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Prakash Chandran: Entering into winter, many of us slow down and become less active. When the snow and slush start to settle in and the roads become less convenient to travel, it's just a lot easier to justify a day in than it is to push through puddles and wet shoes to get to the gym. But what are some of the benefits of staying active during winter?

Here to tell us more is Dr. Edward Appelbaum, an orthopedic surgeon and sports medicine specialist at Harrington Hospital. This is Healthy Takeout, the podcast from Harrington Hospital. My name is Prakash Chandran. So Dr. Appelbaum, really great to have you here today. Thank you so much for being with us. I'd love to start by you telling us a little bit more about your background in sports medicine.

Edward Appelbaum, DO: Thanks for having me. I appreciate it. Yeah. So, I went to University of Maryland for undergraduate. And during my time there, I was a student athletic trainer and worked my way to become the head student athletic trainer, working mostly with the football team, dealing with injury prevention, treatment, rehabilitation, being on the sidelines for all the home and away games. When I was getting my master's degree, I returned to my high school where I was an assistant cross-country and track and field coach. And then I continued to work with high school collegiate and professional sports teams during medical school and residency. I was very fortunate to have a great exposure to subspecialty of orthopedic sports medicine while in residency.

And I went on to complete a fellowship at the University of Madison in Worcester in sports medicine and arthroscopic surgery, where I further developed skills with minimally invasive techniques and joint restoration. During that year, I worked with many area high schools, colleges, as well as the Boston Red Sox and their Triple-A affiliate, the Worcester Red Sox. It was a great experience to work with professional athletes, and I'm excited to continue that trend to work with high school, college, professional athletes, as well as weekend warriors throughout my time here at Harrington Hospital.

Prakash Chandran: Yeah, absolutely. It just really sounds like a really comprehensive set of experience that you have there. And we're definitely lucky to have you. It sounds like you've also been helping athletes stay active throughout the entire year. You know, we're focusing right now on the winter season and I'd love to ask why exactly is it so important that we stay active during winter?

Edward Appelbaum, DO: Yes, that's a great question. So the winter months are notorious for people to focus less on staying active. Whether it be the colder weather, the more treacherous weather conditions or the fact that it gets darker earlier, like I said, it's very common for people to be less active during the winter months. And when you're less active, this this can lead to weight gain and other medical issues. So it's very important to either continue or start an exercise program during these winter months.

Prakash Chandran: Yeah, there's no question about it. I've also heard of this kind of disorder called SAD or seasonal affective disorder. Does winter activity protect against this?

Edward Appelbaum, DO: Yeah, so seasonal affective disorder is a change in someone's mood most commonly during the winter. It can lead to sadness, fatigue, depression. It can also lead to appetite changes and weight gain. So maintaining a schedule with daily exercise can decrease your risk of seasonal affective disorder. I'm sure you've heard of endorphins. Endorphins are chemicals that are released with exercise, also known as, you know, a runner's high. These chemicals can lead to a decrease in stress and anxiety as well as improved sleep. So all of the symptoms of seasonal affective disorder that can be treated with certain medications, it can also be treated with simple diet and exercise.

Prakash Chandran: So Dr. Appelbaum, what are some of the benefits of exercising during the cold season?

Edward Appelbaum, DO: Yes. So there's many activities during the winter that are not available during the other three seasons. And being in New England, Massachusetts, there's a lot of winter activities that you can't get during the other three seasons, like I said, or in other areas of the country. There's numerous opportunities to partake in winter activities like skiing, either cross-country or downhill; snowboarding, snowshoeing, ice skating, sledding. My wife is from Minnesota and I have gone cross-country skiing several times with her and it is definitely a workout.

So this is definitely a great time to learn a new activity. It's also a great time to start an exercise routine. So when you get home from work or if you're already working from home during COVID, as soon as you're done your workday, as soon as you get home, just putting on your exercise clothes and starting your routine, it makes it less of a chore and more of a routine to, you know, add daily exercise.

Prakash Chandran: Yeah. So speaking about getting into that routine, we all know that it is hard to get motivated, especially when it's cold outside or there's bad weather. So I was wondering if you had some simple ways that people can stay active or the types of activities that they should start with in order to get into that rhythm.

Edward Appelbaum, DO: Sure. So the best way to get motivated to begin working out in the cold and most importantly to continue working out is what I think is find someone to work out with. It could be your spouse, your family member, friend, neighbor, coworker. By working out together in a group or with someone else, that holds you accountable to continue to exercise. Another way to keep motivated and to add exercise to your daily schedule is to do exactly that, add it to your schedule. Just like you have a schedule with brushing your teeth, going to work, eating lunch. If you add exercise into your schedule on a daily routine, it doesn't seem such like a chore and more of a routine.

You definitely want to take advantage of technology as well. With the internet, there are so many ways to positively impact your exercise routine. With COVID, being in groups or going to the gym may not be possible. So exercising with friends or family through the internet, whether it be FaceTime, Zoom, another source is a great way to stay connected and encourage each other to work out.

An example is just if you're in a group of people, whether in person or on Zoom or FaceTime, like I said, is for each person to think of one or two individual exercises. And when you do them all together, you can have a collective exercise routine that does not become routine or boring. It can become pretty exciting.

Prakash Chandran: One of the things that people have started doing, especially in the time of COVID is just getting outside and running. And during the winter months, obviously, depending on where you live, sometimes it can be a little hazardous. There could be like snow or ice on the ground. So can you maybe speak to some of the potential hazards that people should be aware of if they choose to work out outside and maybe even address the type of apparel they should be wearing?

