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CNN Saturday Morning News

"Weekend House Call"

Aired March 27, 2004 - 08:30 ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

DR. SANJAY GUPTA, CNN CORRESPONDENT: Good morning and welcome to "House Call." We're coming to you from Jupiter, Florida, where last year's world series champions, the Florida Marlins, are training to keep the title.
Many of us, of course, are starting our own training from everything from baseball to running. And with that rush to get back in the game, sometimes come injuries. Six out of 10 people who start will end up with a sports injury within six weeks. We're going to be talking with the Marlins team trainer in a bit about what you can do to stay healthy this season.

But first, we want to hear from someone who was sidelined last season by what used to be a career-ending injury. Marlin's pitcher, A.J. Burnett is here to tell us about how he goes from the surgeon's office to the pitcher's mound. Let there be no doubt the Florida Marlins won the World Series last year.

How are you doing?

A.J. BURNETT, PITCHER, FLORIDA MARLINS: Very good.

GUPTA: You had a significant problem with your right elbow last year. Tell us about it.

BURNETT: It wasn't significant at the beginning. It was on and off. But it got to the point where I couldn't take it anymore. And it's one of those things you don't want to happen, but I think eventually if you have enough wear and tear on your elbow, it's going to happen.

GUPTA: You had an operation, pretty well known operation, the Tommy John procedure. Tell us about that.

BURNETT: Well, it's a --I wouldn't wish it on my worst enemy. I mean they said 12 to 18 months for a reason. Mine came at the perfect time, you know?

GUPTA: April of last year...

BURNETT: April. But I'm feeling good now. I've done a lot of bullpens and a lot of throwing. And it's just up and down; you have good days and bad days. You just have to stick with it because it's going to be stronger than it ever was.

GUPTA: It's been 11 months, and how long after the operation were you back to throwing? When did you feel comfortable?

BURNETT: Well, I started range of motion really soon, like two weeks right after surgery. I think the four-month mark I started playing catch.

GUPTA: Is that right? People say you might even come back stronger after this operation.

BURNETT: That would be cool.

GUPTA: You think so?

BURNETT: That would be nice.

GUPTA: Are you feeling it?

BURNETT: I feel a little bit. I mean I've thrown a handful of bullpens and each one gets better and better each time.

GUPTA: A lot of people -- guys are on the hunt for the Marlins. You going to keep an eye on...

BURNETT: We need to do it again.

GUPTA: Keep this trophy right here. Good luck to you.

BURNETT: Thank you.

GUPTA: Thanks for your time as well today. You're going to be getting that arm back into major league form as well. Good luck this season.

Could your kids being setting themselves up for that same sort of operation that A.J. had? Well, you might be surprised. We're going to talk about kids and sports injuries later in the show.

But first, you may not be a major leaguer or an Olympian yet, but sometimes those dreams of greatness can get us into big trouble. Over 10 million sports injuries occur each year, often because we go for the gold and we overdo it.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): It's the weekend.

PAUL SEWARDS, WEEKEND WARRIOR: Go shunt! Go shunt!

GUPTA: This day, 34-year-old Paul Seward will play competitive soccer for hours in 40-degree weather.

SEWARDS: Past five years, broken ankle, broke my elbow badly last year and snapped a ligament or tore a ligament, and a fractured a left ankle and two broken ribs. And just various groins and strains and all that stuff.

GUPTA: Thirty-nine-year-old Donald Leka plays tennis, swims and lifts weights.

DONALD LEKA, WEEKEND WARRIOR: I think I get hurt probably once every, about, month and a half or two months.

GUPTA: Donald and Paul are both weekend warriors, they say they're too busy to exercise daily, but cram in a week's worth on the weekends.

Sports Doctor Jordan Metzl sees many weekend warriors in his practice.

DR. JORDAN METZL, ORTHOPEDIC SURGEON: The phone starts ringing very early Monday morning with people who have hurt themselves in any number of different creative ways over the weekend.

GUPTA: So whether it's being a weekend warrior or jumping into exercise and league play too quickly this spring, it's the lack of day-to-day conditioning that results in common injuries.

METZL: Torn muscles in the calf, torn muscles in the shoulder, we see ligament tears, such as ligament tears in the knee or elbow. And we see bone injuries such as fractures.

LEKA: The sad thing is when you do get hurt, you know, there's a couple weeks that go by that generally you can't do anything.

GUPTA: So if you don't want to end up on the disable the list this spring, try these conditioning tips.

METZL: Twenty to 30 minutes a day is really, I think, all you need to really kind of do some good prevention work.

GUPTA: Jog or walk briskly every day. Squeeze in some push-ups, sit-ups, and most importantly, stretch.

METZL: Prepare your body and know your body. And kind of act reasonably within the limits of what was your body can do.

GUPTA: When it comes to exercise, doing something is always better than doing nothing. But it's important to spread it out.

(END VIDEO CLIP)

GUPTA: Limits is not a word most athletes like to hear, but this doesn't always mean cutting back. In some cases, it could mean doing more, expanding those limits. Like remembering, warm up and cool down, taking the extra 10 minutes can help prevent injuries in the long run. Also, make sure to stretch before and after your workout, whether it's baseball or an aerobics class. Invest in good footwear. Make sure you have sport specific shoes, ones that fit properly.

