Joey Wahler (Host): Everyone wants a positive and injury-free experience. So, we're discussing gym safety and cleanliness. Our guest, Justin Bickford, a doctor of physical therapy for Memorial Hermann in North Houston.

Welcome to Every Day Well, a health and wellness podcast brought to you by Memorial Hermann Health System. Tune in for the latest tips and information about healthcare topics that matter most to you. Thanks for joining us. I'm Joey Wahler. Hi there, Justin. Welcome.

Dr. Justin Bickford: Yeah, how are you doing, Joey?

Host: I'm great. Yourself?

Dr. Justin Bickford: Another day in paradise. Thanks for having me.

Host: Excellent. Great to have you aboard. So first, how can gym-goers best prevent infections or diseases and what are the most common hygiene mistakes they can make when working out at a gym? Let's talk about that cleanliness first.

Dr. Justin Bickford: well, honestly, there's no 100% effective way of not running in and exposing yourself to germs at the gym. If you're going to do that, then you're not going to go to the gym. And I say that because everybody sweats, everybody breathes heavy, everybody, when they're exercising, they get their heart rate up. And sometimes they spit, sometimes they leave a little piece of themselves behind after they get off the equipment. So, knowing these things in advance can help set you up for success when you get into the gym.

So if your goal is to stay healthy and practice proper hygiene while in the gym, one of the easiest things you can do is to wash your hands before you work out. Not just after you use the restroom, but washing your hands on your way into the gym, because you're going to touch things that other people have touched. So, washing your hands beforehand means that you're not going to leave anything behind that you're bringing there. And then, after you use the equipment, always wiping down the equipment. Every gym, regardless of CrossFit gym, bodybuilding gym, gymnastics gym, they have sprays and antibacterial soaps that you can wipe down your equipment with, so you don't leave anything there that the next person is going to come back and find.

Host: Gotcha. So, other than reputation, of course, how do you know the equipment you're using is safe and clean at a particular place?

Dr. Justin Bickford: And honestly, you don't know with 100% confidence that the equipment is clean when you get there. You hope that everybody, just as on the honor system, does their best to keep the gym as clean and safe as you might want it to be. But that's not always the case. So if you feel like you may be getting onto or using a piece of equipment that may not be quite germ-free, you can always wipe it down before you actually start using it.

Along with, if you don't feel like you're clean enough to get onto a piece of equipment, then you can always clean yourself beyond washing your hands. You can always shower before you start working out, just to prevent yourself from spreading any unwanted germs either.

Host: Okay. So, how about gym etiquette? What are some of the basics people should keep in mind? You've touched on one or two of them already when we discussed wiping down the equipment, right?

Dr. Justin Bickford: Yeah, I think there are these unspoken rules in the gym, and it's unique because It's universal across all types of gyms. But they're not rules that are sometimes listed. They're not always in the contract that you sign when you start. But if you are strong enough to lift a weight, then you're strong enough to rack that weight. Do not be the person that leaves dumbbells or bars or plates or kettlebells laying around. Those are hazards for anybody that comes through that area. And the next person might not be as strong as you and may not even be able to rack your weight. So if you're leaving it out for someone else to use, still not a good idea all the way around.

Weights at most gyms are typically made out of metal. Sometimes they have rubber or plastic, or sometimes even concrete mixed in with them. But no matter how strong they are, they can still break. So if you're the person that drops your weights, you're the one that the gym owners really, really don't like, because that's how plates break, that's how dumbbells break. And that's how you increase your risk for yourself being injured and the person that's going to use them after you.

If you're working out and you see somebody with headphones in, that means they don't want you to talk to them. So, don't ask somebody to pull out their earbuds so you can ask them a question about their workout. They're there to exercise, and you should be too. If someone asks you for advice, then that's a good time to give it. But don't give advice to somebody that's not asking for it.

One of the most important rules that is kind of universally known is no curls in the squat rack. You don't ever want to take up a leg machine to do something with arms, especially not if you're going to do few curls and then be on your phone for 15 minutes. Be respectful of other people's time, and they'll be respectful of yours.

Host: All great advice indeed coming from someone yours truly that has seen people do all these things in the gym at one time or another. How about those that choose to stretch right in the middle of an area where people are working out. Shouldn't you do that kind of off to the side?

Dr. Justin Bickford: You are exactly right. Now, stretching is important to reduce muscle soreness after exercising and to prevent future injuries of a muscle. So, stretching is always good, but there's a right time and a right place for it.

Host: Oftentimes it seems those that stretch right in the middle of where there's a lot of workout activity going on, they're looking more for attention than anything else, right?

