Episode Transcript
Simon Floss (Host): Hello, and welcome to the “Health and Wellness” podcast series, brought to you by Sanford Health. I’m your host today, Simon Floss with Sanford Health News. This series covers a number of topics to lead to a happy and healthy you.
Our conversation today is on preventing orthopedic injuries. Our guest today, and expert, is Dr. Drew Glogoza, a sports medicine physician in Fargo, North Dakota. Thanks for being here today.
Dr. Drew Glogoza (Guest): Hey, thanks for having me on. Happy to be here.
Simon Floss (Host): This is a really good topic. I know a lot of times when people think of like orthopedic injuries and preventing orthopedic injuries, they would maybe think that’s more fitting for older people. But this happens to a lot of people, and I myself am one of them actually. Since October, I’ve been dealing with two herniated discs, two bulging discs and degenerative disc disease in my back. So things are a little slow moving for me right now. And I think this is a topic that’s going to help a lot of people.
So, first of all, we’re going to just talk about exercising and things like that. How important is it to warm up before exercising, doctor?
Dr. Drew Glogoza: I think it’s actually very important, you know it really helps you get ready for whatever exercise you’re going to do. There might not be a lot of physiologic things that happen if you look at the research from it, but it really prepares your body, both mentally and physically to just do whatever you plan to do, whether it’s a workout or run, play a sport, something like that. It does help reduce the chance of injury as well by doing those things. And I think that that’s really where the value of that is.
Simon Floss (Host): And doctor, really quick here, what is sort of your day-to-day life look like in your position? What happens when you clock in and what happens when you clock out?
Dr. Drew Glogoza: We start here with clinic start at eight, and it’s a mostly just like non-operative orthopedics kind of thing. So, lots of arthritis, joint injuries, knee sprains, ankle sprains, stuff like that that we’ll see kind of all day. And then when I check out of the clinic, I go to the training rooms several days of the week at the colleges here in Fargo. So at NDSU, Concordia and MSUM and take care of the athletic injuries that happened there.
Simon Floss (Host): That’s got to be really cool to see some of the best athletes in the Midwest, and I mean really the United States, and work with them directly.
Dr. Drew Glogoza: Absolutely. It’s fun. Working with an athletic population is great. I’m fortunate to see a lot of people who are motivated to get better and want to get better, and I’m happy to be a part of their process and their recovery.
Simon Floss (Host): And speaking of process, we’re talking about obviously warming up before exercising. What might be a good example of an active warmup?
Dr. Drew Glogoza: So, there’s three different ways that we talk about warming up. So, really the best type of warmup is one that’s going to be dynamic. And when we talk about dynamic, if you’re watching sporting events on TV, basically they’re (dynamic) like exaggerated movements. And it really helps with all sports and exercise, and it’s going to be the best way to prevent injury.
Now the other two types of stretches that people will do when they’re warming up are called ballistic. That’s kind of where you bounce. If you see people, you imagine like trying to stretch your hamstrings and people are bouncing, trying to touch their toes that’s when we be ballistic. Now there’s some association with actually injuring yourself doing that. So that’s one type of exercise that we don’t generally recommend that you do for a warmup.
And then you have your static, which is where you just like stretch and hold. So a very common type of thing really enhances your flexibility. It’s not very long lasting for the flexibility. But doesn’t quite help as good as the dynamic warmup, which is really what we want to do.
Simon Floss (Host): Just for some examples of a dynamic warmup, like if there’s like specific moves if you will, what would maybe be some examples of that? Like maybe a lunge with a twist, but obviously don’t twist too hard, you know? (laugh)
Dr. Drew Glogoza: So, I was a soccer player. So, we did a lot of stuff where you’d be kind of exaggerating a kick. So, you’d do a couple steps and then you’d swing your leg like you’re going to kick, and then you’d switch and then kick your other leg. A lot of people we’ll see, we talk about it kind of like “open the gate.” So you’re warming your hips up, where you kind of do a high knee and then you externally rotate your hip to kind of open the gates a little bit to kind of get your hips moving.