Cross train to avoid overloading any one area of your body. And like A.J. said, go slow when coming back from an injury or starting back up from a sport. Don't rush, where you may end up rushing straight to a doctor's office. To help us stay injury-free this spring and hopefully all year round, we've got Florida Marlins' head athletic trainer, Sean Cunningham. And here's to answer all your questions. He's a certified athletic trainer, a certified strength and conditioning specialist.

You've been with the Marlins for three years; you were with the Expos for 15 years before that. And you're still young still. Good healthy living.

SEAN CUNNINGHAM, ATHLETIC TRAINER, FLORIDA MARLINS: That's right, I started early. So I enjoy doing what I do and I've been doing it right out of school.

GUPTA: Well, thanks so much for joining us.

Listen, we did our own informal count of all the sort of injuries you see in baseball, your sport. About half of them are related to the arms we found. People out there -- there are a lot of people out there aren't professional athletes but still concerned about their arms this spring. What advice do you give them?

CUNNINGHAM: I think my No. 1 advice to them is to pay attention to the exercise, the intensity that they're doing and the frequency with which they do it. You want your muscles to be prepared for what you're going to ask them to do. And the best way to do that is to make sure that you have the muscle strength and the muscle endurance. And you do that through a gradual progression of both duration, how long you're going to be doing the activity. And then also, the progression of the intensity that you're going to do the activity.

GUPTA: These guys -- your guys out here, do they come out her and just start whipping 90-plus-miles fastballs?

CUNNINGHAM: No, you know, our spring training starts in the middle of February. We have them start in early January throwing in their long tossing, and developing arm strength and arm endurance. And then we get out here and actually start; the pitchers don't see hitters right away. They throw some bullpens first and they've thrown bullpens before they even get here. But they throw off of the mound and then they throw a batting practice, which is a -- just a sooth -- the intensity isn't quite the same as the game. And so we progress to that intensity.

GUPTA: Spring is officially here. A lot of people very interested in this topic; e-mails coming in. We have got time for one e-mail before we take a break.

Chris from Ontario wanting to know "What are the best hamstring stretches? How do you treat or prevent recurring hamstring problems?"

Let's start with that stretches question.

CUNNINGHAM: Well, the best -- there are a lot of different hamstring stretches. And the ones that I like are simple. If you start out on the ground, you bend one leg and almost make your legs into like a figure four. And you take it down nice and slow and gradual.

And anytime you stretch you want your stretch to be pain-free. Everybody has their limits. And if it's a little bit tight you might not be able to go as far. But understand that as long as you're taking it not over the edge, but to the edge, you're going to be able to get a good stretch.

GUPTA: And don't bounce back and forth?

CUNNINGHAM: You don't want to don't bounce back and forth. It's a slow, gradual, pain-free stretch. And allow the muscles to just stretch out gradually.

GUPTA: Those can really hurt when you stretch those. We're going to talk a lot more about that. We're also going to talk about your aches and pains as well, when we come back.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Is your workout doing more harm for good than your body? And what's the best way to deal with shin splints? We'll get those answers coming up.

But first, take our "Daily Dose" quiz. When you get injured, doctors tell you to remember the word "rice" when you get injured. What do the letters R-I-C and E stand for? The answers when we come back.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Checking the "Daily Dose" quiz. We asked, when you're injured, what do the letters R-I-C and E stand for? The answer, "R" stands for rest. "I" means ice, apply ice immediately. "C" stands for compression. Wrap the injury with a bandage after icing. And "E" means elevation. Get that injured area above the level of your heart to decrease swelling.

(END VIDEO CLIP)

GUPTA: Welcome back. We're here in Jupiter, Florida, it's beautiful outside. As the days get longer and the weather gets warmer, people are hitting the trails and getting back into their leagues. We're here in Florida at The Roger Dean Stadium, that's the site of the world champion Florida Marlins spring training camp.

Sean Cunningham, their head trainer, is our guest this morning.

Lots of questions coming in. Lots of people enjoying the warm weather; want to get outside. Questions coming in from runners.

This one an e-mail from John in Illinois asking, "I tore the inside ligament of my ankle last fall." Ouch. "The ankle is healed now, but it still bothers me when trying to run. What are good ways to build ankle strength and recover from a sever ankle sprain?"

This can bench you for the season, right?

CUNNINGHAM: Well, it absolutely can anytime you have ligament damage. The ligament provides support for the joint. So what you need to do -- the ligament never -- even when it heals, it never really heals back to its original state. So what you need to do is strengthen the muscles around that particular joint.

And the best thing for the ankle is you can do toe raises for the calf to strengthen up the Achilles and the calf muscle in the back. And then some, you know, walking on the inside and outside of the ankles to functionally strengthen up the muscles on the outside -- the inside and outside of the ankles.

You can do towel drills and even like, rubber -- little rubber tubing resistance drill, where you wrap the rubber tubing around part of your ankle and use the rubber tubing to provide resistance.

GUPTA: At lot of people injure their ankles. They sprain their ankles. What is adage? How long do you put ice on? When do you start putting heat on for all that sort of thing?