Dr. Justin Bickford: You're exactly right. Kind of like those people that yell and slam plates around before they even lift it.

Host: Absolutely. Well, one thing you've certainly covered so far is the fact that there are all types at the gym. All of people's idiosyncrasies will come out over time if you start to see the same people on a regular basis. But of course, if they are following these etiquette rules that you've mentioned, that it can be a great experience of a communal sort.

So switching gears, workout-wise, what's your advice for those just joining a gym or perhaps returning to one after laying off for a while?

Dr. Justin Bickford: I think the most important tool that you have in the gym is the six inches between your ears. If you plan your workouts ahead of time, then you're going to be a lot more successful than going in and trying to figure it out on the fly. Exercising can be tough, and it comes with a lot of obstacles to overcome and hills to climb, but setting small, achievable goals will make that a lot easier.

So if your goal is to exercise long-term, then the small, achievable goal can be, "I want to go to the gym three times a week this week. And in those three times that I'm going to the gym, I want to do at least 30 minutes of weightlifting, and I want to do at least 30 minutes of cardio or mobility." But if your goal is to be in the gym consistently, that cardio and mobility sometimes turns out more valuable than the weightlifting, because it also reduces your risk for injury. But you can't just do one. You got to do all three of them together. Cardio, mobility, and strength training is basically the fountain of youth for our bodies.

Host: Yeah, absolutely. That obviously creates great balance when you're working out. How about the importance of using proper form at the gym and when might someone consider hiring a personal trainer, which would of course pretty much ensure that you have that.

Dr. Justin Bickford: Well, I think if you're new to the gym, so say it's a New Year's resolution or somebody got it for you as like a Christmas present, it's just something you're not accustomed to already. If you're having that anxiety about how to do certain exercises, about what exercises to do or about how to use the equipment, that is the best time for you to hire a trainer.

Now, most gyms, when you start off with a gym membership, they'll give you, say, a one session consultation with a trainer, just to get your measurements as far as your circumference measurements, your strength, your range of motion. Sometimes they'll do a baseline, but sometimes they'll introduce you to the equipment. So if you get one of those, by all means, take advantage of it. They usually come with every new gym membership. But if you get back in the gym and you see somebody doing an exercise that you think looks really cool or something you feel like you could do and be successful at, but you're not quite confident on how to do it safely, that's a really good time for a trainer as well. You'd rather train smarter than harder any day.

Host: Here's kind of an age-old question, which is how do we balance challenging ourselves at the gym without overdoing it? How do we know where that line is? And what are some signs that someone may be overexerting themselves?

Dr. Justin Bickford: Well, anybody that's starting a new workout program or just starting a new exercise that their body hasn't acclimated to before, you can usually notice there's some soreness. Now, you may not be sore while you're exercising. It may take till later on that day or even the next day for it to show up, but muscle soreness is to be expected when you're stressing your muscles in a way that they're not used to. That's how our tissues adapt and that's how our muscles get stronger, is by stressing them. So, stressing them isn't a bad thing. But if that stress that you applied to your muscles is more than your muscles can handle, then that muscle soreness can last much longer than you need it to. So if you have never squatted before, and then you go and do a heavy leg day, and three or four days later your legs still feel like they're on fire, you probably pushed yourself a little too hard. So, it's much easier to do less weight with more reps than more weight with less reps if your goal is to do them correctly and to do them safely, which requires good form.

Host: And you led me beautifully with that last point into this question, which is when is heavy lifting beneficial? And what safety considerations should be kept in mind when doing so?

Dr. Justin Bickford: I think heavy lifting is very beneficial as long as you can do it safely and you can do it with proper form. So, the rule of thumb when increasing the resistance on your exercises is about 10% per week. So if you're somebody that's never done bench press, deadlift, back squat, something like that, and you start off with a lightweight and you feel like it's too light, don't double that weight or triple that weight. Try to pace yourself by going at 10% per week, and you will definitely reduce your risk for injury. If your goal is to, continue to increase your strength once you've hit those PRs, or once you start a new workout program, that same rule applies, even if it's progressing you at a slower pace than what your friends are around you or what that fitness model on Instagram tells you you should. It's always easier to work smarter and injury-free than harder and fighting through an injury.

Host: Absolutely. A few other things. First, you alluded to this earlier briefly. Let's maybe expand on it a bit. How can setting realistic fitness goals help maintain motivation and prevent burnout? And what's the best way to track our progress?