Simon Floss (Host): And as Shakira said, the hips don’t lie. It’s very important to open those up and, you know, prevent a lot of injuries that way. I mean, you already alluded to it, but it is possible to overdo a warmup. Is that correct?
Dr. Drew Glogoza: Yeah, a little bit. You know, you don’t want to do too much. It’s kind of one of those things, too much of a good thing can be a bad thing sometimes. So really, it’s just about get(ting) things going a little bit. Get yourself prepared and ready so that you’re not just going from cold to really try to make sure that we’re not getting injured.
Simon Floss (Host): And should a warmup and a cool down almost look the same or similar?
Dr. Drew Glogoza: Yeah, similar. I think that a lot of times you’ll see more dynamic stuff in the warmup. I told you, that’s probably the best way that we’re going to prevent injury. And then you’re going to see a little bit more of that static kind of things that you’re going to do where you’re just holding for a certain amount of time. Usually it’s 10 or 30 seconds, usually we don’t recommend going past 60 seconds, but you’re going to hold. That kind of gives you some back that flexibility that you have. You might feel a little bit stiff after your workout or playing the sport or something like that. So, it’ll kind of help you feel a little bit better when you’re done.
Simon Floss (Host): So, switching gears a little bit here, what are the best types of shoes that one could wear? Or does it kind of depend on whatever the activities someone is doing?
Dr. Drew Glogoza: This is a really interesting question and there’s lots of research and data that’s going into this. Obviously there’s lots of money from shoe companies and things like that. I don’t have any disclosures, I don’t have any relationships with any shoe companies, but really if you look at the, the data on it, the data suggests that if the shoe is comfortable, that’s going to be the best shoe for you to wear while you’re doing exercise. So, that’s really what you want to look for.
So, if a shoe is not comfortable, that’s probably not going to be a good shoe for you. If we’re talking about running, there’s kind of three different ways people run. People run on their toes, and they run on the kind of their midfoot or they run on their heels where they heel strike first. And there’s lots of different shoes and they market it to kind of these different styles of running, but really the evidence hasn’t really shown much of a difference for the different shoes or styles.
More: Orthopedic walk-in clinics offer more convenience, fast care
Simon Floss (Host): Sure. I’ve heard things like, if you’re going to like squat, deadlift (or) hit legs, and you read a million things on the internet, but I’ve heard you should use a flat shoe to keep your weight on your heels. Is there any merit to that? Or is that just kind of a, you know someone said it and it’s like, “oh, I guess I could look cool at the gym wearing Converse,” you know?
Dr. Drew Glogoza: Yeah. I don’t think of that typically for it. Now you’re probably not looking as much for comfort like you are running-wise, but you probably want to make sure that it does have some support to it. A lot of the shoes are, if you try to squish them a little bit when you’re in the store, you can kind of see what their heel is going to look like if you’re putting a lot of pressure on a different part of the shoe. So, you might look for something that maybe has a little bit more support. A lot of that’s actually going to come down to your form and probably not a whole lot to actually your shoes.
Simon Floss (Host): Are there a few, just like off the top of your head, like name brand shoes that you, in your world, have heard good things about?
Dr. Drew Glogoza: Especially for running is, is really where people really talk about shoes. A lot of people like the on clouds wearing them all the time. I don’t know that I see as many people run them, but for running, you’re talking about people are in Hokas, Saucony, Asics, things like that. So, and again, I really think it’s important to try to find one that fits the way you like. I’ve tried out a couple different pairs. There’s some pretty cushiony shoes out there that maybe feel great to take off some of that pounding from the running when you’re on with the ground. But, for me personally, for being a soccer player, I like lighter shoes. My soccer cleats are always very light, so I’m just used to running in something that’s light. So, I’ve migrated towards a lighter shoe when when I exercise.
