”.

May the force not be with you

Working out is supposed to prevent injuries so that you can do those activities that require being fit; it should not cause injuries. Place a brick on one shoulder; have a second brick thrown at the other shoulder. Both weigh the same, but one will land you in the emergency room.  Same applies with exercise; explosive force is dangerous. From this study Slow exercise better for menopausal women: “Results showed that slower movement and fewer repetitions of exercises helped increase muscle mass in menopausal women which could aid future studies into the benefits of exercise as a treatment for menopausal symptoms. These findings will be used to design specific exercise programs for everyday use to reduce the risk of injury and thus significantly contribute to a better quality of life in old age." Google any strength training program along with the key words injury-rate, and you’ll likely see a whole lot of hits. With a program with high potential risks you might make a few steps forward barring injury, but if you are injured you will likely take many more backward. It is not the weight that injures; it is the explosive force created when attempting to move that weight. At New Orleans Strength Trainers and Austin Strength Trainers we use MedX equipment with its special medical rehab features; explosive force is not needed to move the weight.

A year after hitting bottom

The persistent aches and pains from old injuries were my excuse for not exercising. Not exercising led to more aches and pains, less activity, weight gain, and weakness. In a weakened state illnesses are likely to be more frequent and protracted. I got pneumonia and bronchitis, and my asthma flared up. My blood oxygen absorption rate fell to the low 80s. My heart had to work harder to get the oxygen I needed. As a result my blood pressure rose, and my resting pulse was twenty beats per minute higher. I was listless and constantly tired. My cardiologist was concerned that I may have had a silent heart attack, so he conducted a series of tests.  I passed.

That was almost a year ago, the bottom of a negative cycle. They say you have got to hit rock bottom before you commit to making a change. Since that time I have changed my eating habits. I have not missed a strength training session regardless of the aches and pains. Funny thing is, the exercise made the aches and pains go away. Pain-free, I was able to add other activities. I began biking a couple times a week. Results: Thirty-seven pounds lighter, greatly reduced blood pressure, blood oxygen absorption level in the high 90s, pulse more than 20 beats per minute slower, and no aches or pains.

Recently I went riding bikes with my tireless daughter. We spent 3 1/2 hours riding bikes one day and an hour and 45 minutes the next day through the hills of Austin where deer abound. That would have been unthinkable a year ago. As reassuring at the positive numbers have been what is most gratifying is to be able to do things you have not done in years with greater ease and to be able to get out of bed the next day and do it again - a positive cycle. This positive cycle begins with increasing one's strength.

At Austin Fitness Training and New Orleans Fitness Training we use MedX medical rehab equipment that is better tolerated by those with pain and joint problems. Our personal trainers can set up a program that will increase your strength and enduranceeliminate pain, and dramaticallyincrease your quality of life.

Sleeping injuries

Yep, I hurt myself sleeping. It is a damn shame when you hurt yourself sleeping. In my defense it might be that I have lost a little padding around my hips. I am down five belt loops and thirty-five pounds.

I consulted my physical therapist, and he said it happens occasionally. From this web page, Part 6 Common Sleep Injuries: Hip Injuries, this quote:

“The trochanteric bursa is on the outside of the hip. If you sleep on one side for most of the night, you can compress it, causing swelling and inflammation, or Greater Trochanteric Pain Syndrome (GTPS.) You will wake up in the morning or in the night with pain and tenderness on the side of your hip, which may feel like a bad cramp. If the inflammation gets worse, any kind of walking or climbing motion will aggravate the bursa and cause more pain.”

I once had this injury twenty-five years ago and limped for days. This time there was just a bit of aggravation.  It helps if you have muscle protecting those joints. At New Orleans Personal Trainer and Austin Personal Trainer we can help you with that.

My pain is gone

Imagine living with pain every day.  You are getting older and your life has become compromised. The prospect that the pain will always be there presents a bleak picture.  It does not have to be that way.  

At both our locations, Austin Personal Trainers and at New Orleans Personal Trainers, our trainers use MedX rehabilitative exercise equipment.  It is used by elite athletes as well as those recovering from injuries.  

Gretchen, one of our trainers, trains Larry. Larry is recovering from injuries sustained as a result of a motorcycle accident.  Prior to beginning exercise he lived in pain every day.