CUNNINGHAM: Well, you know, obviously that can vary, depending on the injury. But we like to ice for the first 48 to 72 hours. If it's real bad ankle sprain, you might ice for a fourth day, depending upon how long you think it's going to take to heal from the initial evaluation. And then from there you go to heat before the activity.

After three to four days, you'll go with heat before the activity to increase blood flow to the area. At then at the end of the activity, you might ice down for 15 or 20 -- no more than 20 minutes.

GUPTA: We're talking with Sean Cunningham, head trainer for the Florida Marlins.

Lots of e-mails coming in. Steve from Maryland wants to know, "Are there specific treatments for shin splints and exercises to help avoid them?"

I think everyone has probably has had shin splints at one point or another.

CUNNINGHAM: Yes. And if you've had them, they're painful. They'll just flat out stop you in your tracks. And you know, there are several causes to shin splints. The type of surface that you're running on can be one. Another cause is some muscle imbalance. You know, you might not have the arch support; your foot -- biomechanics of your foot may be contributing.

But a lot of times what we try and do is we do a lot of calf stretching with our stretching with our shin splints. We do an awful lot of calf stretching. And then we look to strengthen the muscles on the inside and the outside of the ankle, just to create a little bit of a muscle balance. And then we look at the arch support that they have. Try to provide you, through tape or through some sort of form-fitted orthotic, some sufficient arch support to try to alleviate some of that. And we back off the running until the pain subsides. We might do a low impact form of conditioning. And then once the pain is gone along the inside of the shins, we look to resume running at a progressive rate, where we don't pick up right where we left off. We might start with the running less. And then as we know that we've taken care of the symptoms, we gradually increase that.

GUPTA: A lot of people are going to walk out of their front doors now it's warm outside, and they're going to immediately start running. Should they run first, should they stretch first, something in between?

CUNNINGHAM: Well, something in between. And this is an ongoing discussion. The thing that we know is if you stretch a muscle cold, you can damage that muscle. And as a result, they like to have -- you like to have a little bit of a warm-up.

We'll have our guys ride the bike just for five minutes before they get active. We'll have them do in the pre-game stretch; just a real light jog before they actually get -- and a lot of this is to just generate just a little bit of a blood flow so that it's not a stone cold, cold muscle that's being stretched. But one that has a little blood flow and you get a much better stretch.

GUPTA: I think, just from personal experience, I think it's a great way to prevent injuries. Do a little something, a quick walk or something before you stretch those muscles.

More e-mail questions coming in. William in Georgia asking, "My hips and legs tighten up after a run. Could this indicate that my shoes are past their prime? At what point, or after how many miles, would you suggest a runner buy new shoes?"

CUNNINGHAM: Well, I think what's important, one is, it could indicate, it doesn't necessarily mean, you know, the fact that your hips are tight doesn't necessarily mean the shoes are the problem. So it could indicate that the shoes are the problem. A typical shoe will last 350, 400 miles. Now, if you're not into keeping...

GUPTA: Just a weekend or so.

(LAUGHTER)

CUNNINGHAM: Exactly. If you're not into keeping track of how many miles you're actually running, you can actually just visually look at your show shoes and see if there's any uneven wear on the sole. And if there is uneven wear on the sole that means that the stress is changing on your ankles, and knees, and low back.

GUPTA: We've got other advice on shoes as well. The American Academy of Orthopedic Surgeons has more tips on keep your body healthy while running. Avoiding hard surfaces like asphalt and concrete. Also, keep those surfaces flat, even in areas when running on hills, since that might increase the stress on both your ankles and your foot. And as the weather gets hotter, try running in the early morning or evening to avoid heat exhaustion. That's an important point as well.

We're going to toss it to a quick break. Lots of questions coming up, lots of discussion -- further discussion, aches and pains, and getting in shape for spring training. We're with Sean Cunningham, head trader -- trainer of the Florida Marlins. Stay with us.

UNIDENTIFIED FEMALE (voice-over): Baseball. Football. Skating. Soccer. Kids are playing more sports than ever before and have the scars to prove it. With 40 percent of sports injuries happening in kids, what can you do to keep your child healthy this spring season? Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Welcome back. We're talking about getting fit and staying injury-free this spring. We've been talking with adults up till now, but kids are actually more susceptible to sports injuries than their parents. More than 3 million kids every year-end up in a doctor's office or emergency room with a sports related injury.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): Jumping and falling have been a huge part of 15-year-old Amy Goldstein's life as a competitive skater. But over the years, years, small injuries mounted and nagged until one day, she couldn't mask the pain.

AMY GOLDSTEIN, FIGURE SKATER: Every time I was landing, I would land and like, wince. Like, that. There was pain and tears were like, welling up in my eyes, but I didn't want to stop. I just want the to keep skating.

GUPTA: Amy was diagnosed with what's called SI Joint Overload. She had bruised a joint connecting her spine to her pelvis.

METZL: Child athletes are at greater risks. And the consequence of their injuries are more significant because they has these -- they have these growing bones, which are more prone to injury.

GUPTA: Specifically what doctors call growth plate injuries.

METZL: If a kid injuries the growth plate in their bone, it can affect how that bone grows into adulthood. We see growth plate injuries in kids; we don't see those in adults at all.