Simon Floss (Host): Can you stress the importance of progression and easing into something or not overdoing it?
Dr. Drew Glogoza: Yeah, so it’s really important to kind of get used to exercising again. If it’s been a couple months since you did something, or maybe it’s been a couple years and you’re trying to get back into it, you’re not going to want to just jump back into it like you did when you were in high school because you’re just not going to be able to do that at the same level. So you have to modify your expectations and kind of ease into it, you know?
The goal of exercise isn’t really to necessarily cause yourself pain. A lot of times people feel sore and things like that after they’ve done a workout or something like that and they’ll say, “yeah, I can tell I worked out” because you’re feeling a little bit, but that doesn’t necessarily have to be a part of it. You don’t have to push yourself to that point. And that’s where I think kind of working into it can be a really nice thing where you start very simple and easy and just get yourself going a little bit and then slowly progress yourself.
Plus, everybody’s busy these days and it’s not always that enjoyable to be really sore at work. And if you can get yourself active and not really struggle with that pain and things like that where you’re doing your daily stuff, it can be is really nice.
Simon Floss (Host): And personally, this is something that I have had to learn the hard way. With my back, I’ve actually had a couple epidural injections, and after the first one, the problem with epidural injections is that they work, so I was like, “oh baby, I’m back,” and I immediately jumped back into things that I was doing and a few weeks later I was in worse shape than I was beforehand. So, definitely something to stress and a little bit goes a long way.
Dr. Drew Glogoza: Absolutely. Yeah. We do a lot of injections up here in Fargo, so we caution people about that too. Just knowing that you’re going to feel good and try to not overdo it.
Simon Floss (Host): Is it good to work out with an accountability partner, whether it be like a trainer or friend to kind of keep you at the reins if you’re injured, or just make sure you’re doing things correctly, if you’re just trying to exercise more?
Dr. Drew Glogoza: I think it’s very helpful. That might be my personal bias a little bit. I’m a team sport athlete, so I kind of like that team thing. If you look at some of the sports research and things like that, you’ll find that there’s individual sport and then there’s the team sports and people kind of migrate to the way that they kind of like to be.
So, for me personally, I like to have a workout buddy, or somebody to kind of hold you accountable, do the workouts with you, and make sure that you’re staying on top of it.
I talk about this a lot with patients when I’m talking about physical therapy. Actually, some people are motivated to do it on their own. Other times you just need somebody there to kind of help you through it and make sure you’re doing it right, keep you accountable and really help you on your way.
Simon Floss (Host): So, what are some benefits of cross-training or weight-bearing exercises specifically?
Dr. Drew Glogoza: So, it really helps make sure that everything is strong. A lot of times people kind of get focused in on one area, like, “I’m just going to lift weights,” or, “I’m just going to run because I just want to get in shape,” or something like that. And really there’s a lot of benefit (to both) and they both help each other. Weights and cross-training really help running.
Running is not going to make you throw a lot of weight around in the weight room, but it is going to help you with some of your stamina and endurance. But really the weights do help running a lot, and a lot of people who are doing a lot of running, it is very important to do that and it really just helps kind of condition the whole body.
Related: Why running is good for you, according to doctors
Simon Floss (Host): And I want to circle back on that for a second because I’ve personally experienced, if I place a little bit of an emphasis on lifting more than running, I found that when I did start running again, I was slower than I was before. Is that something that’s common for people to experience, or how could one combat that, I guess?
Dr. Drew Glogoza: So, you’re saying you were slower after you started doing weightlifting?
Simon Floss (Host): Yeah. And that certainly might be a product of if there’s a little bit more muscle, then of course you’re just weighing a little bit more.