A quote from Larry:  

“Prior to starting at Kelly Personal Training  I was taking at between 4 and 8 ibuprofens a day just so my knees, back, and shoulder weren’t hurting. I was icing my back a couple times a week. Now I don't need anything for pain because the pain is gone. My work requires me to walk around in attics. I can tell my balance has improved as well. The slight discomfort during the workout is well worth the benefits. I have lost 32 pounds too.”

Our equipment is better tolerated by those who have physical limitations, and workout itself will alleviate pain.  Many live in a state of chronic pain.Years ago I was one of them for almost three years. With the right exercise that can change dramatically. 

How to stay limber and avoid aches and pains

Injuries can happen suddenly such as a pulled muscle or can happen slowly over time such as a repetitive use injury.  Years later these injuries can come back to haunt us as the aches and pains we live with.  You can keep those aches at bay by remaining strong and limber.  The trick is to do exercises that do not aggravate those old injuries.

At Austin Personal Training and  New Orleans Personal Training  we use MedX medical rehab equipment that can be precisely customized with a premium on safety for those who have those haunting injuries. Exercise safely, release those endorphins, and the pains will go away.

Heavy Weights with Minimal Force Can Be Safer than Light Resistance with a Lot of Force

Care should be taken to minimize the likelyhood of injury when exercising. At New Orleans Personal Trainers and Austin Personal Trainers we use smooth controlled movement that minimize the ballistic forces that can cause injuries.  We also will use MedX medical rehab equipment that can be used by both athletes and those recovering from injury.

Chronic pain: Exercise can bring relief - part 2

A year and half ago I could not reach up and adjust my rear view mirror without shooting pain. I had trouble reaching out to close the car door. Often just laying in bed was painful. Now I do those things without a care in the world.  Exercise changed things dramatically.   

To avoid chronic pain such as arthritis those afflicted will avoid movements that cause them pain. Eventually that leads to a loss of strength, a decreased range of motion, and more pain – a vicious cycle.   Proper exercise will eliminate the pain, increase strength and range of motion, and create a positive cycle.

The right exercise will have the following components:

  • The ability to limit the range of motion to a pain-free range of motion. For some that may be just a few degrees. For most people that range will gradually increase over time. At Austin Personal Training and New Orleans Personal Training we use state-of-the-art MedX medical rehab equipment that is better tolerated by those with painful joint problems. One of the features of this equipment is the ability to limit the range of motion to just a few degrees if necessary.


  • Eliminate harmful forces associated with rapid acceleration. Use slow controlled movements. We use a protocol of controlled movements that was written up in the magazine, Arthritis Today. This protocol is highly effective, and it minimizes stress to the joints and connective tissue.


  • Eliminate certain pain-causing movements entirely. If possible perform similar movements at a different angle. One client with arthritic shoulders cannot perform an over-head press without pain, but he has been doing the bench press for years now with no difficulty.


  • Do just enough exercise to facilitate a positive change. The body, when exposed to more that it is used to handling, will make a positive adaption as a form of self-protection. The proper amount of exercise is the amount that stimulates that positive change. Anything more that is at best a waste of time and at worst, especially for those suffering chronic pain, counter-productive bringing on more pain and repetitive-use injuries.


Following these guideline we have helped several clients make profound improvements in their lives.

Chronic pain: Exercise can bring relief

Exercise can be a great way to ease chronic pain. There are risks associated with inactivity and benefits associated with movement.

When you're in pain, exercise is probably the last thing on your mind, but regular exercise can be a versatile weapon in the fight against chronic pain.

When you're inactive, your muscles — including your heart — lose strength and work less efficiently. Your risk of high blood pressure, high cholesterol and diabetes increases. Inactivity can increase fatigue, stress and anxiety as well.

"Years ago, people who were in pain were told to rest," says Edward Laskowski, M.D., a physical medicine and rehabilitation specialist and co-director of the Sports Medicine Center at Mayo Clinic, Rochester, Minn. "But now we know the exact opposite is true. When you rest, you become deconditioned — which may actually contribute to chronic pain."