Dr. Justin Bickford: Well, I think your small, attainable goals are a great way to track your progress. So, let's say if you have a goal of bench pressing 225 pounds. Say, that's two plates on the bar, that's where you get street cred, that's where you really know you're getting something out of it is when you can get up to that, kind of weight, then your goal to get to your ultimate goal of lifting 225 may be to work bench press or some kind of pushing exercise into your workout routine three times a week in preparation for that. So if your goal is to make the ultimate goal of 225 pounds, utilizing these small goals can help track your progress on your way to achieving that big goal. So if your first week you're benching at 150, and then the next week you go up by 10 percent, it may take you several weeks or even several months to achieve that goal, but you're going to be doing it correctly. You're going to be reducing your risk for injury, and it's going to be quality reps where you can work out through your lifetime without having to work out real hard and then recover from an injury for doing too much too soon.

Host: Now, here's one that involves something many avoid at their own peril, if you will. Before and after working out how important is stretching and cooling down and what tips do you have there?

Dr. Justin Bickford: Stretching is very important for the health of your muscles and the range of motion in your joints. So, I'm a big fan of stretching. But some people are born where they can stand up flat footed and touch their palms to the floor. Some people can barely touch their knees. So, not all bodies are created equal. Some people are naturally more flexible and drawn to things like cheerleading, gymnastics, Pilates, yoga. Some people are naturally stiff and are drawn to sports that require a little bit less range of motion, like powerlifting, like football, things like that, where you need to put forth a lot of force, but don't need to go through a great range of motion. So, not everybody needs to stretch before they work out. And I say that, because usually whatever sports team you're involved in, they do a lot of stretching. So, stretching isn't bad before games, but if you're somebody that's already very flexible, you might not need to devote as much attention to stretching before you exercise.

But regardless of how flexible you are, everybody needs to warm up. Everybody needs to be sweaty from their warm up before they start lifting. Not only does it get your heart rate up, but it gets your body temperature up. It primes your central nervous system to fire at a much more rapid rate. So, the people that don't warm up beforehand, they typically are at a disadvantage when it comes to producing force during their workout.

But let's say you've done your workout. Everything's good, you had a great lift session, that's the time where everybody should stretch. So, everybody should stretch afterwards as part of a cool down, but not everybody needs to stretch beforehand as part of a warm up. But if you're somebody that's not flexible, like me, I'm one of those people that my body's built for power and stability. It's not built for flexibility at all. If you're somebody like me, warming up, then stretching, then lifting, and then cool down, stretching at the end is typically the best way to keep you in the gym and out of the doctor's office.

Host: Yeah, I'm with you. I was not born with whatever genes make you very naturally flexible. And as I've gotten older, I've tried to do things at the gym to compensate for that, right?

In summary, there's so much information now more than ever out there about working out, working out tips, working out videos, working out podcasts, et cetera. But on the other hand, sometimes that can make our heads explode. We don't know what's right, what's wrong. Sometimes it's conflicting information. So in summary, can you recommend any resources to maintain the gym safety and cleanliness that we're talking about in general? How do people know-- beyond what we've just discussed-- where to turn as a good benchmark, to use a gym term, if you will?

Dr. Justin Bickford: I think if you ever have questions, you can always talk to somebody that works there. In gyms, unless they're commercial gyms, usually the owners work there. If it's a small town gym or if it's a gym that maybe only has one building, you're usually going to find people around there that are passionate not only about the profession of owning a gym, but about keeping people safe and healthy while in the gym, and most of the time they work out as well.

So, if you ever have general questions about the gym, there's usually somebody behind the front desk. And it's usually, if they aren't the owner, they can get you to talk to the owner. But if they're not available, have a consultation with a personal trainer. They're definitely somebody that can kind of guide you around the ins and outs of their specific gym.

Now, if you're looking for information on gyms in general, you can find that information online, but I would encourage you to stay away from some of those bodybuilding magazines. Sometimes they do a really good job of showing you the sexy stuff and the guys that are Mr. Olympia quality, but they don't always focus on some of the lesser known injury prevention strategies that you use in the gym. Sometimes they advertise products that aren't necessarily in your best interest, but they look really good on a Photoshop picture online. So if you have further questions about the gym, you can always talk to a physical therapist.

Host: Absolutely. Hint, hint, right?

Dr. Justin Bickford: Right.

Host: Well, folks, we trust you're now more familiar with gym safety and cleanliness. Justin Bickford, great advice indeed that we all can use at any level. Thanks so much again.

Dr. Justin Bickford: Thank you.

Host: And to learn more about Memorial Hermann Sports Medicine and Rehabilitation, please visit mhhs.org/physicaltherapy to pick up on what Justin just said at the conclusion of our chat. Now, if you found this podcast helpful, please do share it on your social media and explore our entire podcast library for more topics of interest as well. I'm Joey Wahler. And thanks again for being part of the Memorial Hermann Every Day Well podcast.