GUPTA: What kids and adults do have in common are overuse injuries. Overuse is a result of repetitive movement, hitting, pitching, kicking over and over; movement that can cause micro damage to muscle tissue.

On the baseball field overuse comes from throwing pitches too hard and too often, resulting in what some doctors are calling "little league elbow." These little league injuries can add up to big problems because of those growth plates.

Parents and coaches may not spot overuse injuries in children since they happen over time. But there are ways: if your child feels pain, stiffness, swelling, or redness over the course of several weeks; if there's a clicking or creaking sensation in their joints soon after coming off the field; and if these symptoms are present all the time.

Kid shouldn't throw in the towel of sports. Study show that being involved makes them inclined to better health in adulthood. The key is don't push too hard, no matter what your age.

(END VIDEO CLIP)

GUPTA: Well, as you heard, young athletes are not just small adults. Yet the advice from experts for preventing injuries is very similar. Make sure they wear safety gear and that they warm up before playing. Plus, keep them drinking water. And if they're in pain, avoid letting them play. Also, before starting any new sport, all children should receive a health exam.

We're talking with Sean Cunningham, he's head athletic trainer for the Florida Marlins.

Congratulations, by the way, on the World Series.

CUNNINGHAM: Thank you. Appreciate that.

GUPTA: Nice job.

CUNNINGHAM: Yes, we had a lot of fun.

GUPTA: I bet you did.

Lots of e-mails coming in. Lots of people want to be where your players are, and they're kids now but they want to be where your players are when they're adults.

Jay -- an e-mail from Jay in Arizona asking, "My son plays on a club basketball team that's 11 and under. They have recently won two national titles and are one of the elite teams in the country. My question is, how much is too much? We practice and play 11 months out of the year. My son still enjoys the schedule and, to date, has not suffered any serious injuries. All of his best friends are on the team, and they all look forward to being together," all that camaraderie. "What are some of the signs of 'burnout?'"

CUNNINGHAM: Well, that's a good question. There are two types of burnouts. There's emotional burnout and physical burnout. And we'll just touch base on physical burnout.

And I think the No. 1 factor that you have to pay attention to is recovery. These children are growing. And they need time to recover. And it's going to vary from individual to individual. You know your child better than anybody. So you need to really pay attention. If the child's complaining of pain and discomfort, starting to show signs that he just doesn't want to participate anymore, he may need a little bit of a break. And I think if you're just practicing once a week and playing once a week, I think that that allows for recovery.

But it's very important because when you get into the elite travel teams that are practicing three, four, five times a week with games, you start to run into problems. Your body, whether you're a child or an adult, needs time to recover. And you have to allow that. And the problem as adults is you can control the recovery as an adult. But the children don't have the ability to control their recovery. The adults are usually dictating what the practice is and what the game schedule is.

GUPTA: I can imagine there's so much pressure now on young players. They want to grow up to be the A.J. Burnett's in the Florida Marlins of the future. That's good advice, though. Good advice, not too much pressure.

We're not finished yet though. Coming up

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Grab a pen. We'll point you to a web site where you can research all your aches and pains, from treatment to prevention; information is just a click away.

First, some of this week's medical headlines in today's "For Your Health."

UNIDENTIFIED FEMALE (voice-over): Stress alone may cause an irregular heartbeat. A new study in the journal "Circulation" looked at people broken prone to irregular heart beats. They found that mental stress was enough to cause irregular rhythms. The study pointed out that although physical stress affects the heart more, mental stress can still have a significant impact.

Also, the FDA is asking manufacturers of some antidepressants to add or strengthen suicide warnings on their label. And they want doctors to watch for signs of worsening depression symptoms. The FDA says people shouldn't stop taking these drugs, but want further studies done on the potential risks of antidepressants.

(END VIDEO CLIP)

GUPTA: If you're feeling the pain or trying to avoid it, go to orthoinfo.aaos.org. That's the American Academy of Orthopedic Surgeons web site. Scroll down to the sports section, you're going to find fact sheets on preventing and treating injuries in a variety of sports, from golf and skate boarding to gymnastics and baseball.

We've been talking with Sean Cunningham. He's the head trainer for the World Series winning Florida Marlins.

Congratulations again on that.

A lot of people out there want to get in shape this spring. What's your final thought for them today? CUNNINGHAM: I think more than anything, try to build up to the activity that you're going to participate in. You know, prepare your body the best way you can. And to listen to your body; it's going to tell you if something is not quite right. And you need to be the one that picks up on those little cues.

GUPTA: You want to see my 98-mile an hour fastball?

(LAUGHTER)

CUNNINGHAM: Oh, hey. You have a 98-mile an hour fastball; we might have you out here shortly.

(LAUGHTER)

GUPTA: We'll talk. That's right.

That's all the time we have here today.

Sean, thank you so much for answering viewer's questions.

CUNNINGHAM: My pleasure.

GUPTA: Very helpful information.

Thanks as well at home for all those e-mails. Make sure to watch next week and we're going to be talking about sleep, from springing forward to insomnia. We're going to answer all your questions about getting those ZZZ's. That's next week on "House Call," 8:30 Eastern. E-mail us your questions at housecall@cnn.com.

Thanks for watching. I'm Dr. Sanjay Gupta.