As tough as it may be to start an exercise program, your body will thank you. Exercise can:

  • Prompt your body to release endorphins. These chemicals block pain signals from reaching your brain. Endorphins also help alleviate anxiety and depression — conditions that can make chronic pain more difficult to control."Endorphins are the body's natural pain relievers," Dr. Laskowski says. "Endorphins have the potential to provide the pain-relieving power of strong pain medications, such as morphine."
  • Help you build strength. The stronger your muscles, the more force and load you'll take off your bones and cartilage — and the more relief you'll feel.
  • Increase your flexibility. Joints that can move through their full range of motion are less likely to be plagued with aches and pains.
  • Improve your sleep quality. Regular exercise can lower your stress hormones, resulting in better sleep.
  • Boost your energy level. Think huffing and puffing through a workout will leave you wiped out? Not likely. Regular exercise can actually give you more energy to cope with chronic pain.
  • Help you maintain a healthy weight. Exercise burns calories, which can help you drop excess pounds. This will reduce stress on your joints — another way to improve chronic pain.
  • Enhance your mood. Exercise improves blood and oxygen flow to your muscles and contributes to an overall sense of well-being. Looking and feeling better can improve your confidence and self-image as well.
  • Protect your heart and blood vessels. Exercise decreases the risk of high blood pressure, diabetes, heart attack and stroke.


For those with chronic pain consult your doctor to be cleared to exercise. It's natural to be worried about hurting yourself or making your pain worse, but with your doctor's reassurance and guidance, you can safely exercise with the knowledge that your pain isn't serving a useful protective purpose. Regular exercise actually eases chronic pain for many people.

Even if you recognize the benefits of exercise, staying motivated can be a challenge. "Remember to start slowly," Dr. Laskowski says. "Don't rush into a strenuous workout regimen before your body is ready. Consistency is more important than intensity — especially if you have severe pain." It's also helpful to build your exercise program around activities you enjoy. As your energy increases and your mood improves you may actually look forward to exercising.

Also it helps to have the very best equipment. At Austin Fitness Training and New Orleans Fitness Training we use MedX medical rehab equipment that is better tolerated by those with painful joint problems.

Exercising the cardiovascular system with minimal stress on the joints

According to Runner's World 80 percent of all runners will experience an injury in a given year.  That is counterproductive to what you set out to accomplish.  I was slow to learn this.  Years of running has taken its toll on my joints.  Fortunately I have found a piece of aerobic equipment that enables me to effectively work my cardiovascular system with minimal stress on my joints.  We have this piece of equipment at our New Orleans Personal Trainers and our Austin Personal Training locations.

What to do when chronic running injuries occur

Ted was a gifted runner. In his late forties his knees began to aggravate him, and they got worse each year.  At age 54 his doctor advised him to stop running. He started strength training with the aim of getting back to running.

We worked around his condition for a while and slowly incorporated leg exercises into the routine - leg curl, calf raises, leg press, adduction, abduction, squats, and occasionally partial leg extensions.

Ted wanted to start running again.  He did and the next day his was limping again. I told him, “You are able to lift 450 pounds on the leg press to a very deep fatigue to the point where your legs are unable to move, and the next day you have not a hint of pain.”  For Ted with adequate rest after strength training he came back stronger each week.  With running there was no recovery or improvement, only injury.

We were following a high intensity interval training (HIIT) routine – one to three different exercises per body part with very little rest between sets.  We were not doing endless sets exposing the knees to unnecessary stress. With this protocol there is less chance of repetitive-use injuries.

Ted saw that it was working, but he was concerned about weight gain. I told him, “I could run a mile and be in pain for days, or I could eat three less Oreos and stick to a strength training program that will increase my resting metabolism. Besides, you will burn calories after the workout as well”.

Ted had a choice.  Run, get injured,and gain weight from inactivity, or strength train, get added protection against injury, and make some dietary changes. It is either the latter or face the possibility of knee replacement well before it might have have been otherwise. For those who overdo it or have a predisposition to injuries that result from running, injuries will occur. It might take years before they become ruinous. I don’t rule out running, but don’t run to the point of injury and take steps to enhance your strength so you can better support your joints. 

No amount of running will add strength to your legs, - endurance yes, but strength no. A ten year study comparing non-runners to runners showed that both groups had lost the same amount of lean body weight over the decade. Loss of muscle mass it part of the aging process. The best you can do is to take steps to keep or add the strength and muscle that inexorably diminishes each year without strength training.

There cardiovascular effects from HIIT as well. Start with leg press or squats and work the muscles to a deep fatigue. You will reach your target heart rate very quickly. Just seconds after completion of the first exercise begin the next exercise. You will continue breathing hard, and your pulse will remain elevated. Work all the major muscle groups with minimal rest between each exercise. You will breath hard from start to finish. This type of training produces a high E.P.O.C. response – a large after-workout calorie burn.