Dr. Drew Glogoza: So, what the basics of what weightlifting or strength training is going to do if you’re a runner is it’s going to increase your strength of course. That’s what you’re doing. But it’s also going to increase your explosiveness. So, that is really how it can help your running is it’s going to make you stronger so then your muscles are going to work better and you’re going to be able to go a little bit longer, but it’s also going to help you a little bit faster. So, if you’re trying to get faster, if you have a goal in mind for a race or you just have a time in mind just for whatever you want, it’s going to help with those things.
If you’re just strictly running, it’s really just endurance is all that it is. It doesn’t help your muscles a lot. So, I would say that’s probably maybe a little bit of an atypical experience because usually it should help. It really should. Sure. And they usually do work good together.
Simon Floss (Host): Well, maybe I need to make a couple trips up to Fargo and work with you and you can help me get back to my 7:30-mile running days. But anyway, I’m digressing. Can you stress the importance of good form?
Dr. Drew Glogoza: Yeah. This is where it’s going to be really key, and this is going to be hard for everyone to work on, but this is probably where a lot of injuries are even going to come from. So, you’ve really got to have the right form.
Every workplace is always telling you to do all the work stuff right, lift the right way, stand the right way, all those things. So, if it’s important enough that it’s kind of bled into the workplace, we know that it’s definitely going to be important, especially if you’re really shooting to try to lift some serious weights, if you’re not using the right form, you’re definitely going to injure yourself.
Simon Floss (Host): Yeah, that makes sense. Can it be dangerous to lift weights?
Dr. Drew Glogoza: It could be. If you have some underlying health stuff, you hear a lot of stuff about check with your regular doctor before you do an exercise and once you start to get into maybe in middle age that that can be a legitimate thing. You don’t want to cause yourself more problems from exercise when you’re trying to get healthy. Now that maybe is a little bit counterintuitive. You hear us all talk about how important to exercise, but sometimes you got to make sure that you’re doing the right kind of exercise and the right amount of exercise so that it’s safe.
Simon Floss (Host): I’m just curious, in your world, do you see more – and maybe it just depends on the body – but do you see more injuries from weightlifting or running and things like that?
Dr. Drew Glogoza: I feel like I see a lot more from running. You see a lot more just like (over)use. The people that would come in who are hurting themselves with the weightlifting are probably going to be the athletes who are doing CrossFit. Now, that’s a little bit of, it’s like a combination of what they’re doing. They’re doing like max reps, like as hard as they can go, and it’s just a really hard thing on their bodies. But not necessarily like in the weight room, benching 400 pounds kind of hurting yourself kind of a thing. I don’t see a lot of that. Usually, those people have got to the point that they are because they’re probably pretty good at lifting weights and they’ve got good form and they’re really good at taking care of their body.
Now, some of the other stuff, the running and the CrossFit is where you get a lot of people who are your weekend warriors or people who are just trying to be healthy kind of a thing. Trying to get back to being healthy, that kind of stuff. And that’s where we have bad form and do maybe not the best exercises. We’re not following the best running program, things like that. And that’s where we start to get ourselves into trouble.
Simon Floss (Host): Yeah, for sure. So, what are some measures that people could take to speed up recovery for orthopedic specific pain?
Dr. Drew Glogoza: Lots of different stuff that people will try. Obviously, there’s the ice and heat out there. If you’re going to break it down, heat, I generally think of for stiffness. So, if you’re feeling stiff after a workout or before a workout or something like that, I’m probably going to use a little bit of heat to try to warm it up. It’s really a superficial treatment. It’s going to increase some blood flow. Really kind of give you some of that flexibility back if you’re feeling stiff. Maybe help with a little bit of pain too.
Cold’s kind of the opposite, more so for pain. I don’t, I mean I think that’s really what I would use cold things for. It’s going to decrease blood flow, so probably not the best thing to do before a workout, because you want your muscles to be adequately getting everything that they need.