Stay tune now to CNN for more news.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com

Aired March 27, 2004 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, CNN CORRESPONDENT: Good morning and welcome to "House Call." We're coming to you from Jupiter, Florida, where last year's world series champions, the Florida Marlins, are training to keep the title.
Many of us, of course, are starting our own training from everything from baseball to running. And with that rush to get back in the game, sometimes come injuries. Six out of 10 people who start will end up with a sports injury within six weeks. We're going to be talking with the Marlins team trainer in a bit about what you can do to stay healthy this season.

But first, we want to hear from someone who was sidelined last season by what used to be a career-ending injury. Marlin's pitcher, A.J. Burnett is here to tell us about how he goes from the surgeon's office to the pitcher's mound. Let there be no doubt the Florida Marlins won the World Series last year.

How are you doing?

A.J. BURNETT, PITCHER, FLORIDA MARLINS: Very good.

GUPTA: You had a significant problem with your right elbow last year. Tell us about it.

BURNETT: It wasn't significant at the beginning. It was on and off. But it got to the point where I couldn't take it anymore. And it's one of those things you don't want to happen, but I think eventually if you have enough wear and tear on your elbow, it's going to happen.

GUPTA: You had an operation, pretty well known operation, the Tommy John procedure. Tell us about that.

BURNETT: Well, it's a --I wouldn't wish it on my worst enemy. I mean they said 12 to 18 months for a reason. Mine came at the perfect time, you know?

GUPTA: April of last year...

BURNETT: April. But I'm feeling good now. I've done a lot of bullpens and a lot of throwing. And it's just up and down; you have good days and bad days. You just have to stick with it because it's going to be stronger than it ever was.

GUPTA: It's been 11 months, and how long after the operation were you back to throwing? When did you feel comfortable?

BURNETT: Well, I started range of motion really soon, like two weeks right after surgery. I think the four-month mark I started playing catch.

GUPTA: Is that right? People say you might even come back stronger after this operation.

BURNETT: That would be cool.

GUPTA: You think so?

BURNETT: That would be nice.

GUPTA: Are you feeling it?

BURNETT: I feel a little bit. I mean I've thrown a handful of bullpens and each one gets better and better each time.

GUPTA: A lot of people -- guys are on the hunt for the Marlins. You going to keep an eye on...

BURNETT: We need to do it again.

GUPTA: Keep this trophy right here. Good luck to you.

BURNETT: Thank you.

GUPTA: Thanks for your time as well today. You're going to be getting that arm back into major league form as well. Good luck this season.

Could your kids being setting themselves up for that same sort of operation that A.J. had? Well, you might be surprised. We're going to talk about kids and sports injuries later in the show.

But first, you may not be a major leaguer or an Olympian yet, but sometimes those dreams of greatness can get us into big trouble. Over 10 million sports injuries occur each year, often because we go for the gold and we overdo it.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): It's the weekend.

PAUL SEWARDS, WEEKEND WARRIOR: Go shunt! Go shunt!

GUPTA: This day, 34-year-old Paul Seward will play competitive soccer for hours in 40-degree weather.

SEWARDS: Past five years, broken ankle, broke my elbow badly last year and snapped a ligament or tore a ligament, and a fractured a left ankle and two broken ribs. And just various groins and strains and all that stuff.

GUPTA: Thirty-nine-year-old Donald Leka plays tennis, swims and lifts weights.

DONALD LEKA, WEEKEND WARRIOR: I think I get hurt probably once every, about, month and a half or two months.

GUPTA: Donald and Paul are both weekend warriors, they say they're too busy to exercise daily, but cram in a week's worth on the weekends.

Sports Doctor Jordan Metzl sees many weekend warriors in his practice.

DR. JORDAN METZL, ORTHOPEDIC SURGEON: The phone starts ringing very early Monday morning with people who have hurt themselves in any number of different creative ways over the weekend.

GUPTA: So whether it's being a weekend warrior or jumping into exercise and league play too quickly this spring, it's the lack of day-to-day conditioning that results in common injuries.

METZL: Torn muscles in the calf, torn muscles in the shoulder, we see ligament tears, such as ligament tears in the knee or elbow. And we see bone injuries such as fractures.

LEKA: The sad thing is when you do get hurt, you know, there's a couple weeks that go by that generally you can't do anything.

GUPTA: So if you don't want to end up on the disable the list this spring, try these conditioning tips.

METZL: Twenty to 30 minutes a day is really, I think, all you need to really kind of do some good prevention work.

GUPTA: Jog or walk briskly every day. Squeeze in some push-ups, sit-ups, and most importantly, stretch.

METZL: Prepare your body and know your body. And kind of act reasonably within the limits of what was your body can do.

GUPTA: When it comes to exercise, doing something is always better than doing nothing. But it's important to spread it out.

(END VIDEO CLIP)

GUPTA: Limits is not a word most athletes like to hear, but this doesn't always mean cutting back. In some cases, it could mean doing more, expanding those limits. Like remembering, warm up and cool down, taking the extra 10 minutes can help prevent injuries in the long run. Also, make sure to stretch before and after your workout, whether it's baseball or an aerobics class. Invest in good footwear. Make sure you have sport specific shoes, ones that fit properly.

