Barry came to me recently complaining he'd experienced dizziness upon standing up quickly after a workout. He couldn't understand how this could happen; he is a well-conditioned, healthy athlete.
Since his cardiogram and physical examination were normal, his diagnosis was orthostatic hypotension, or low blood pressure occurring as you stand up from a sitting position. Although the condition can be alarming, it is usually harmless. Surprisingly, being in good physical condition increases your chance of developing orthostatic hypotension.
The better shape you're in, the slower your heartbeats. Athletes often have resting heart rates of fewer than 60 beats a minute; for non-athletes it may be more than 70 beats a minute. Athletic training makes the heart stronger so it can pump more blood with each beat, so it doesn't have to beat as often to supply the body with blood.
When you rise from lying to sitting or from sitting to standing, gravity briefly reduces the flow of blood to your head. It may take one or two seconds for a well-conditioned, slow-beating healthy heart to pump blood back up to your head to end the temporary lower blood pressure.
If standing up makes you feel dizzy and weak or causes you to see black spots before your eyes, try getting up more slowly.
Orthostatic hypotension can be aggravated by dehydration, which reduces your blood volume, so the symptoms are more common after hot-weather workouts. Be sure to drink plenty of fluids before, during and after exercise.
If rising slowly and drinking fluids doesn't prevent the symptoms, see your doctor. Orthostatic hypotension can signal more serious problems, such as heart disease or anemia.
Q: What is the best way to treat tendinitis?
A: Tendinitis is damage to a tendon, making its fibers swell. The pain of tendinitis is more intense when you first get up in the morning and lessens during the day as you use the affected tendon. When you begin to work out, though, your injured tendon will be extremely painful. Then, as you continue to exercise, the pain will subside.
Common forms of tendinitis include: Achilles, in the back of your lower leg, in running sports (basketball, football, soccer, track); the shoulder in baseball and swimming; the elbow in tennis.
Treatment is the same. When you first feel pain in a tendon, stop exercising that part of your body until you don't feel pain when you use it. Steroid injections can reduce swelling and pain
temporarily, but they do not increase the rate of healing. They also weaken the tendon and make it more susceptible to tearing -- if you continue to exercise.
Dr. Mirkin is a practicing physician in Silver Spring specializing in TC sports medicine and nutrition.