The cryotherapies are a big thing, you know, whole body or certain limbs or stuff like that is kind of a mainstream kind of idea right now. Really the concept behind that when you do it after the workout is that it’s kind of vasoconstrict. So, it’s going to constrict everything go into your body, so it’s going to just kind of shut everything off to your muscles and things like that. And then after you warm back up, everything’s going to kind of open back up and the thought it’s going to kind of wash away a lot of that extra stuff in there that is going to make your muscles feel sore. And I think that’s what people like about those cold tub immersions and things like that, that are pretty popular right now.
Simon Floss (Host): Yeah, I’ve sort of adopted a little bit just taking cold showers and I tell my fiancée that and she’s like, “you are an insane person.” (Laugh)
Dr. Drew Glogoza: There’s a lot of insane people out there with you then I guess (laugh). Yeah.
Simon Floss (Host): Yeah, there’s lots of us. So, this industry that we’re going to tap into is huge: supplements. Are there any supplements that can prevent orthopedic injuries?
Dr. Drew Glogoza: When you’re talking about prevention, it’s probably not (going to help) if you’re like actually going by what research is showing now. There’s lots of research and there’s kind of a lot of stuff that just kind of maybe works, maybe doesn’t work, and that’s sometimes what research shows.
Things that you can really do, you got to alternate between high intensity and low intensity activity just generally. Now that’s not a supplement, but if you’re alternating, that’s hopefully going to help you recover some. If we’re talking about things that you can do, protein supplement is actually a pretty good idea. When I was in high school and a college athlete, that was not quite that big of an idea yet, that was more like the, you’re built trying to build a lot of muscle if you’re taking protein.
And that’s really not true. Being an athlete and being an athletic person requires more protein. Your body just needs that to recover. So, I think that can be a really good way to help your body out, whether it’s adding it in your diet with the meats and things that you eat or if you want to use whey protein for a protein shake to recover, it really helps with your muscle synthesis. It’s really good post-exercise. So it’s really going to help you just get all that recovery.
Creatine is a pretty popular thing to be the help with short duration, high intensity kind of thing. So definitely if you’re working on trying to improve your weight room performance, you’re going to want to add some creatine in. But then there’s other things like vitamin D or vitamin C and you know, a lot of people are taking a lot of these supplements. Vitamin D is going to help with your bone health.
If you’re an endurance runner or something like that and you can get into trouble with some bone health issues, might not be a bad idea to try to help with that and make sure that you’re keeping yourself recovered. Vitamin C is going to help you retain iron. So sometimes our endurance athletes get into trouble with anemia and low blood counts and stuff like that, so that might help. Things like that. There’s also some thought that maybe it just helps you recover in general. Vitamin C sometimes is kind of this like wonder vitamin that a lot of people try to use for a lot of stuff.
Simon Floss (Host): That’s great information to hear because I’ve heard things like amino acids, magnesium, you know, all these things. And so, it’s nice to hear stuff that can help from an expert and a trusted source such as yourself. So actually, just one more question here before I let you get on your way. It’s well documented that our pros like yourself have worked with some of the greatest athletes. What makes care so special at Sanford or why should someone want to work with us?
Dr. Drew Glogoza: I think we just have a really great team here is probably what it comes down to. So, athletes are used to working with a team and then when you have an unfortunate bump in your road or your path and you need to interact with us, you’re getting the best team that we have. Physical therapists, non-operative orthopedics. We have surgeons. We have everybody. Everybody communicates really well and works really well, and we understand the goals of what the athlete is trying to achieve or what they want to achieve. And we make sure that we work together to try to achieve it.
Simon Floss (Host): Awesome. Well, doctor, thanks again so much for your time and expertise here today.
Dr. Drew Glogoza: No problem. Thanks for having me on.
Simon Floss (Host): This episode is part of the “Health and Wellness” series by Sanford Health. For additional podcast series by Sanford Health, find us on Apple, Spotify, and news.sanfordhealth.org. Thanks again for listening. I’m Simon Floss.
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