By Dr. David Geier, AOSSM

One of the most common reasons patients give for not exercising is an injury or pain. People often use knee or shoulder pain or some other limitation as an excuse for not playing sports or being physically active. And while certainly musculoskeletal injuries can affect participation, rarely should these injuries keep people on the sidelines permanently.

Joint pain is unfortunately a fairly common affliction among the United States population. According to the Centers for Disease Control and Prevention, in 2006 approximately 30% of adults reported that they experienced some sort of joint pain in the previous 30 days. Musculoskeletal injuries are rarely completely incapacitating, however. While many weekend warriors cite old knee or shoulder injuries as reasons that they can't exercise now, with so many options available, even people with real injuries should be able to modify their routines and still get in a good workout.

For example, a female with early knee arthritis can still perform cardiovascular-enhancing exercise. She might not be able to run long distances six or seven days a week, but she might be able to run two days a week and swim or ride a bicycle the other days to decrease the repetitive impact on her knees. A male with rotator cuff impingement from overuse at work or in the yard might have to back off from tennis or baseball, which might aggravate his shoulder, but he could play soccer or another non-throwing sport. And for athletes who enjoy lifting weights, simply adjusting a few of the exercises might be enough to exercise in spite of a current injury.

For those who fear that they are making an injury worse, they should see a sports medicine physician. Most injuries do not need surgery, and often there are simple initial treatments, such as physical therapy, home exercises, taping, or anti-inflammatory medications. And while patients are often reluctant to go to the doctor for fear of being completely shut down from a sport or activity, sports medicine physicians usually try to encourage treatments and rehabilitation that get people back to sports and exercise as quickly as possible.

Finally, even if the activity is potentially detrimental to a joint, it might not always be that bad. Someone with near bone-on-bone knee arthritis is possibly making his knee worse running every day. Having said that, if he wants to keep running, the benefits of his overall health might outweigh the risks to his knee. Daily exercise can provide multiple medical benefits, including improved cardiovascular function, lower blood pressure, and weight loss, as well as improved sleep and mood. Even if he needs a knee replacement in the future, the medical upside to exercise is significant.

While aches and pains can be an obstacle to physical activity, they shouldn't be permanent barriers to all exercise. If you are worried about injuries or exercise modification discuss it with a doctor and know that being physically active is possible despite these pains.

What kind of activities can we promote to keep people moving no matter the aches and pains?