Cross train to avoid overloading any one area of your body. And like A.J. said, go slow when coming back from an injury or starting back up from a sport. Don't rush, where you may end up rushing straight to a doctor's office. To help us stay injury-free this spring and hopefully all year round, we've got Florida Marlins' head athletic trainer, Sean Cunningham. And here's to answer all your questions. He's a certified athletic trainer, a certified strength and conditioning specialist.

You've been with the Marlins for three years; you were with the Expos for 15 years before that. And you're still young still. Good healthy living.

SEAN CUNNINGHAM, ATHLETIC TRAINER, FLORIDA MARLINS: That's right, I started early. So I enjoy doing what I do and I've been doing it right out of school.

GUPTA: Well, thanks so much for joining us.

Listen, we did our own informal count of all the sort of injuries you see in baseball, your sport. About half of them are related to the arms we found. People out there -- there are a lot of people out there aren't professional athletes but still concerned about their arms this spring. What advice do you give them?

CUNNINGHAM: I think my No. 1 advice to them is to pay attention to the exercise, the intensity that they're doing and the frequency with which they do it. You want your muscles to be prepared for what you're going to ask them to do. And the best way to do that is to make sure that you have the muscle strength and the muscle endurance. And you do that through a gradual progression of both duration, how long you're going to be doing the activity. And then also, the progression of the intensity that you're going to do the activity.

GUPTA: These guys -- your guys out here, do they come out her and just start whipping 90-plus-miles fastballs?

CUNNINGHAM: No, you know, our spring training starts in the middle of February. We have them start in early January throwing in their long tossing, and developing arm strength and arm endurance. And then we get out here and actually start; the pitchers don't see hitters right away. They throw some bullpens first and they've thrown bullpens before they even get here. But they throw off of the mound and then they throw a batting practice, which is a -- just a sooth -- the intensity isn't quite the same as the game. And so we progress to that intensity.

GUPTA: Spring is officially here. A lot of people very interested in this topic; e-mails coming in. We have got time for one e-mail before we take a break.

Chris from Ontario wanting to know "What are the best hamstring stretches? How do you treat or prevent recurring hamstring problems?"

Let's start with that stretches question.

CUNNINGHAM: Well, the best -- there are a lot of different hamstring stretches. And the ones that I like are simple. If you start out on the ground, you bend one leg and almost make your legs into like a figure four. And you take it down nice and slow and gradual.

And anytime you stretch you want your stretch to be pain-free. Everybody has their limits. And if it's a little bit tight you might not be able to go as far. But understand that as long as you're taking it not over the edge, but to the edge, you're going to be able to get a good stretch.

GUPTA: And don't bounce back and forth?

CUNNINGHAM: You don't want to don't bounce back and forth. It's a slow, gradual, pain-free stretch. And allow the muscles to just stretch out gradually.

GUPTA: Those can really hurt when you stretch those. We're going to talk a lot more about that. We're also going to talk about your aches and pains as well, when we come back.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Is your workout doing more harm for good than your body? And what's the best way to deal with shin splints? We'll get those answers coming up.

But first, take our "Daily Dose" quiz. When you get injured, doctors tell you to remember the word "rice" when you get injured. What do the letters R-I-C and E stand for? The answers when we come back.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Checking the "Daily Dose" quiz. We asked, when you're injured, what do the letters R-I-C and E stand for? The answer, "R" stands for rest. "I" means ice, apply ice immediately. "C" stands for compression. Wrap the injury with a bandage after icing. And "E" means elevation. Get that injured area above the level of your heart to decrease swelling.

(END VIDEO CLIP)

GUPTA: Welcome back. We're here in Jupiter, Florida, it's beautiful outside. As the days get longer and the weather gets warmer, people are hitting the trails and getting back into their leagues. We're here in Florida at The Roger Dean Stadium, that's the site of the world champion Florida Marlins spring training camp.

Sean Cunningham, their head trainer, is our guest this morning.

Lots of questions coming in. Lots of people enjoying the warm weather; want to get outside. Questions coming in from runners.

This one an e-mail from John in Illinois asking, "I tore the inside ligament of my ankle last fall." Ouch. "The ankle is healed now, but it still bothers me when trying to run. What are good ways to build ankle strength and recover from a sever ankle sprain?"

This can bench you for the season, right?

CUNNINGHAM: Well, it absolutely can anytime you have ligament damage. The ligament provides support for the joint. So what you need to do -- the ligament never -- even when it heals, it never really heals back to its original state. So what you need to do is strengthen the muscles around that particular joint.

And the best thing for the ankle is you can do toe raises for the calf to strengthen up the Achilles and the calf muscle in the back. And then some, you know, walking on the inside and outside of the ankles to functionally strengthen up the muscles on the outside -- the inside and outside of the ankles.

You can do towel drills and even like, rubber -- little rubber tubing resistance drill, where you wrap the rubber tubing around part of your ankle and use the rubber tubing to provide resistance.

GUPTA: At lot of people injure their ankles. They sprain their ankles. What is adage? How long do you put ice on? When do you start putting heat on for all that sort of thing?