Edward Appelbaum, DO: Sure. Yeah. So speaking of apparel, you definitely want to dress in layers. At the beginning of a workout, when you're not truly warmed up, you're going to be cold. Being able to remove a layer once you break a sweat is very important. The layer closest to your skin should be moisture wicking, and this allows the clothing to actually take the sweat and moisture away from your body in order to evaporate. You want to make sure that you have a hat and gloves to protect your hands and to keep a lot of the warmth with a hat. Since there's less daylight, if you're working out in the morning or the evening, when it's dark, it's very important to wear reflective clothing so that way you're seen by other pedestrian and especially vehicles.

When talking about potential hazards, definitely want to take a look at the weather before going outside. You obviously do not want to be in a blizzard or if the temperature is too low. You want to take advantage of warmer days to be outside. Go for walks, cycling, hikes, or running. And you want to make sure that you have appropriate footwear with good traction and arch support. You always want to be careful of uneven surfaces, snow or ice, especially during the winter.

And one thing that's really important and to prevent injuries is stretching. You want to stretch both before and after exercising. No matter what the exercise is, you want to make sure that you're stretching because that increases flexibility and decreases your risk of injury.

Prakash Chandran: Yeah. You know, one of the things that I wanted to ask you as we start to close here is you have worked with so many athletes across the different seasons, especially people that are performing at a very high level, you know, kind of during the winter months, kind of what's one thing that you've learned from working with all of them that we as kind of the lay people and the normal people can take away?

Edward Appelbaum, DO: Sure. So it's definitely a routine. Focus on adding exercise and diet into your daily schedule, so that way it doesn't seem like a chore, it doesn't seem like a bother. It just is part of your life. So if you're out there and you think that working out is too hard or too strenuous, there's definitely ways to ease in and add this to your daily routine.

So let's take running for example, if you're not a runner and you think that it's, you know, too difficult to start, you want to begin with short distances and slow speeds. After a few weeks, when you build up enough stamina and muscle strength, you can either increase the speed or the distance. A very common mistake is to feel good running or walking at a short distance and then all of a sudden you increase your distance, increase your speed, running faster, and that can lead to an overuse injury that can affect your feet, your knees, your hips. So it's definitely important to start slow and increase with time.

Prakash Chandran: I'm so glad that you mentioned that because this is a mistake that I have personally made too many times. Like I will get a surge of motivation, I'll put on my running shoes and I will go hard. I'll go outside and run as fast as I can. And I always inevitably ended up injuring myself or being very sore. And it's actually de-motivating because of the recovery time that it requires because I overexerted myself. I'm sure you see this all the time.

Edward Appelbaum, DO: Yeah. So when the pandemic started, everyone wanted to stay inside and everyone's working out in these exercise bikes and people went from not exercising at all to now, "I've all this time at home. I want to use this exercise bike that's been sitting in the corner." And we saw so many patients come in with hip pains, knee pains. And the number one question was, you know, "When did this start?" And, "Oh, I wasn't very active. And then all of a sudden I jumped on this bike. I started working out very strenuously for seven days a week and now my knees hurt, my hips hurt." So it's very important to start out slow and everyone works at their own pace. But eventually, you'll get to where you want to be and get fit, get in shape, lose weight, and have all the added benefits of exercise.

Prakash Chandran: So Dr. Applebaum, just before we close here today, is there anything else that you'd like to share with our audience about staying active during the winter, or just staying active in general?

Edward Appelbaum, DO: Sure. So I know we've talked a lot about exercising and winter activities and running and walking, but I want to make a point to diet. Everyone thinks that or many people think that in order to lose weight or get in shape, you need to work out for hours and hours every day. The most important thing to focus on is your diet.

So around the holidays, many people, including myself, forget about portion control, eat a little bit too much. And that starts the whole winter hibernation, if you want, where people kind of focus on not really working out or eating a little bit too much and, you know, the bear hibernating situation. So by focusing on eating healthy foods in moderation and portion control, you can start the journey to losing weight and getting healthy.

So one example that I need to learn and live with is instead of eating snacks directly out of a bag, pour appropriate amount into a bowl, and that will stop you from overeating.

Prakash Chandran: You're talking crazy now.

Edward Appelbaum, DO: Yeah, I know. Trusts me. I love to sit down with a bag and, you know, all of a sudden, you know, you realize the bag's gone and you say, "Wow, I ate a little bit too much." So, just simple things, you know, portion control, focusing on eating good proteins, fruits and vegetables, whole grains, that really is important in your overall health, diet-exercise routine. And if you need help, we have dieticians and nutritionists that we can set you up with in order to help you on this journey.

And then the last point I want to make is just focusing on your overall health. You want to think of your overall health as an investment in yourself. If your car breaks down, you can get another car. If your phone breaks, you can get a new phone. But if you break down, there is only you, there is only one you. So it's important to invest in yourself, healthy diet, daily exercise routine in order to have a healthy long life.

Prakash Chandran: Well, I think that's great advice and the perfect place to end. Thank you so much for your time today, Dr. Appelbaum.

Edward Appelbaum, DO: Sure. Thanks for having me.

Prakash Chandran: That was Dr. Edward Appelbaum, an orthopedic surgeon and sports medicine specialist at Harrington Hospital. Thanks for checking out this episode of Healthy Takeout. You can call (508) 764-2772. Or to learn more, please visit harringtonhospital.org.

if you've found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks again for listening. My name is Prakash Chandran, and we'll talk next time.