You build up to this workout slowly. At Austin Personal Trainers and New Orleans Fitness Training we can show you how.

The Price Of Inactivity

In the last 35 years I have had about a half dozen times where I got out of the habit of exercising as a result of injuries or life just getting in the way. When that happened I had a greater propensity to eat more comfort food. I would even get up in the middle of the night to eat. Of course I gained weight, sugar levels went up, bad cholesteral went up, and my blood pressure was a little harder to control. What was more striking was how badly I felt. Old injuries came back to haunt me.

Last year I tore my Achilles tendon right in two. The recovery was slow. I stopped all exercise for months. I woke up one day with a pain in my shoulder that’s lasted for days. I further injured it playing around with my daughter. The pain, numbness, and restricted movement lasted for months. Because I favored one shoulder I slept on the other shoulder, and it soon began to hurt as well.

The pain and numbness just would not go away. I couldn’t reach over my head, reach out to close the car door, and had trouble putting on a shirt. I couldn’t sleep; the pain was persistent. Each night was constant struggle to find a position that would not hurt or make my arms numb. I began therapy with positive results. Massage helped too. I eventually got a shot of cortisone, and the pain subsided enough that I began strength training again, slowly building up.

The pounds started coming off and the pain totally disappeared. I was motivated to eat better. If I was going to all this effort of exercising I did not want to sabotage it with bad eating habits. Eventually I could move my shoulders effortlessly without having to be conscious of every movement.

At New Orleans Fitness Trainers and at Austin Personal Training we have extensive lines of Medical rehab equipment that can be finely adjusted to accommodate those with physical limitations to get you back to effortlessly doing the things you want to do and increase your quality of life. The time, effort, and price of price of exercising far outweigh the price of not exercising.

Getting it right after a hip or knee replacement

A recent NYT article (Getting a New Knee or Hip? Do It Right the First Time), as the title suggests, details the proper steps one should take if they are contemplating a hip or knee replacement – get a good doctor who has done a lot of the procedures, gather lots of data, adjust expectations, and follow doctors advice regarding recovery.

There was no mention of exercise. As personal trainers it is beyond our pay grade to prescribe and administer an exercise regime immediately after surgery, but we have worked with a large number of clients who have undergone hip, knee, and shoulder replacements once they have completed their rehab with a physical therapist.

Some examples:

• Doris aged 74 had both knees, both hips and one shoulder replaced. She exercised every week.

• Gale had a double hip replacement and had finished her therapy. When she entered our New Orleans Personal Training facility she was still using a walker. Years later she is still going strong with not a hint of a problem to her hips.

• At age 72 Jack started working out after his first knee replacement and right before his second knee replacement. A couple of months after his second surgery he was able to climb in and out of a bass boat to go duck hunting. Meanwhile his law partner who had the same operation at the same time was still using a walker.

• Tom aged 53 had a total shoulder replacement as a result of an accident. Prior to the accident he had been working out at our Austin Personal Training facility. It was seven months before he was able to return. He was told that the most he could expect was to lift his extended arm to should level. When his doctor saw him lift his arm directly over his head he said it was "amazing and remarkable” .

We follow simple guidelines. With the MedX rehabilitative exercise equipment we use we can make fine adjustments and limit the movement to a pain-free range of motion. Gradually we increase the range and make small increases in the resistance. Over time with small continuous improvements the results can be dramatic.

More information on joint replacement and exercise:
Exercise, Osteoarthritis, and Joint Replacement Part 1
Exercise, Osteoarthritis, and Joint Replacement Part 2
Exercise, Osteoarthritis, and Joint Replacement Part 3

What clients are saying: "I was in tears walking on the Great Wall of China"

Number 14 in a series about what clients have to say about their workouts. 


“It was emotional partly because I was walking on a part of history that has been there for over a thousand years. I also remembered back to a year ago and it was emotional to think of how much I had changed. A year ago I was in such pain that it was difficult for me to even go out and buy groceries. It had been a year and one week since my hip replacement.”

The operation was life changing, and Cindy has made great progress since her hip replacement. Cindy is one of many we have worked with who have had hip, knee or shoulder replacements. It is our good fortune to be able to play a small part in helping people make positive changes in their lives. Seeing clients make positive changes is what makes our jobs worthwhile.

At both of our locations, Austin Personal Trainers and New Orleans Personal Training, we use MedX rehabilitative exercise equipment that is suitable for those with joint problems, but it is also suitable for those who are in peak condition.