CUNNINGHAM: Well, you know, obviously that can vary, depending on the injury. But we like to ice for the first 48 to 72 hours. If it's real bad ankle sprain, you might ice for a fourth day, depending upon how long you think it's going to take to heal from the initial evaluation. And then from there you go to heat before the activity.

After three to four days, you'll go with heat before the activity to increase blood flow to the area. At then at the end of the activity, you might ice down for 15 or 20 -- no more than 20 minutes.

GUPTA: We're talking with Sean Cunningham, head trainer for the Florida Marlins.

Lots of e-mails coming in. Steve from Maryland wants to know, "Are there specific treatments for shin splints and exercises to help avoid them?"

I think everyone has probably has had shin splints at one point or another.

CUNNINGHAM: Yes. And if you've had them, they're painful. They'll just flat out stop you in your tracks. And you know, there are several causes to shin splints. The type of surface that you're running on can be one. Another cause is some muscle imbalance. You know, you might not have the arch support; your foot -- biomechanics of your foot may be contributing.

But a lot of times what we try and do is we do a lot of calf stretching with our stretching with our shin splints. We do an awful lot of calf stretching. And then we look to strengthen the muscles on the inside and the outside of the ankle, just to create a little bit of a muscle balance. And then we look at the arch support that they have. Try to provide you, through tape or through some sort of form-fitted orthotic, some sufficient arch support to try to alleviate some of that. And we back off the running until the pain subsides. We might do a low impact form of conditioning. And then once the pain is gone along the inside of the shins, we look to resume running at a progressive rate, where we don't pick up right where we left off. We might start with the running less. And then as we know that we've taken care of the symptoms, we gradually increase that.

GUPTA: A lot of people are going to walk out of their front doors now it's warm outside, and they're going to immediately start running. Should they run first, should they stretch first, something in between?

CUNNINGHAM: Well, something in between. And this is an ongoing discussion. The thing that we know is if you stretch a muscle cold, you can damage that muscle. And as a result, they like to have -- you like to have a little bit of a warm-up.

We'll have our guys ride the bike just for five minutes before they get active. We'll have them do in the pre-game stretch; just a real light jog before they actually get -- and a lot of this is to just generate just a little bit of a blood flow so that it's not a stone cold, cold muscle that's being stretched. But one that has a little blood flow and you get a much better stretch.

GUPTA: I think, just from personal experience, I think it's a great way to prevent injuries. Do a little something, a quick walk or something before you stretch those muscles.

More e-mail questions coming in. William in Georgia asking, "My hips and legs tighten up after a run. Could this indicate that my shoes are past their prime? At what point, or after how many miles, would you suggest a runner buy new shoes?"

CUNNINGHAM: Well, I think what's important, one is, it could indicate, it doesn't necessarily mean, you know, the fact that your hips are tight doesn't necessarily mean the shoes are the problem. So it could indicate that the shoes are the problem. A typical shoe will last 350, 400 miles. Now, if you're not into keeping...

GUPTA: Just a weekend or so.

(LAUGHTER)

CUNNINGHAM: Exactly. If you're not into keeping track of how many miles you're actually running, you can actually just visually look at your show shoes and see if there's any uneven wear on the sole. And if there is uneven wear on the sole that means that the stress is changing on your ankles, and knees, and low back.

GUPTA: We've got other advice on shoes as well. The American Academy of Orthopedic Surgeons has more tips on keep your body healthy while running. Avoiding hard surfaces like asphalt and concrete. Also, keep those surfaces flat, even in areas when running on hills, since that might increase the stress on both your ankles and your foot. And as the weather gets hotter, try running in the early morning or evening to avoid heat exhaustion. That's an important point as well.

We're going to toss it to a quick break. Lots of questions coming up, lots of discussion -- further discussion, aches and pains, and getting in shape for spring training. We're with Sean Cunningham, head trader -- trainer of the Florida Marlins. Stay with us.

UNIDENTIFIED FEMALE (voice-over): Baseball. Football. Skating. Soccer. Kids are playing more sports than ever before and have the scars to prove it. With 40 percent of sports injuries happening in kids, what can you do to keep your child healthy this spring season? Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Welcome back. We're talking about getting fit and staying injury-free this spring. We've been talking with adults up till now, but kids are actually more susceptible to sports injuries than their parents. More than 3 million kids every year-end up in a doctor's office or emergency room with a sports related injury.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): Jumping and falling have been a huge part of 15-year-old Amy Goldstein's life as a competitive skater. But over the years, years, small injuries mounted and nagged until one day, she couldn't mask the pain.

AMY GOLDSTEIN, FIGURE SKATER: Every time I was landing, I would land and like, wince. Like, that. There was pain and tears were like, welling up in my eyes, but I didn't want to stop. I just want the to keep skating.

GUPTA: Amy was diagnosed with what's called SI Joint Overload. She had bruised a joint connecting her spine to her pelvis.

METZL: Child athletes are at greater risks. And the consequence of their injuries are more significant because they has these -- they have these growing bones, which are more prone to injury.

GUPTA: Specifically what doctors call growth plate injuries.

METZL: If a kid injuries the growth plate in their bone, it can affect how that bone grows into adulthood. We see growth plate injuries in kids; we don't see those in adults at all.

GUPTA: What kids and adults do have in common are overuse injuries. Overuse is a result of repetitive movement, hitting, pitching, kicking over and over; movement that can cause micro damage to muscle tissue.

On the baseball field overuse comes from throwing pitches too hard and too often, resulting in what some doctors are calling "little league elbow." These little league injuries can add up to big problems because of those growth plates.

Parents and coaches may not spot overuse injuries in children since they happen over time. But there are ways: if your child feels pain, stiffness, swelling, or redness over the course of several weeks; if there's a clicking or creaking sensation in their joints soon after coming off the field; and if these symptoms are present all the time.

Kid shouldn't throw in the towel of sports. Study show that being involved makes them inclined to better health in adulthood. The key is don't push too hard, no matter what your age.

(END VIDEO CLIP)

GUPTA: Well, as you heard, young athletes are not just small adults. Yet the advice from experts for preventing injuries is very similar. Make sure they wear safety gear and that they warm up before playing. Plus, keep them drinking water. And if they're in pain, avoid letting them play. Also, before starting any new sport, all children should receive a health exam.

We're talking with Sean Cunningham, he's head athletic trainer for the Florida Marlins.

Congratulations, by the way, on the World Series.

CUNNINGHAM: Thank you. Appreciate that.

GUPTA: Nice job.

CUNNINGHAM: Yes, we had a lot of fun.

GUPTA: I bet you did.

Lots of e-mails coming in. Lots of people want to be where your players are, and they're kids now but they want to be where your players are when they're adults.

Jay -- an e-mail from Jay in Arizona asking, "My son plays on a club basketball team that's 11 and under. They have recently won two national titles and are one of the elite teams in the country. My question is, how much is too much? We practice and play 11 months out of the year. My son still enjoys the schedule and, to date, has not suffered any serious injuries. All of his best friends are on the team, and they all look forward to being together," all that camaraderie. "What are some of the signs of 'burnout?'"

CUNNINGHAM: Well, that's a good question. There are two types of burnouts. There's emotional burnout and physical burnout. And we'll just touch base on physical burnout.

And I think the No. 1 factor that you have to pay attention to is recovery. These children are growing. And they need time to recover. And it's going to vary from individual to individual. You know your child better than anybody. So you need to really pay attention. If the child's complaining of pain and discomfort, starting to show signs that he just doesn't want to participate anymore, he may need a little bit of a break. And I think if you're just practicing once a week and playing once a week, I think that that allows for recovery.

But it's very important because when you get into the elite travel teams that are practicing three, four, five times a week with games, you start to run into problems. Your body, whether you're a child or an adult, needs time to recover. And you have to allow that. And the problem as adults is you can control the recovery as an adult. But the children don't have the ability to control their recovery. The adults are usually dictating what the practice is and what the game schedule is.

GUPTA: I can imagine there's so much pressure now on young players. They want to grow up to be the A.J. Burnett's in the Florida Marlins of the future. That's good advice, though. Good advice, not too much pressure.

We're not finished yet though. Coming up

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Grab a pen. We'll point you to a web site where you can research all your aches and pains, from treatment to prevention; information is just a click away.

First, some of this week's medical headlines in today's "For Your Health."

UNIDENTIFIED FEMALE (voice-over): Stress alone may cause an irregular heartbeat. A new study in the journal "Circulation" looked at people broken prone to irregular heart beats. They found that mental stress was enough to cause irregular rhythms. The study pointed out that although physical stress affects the heart more, mental stress can still have a significant impact.

Also, the FDA is asking manufacturers of some antidepressants to add or strengthen suicide warnings on their label. And they want doctors to watch for signs of worsening depression symptoms. The FDA says people shouldn't stop taking these drugs, but want further studies done on the potential risks of antidepressants.

(END VIDEO CLIP)

GUPTA: If you're feeling the pain or trying to avoid it, go to orthoinfo.aaos.org. That's the American Academy of Orthopedic Surgeons web site. Scroll down to the sports section, you're going to find fact sheets on preventing and treating injuries in a variety of sports, from golf and skate boarding to gymnastics and baseball.

We've been talking with Sean Cunningham. He's the head trainer for the World Series winning Florida Marlins.

Congratulations again on that.

A lot of people out there want to get in shape this spring. What's your final thought for them today? CUNNINGHAM: I think more than anything, try to build up to the activity that you're going to participate in. You know, prepare your body the best way you can. And to listen to your body; it's going to tell you if something is not quite right. And you need to be the one that picks up on those little cues.

GUPTA: You want to see my 98-mile an hour fastball?

(LAUGHTER)

CUNNINGHAM: Oh, hey. You have a 98-mile an hour fastball; we might have you out here shortly.

(LAUGHTER)

GUPTA: We'll talk. That's right.

That's all the time we have here today.

Sean, thank you so much for answering viewer's questions.

CUNNINGHAM: My pleasure.

GUPTA: Very helpful information.

Thanks as well at home for all those e-mails. Make sure to watch next week and we're going to be talking about sleep, from springing forward to insomnia. We're going to answer all your questions about getting those ZZZ's. That's next week on "House Call," 8:30 Eastern. E-mail us your questions at housecall@cnn.com.

Thanks for watching. I'm Dr. Sanjay Gupta.

Stay tune now to CNN for more news.

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