While plant lovers celebrate National Gardening Day, doctors warn the fertile form of exercise is leading to a growing number of injuries this time of year. "As with any exercise, if you haven't done it in a while, aches and pains are going to crop up," said Paul Cooke, a physical medicine and rehabilitation specialist at Manhattan's Hospital for Special Surgery.

Everyone from First Lady Michelle Obama to Weight Watchers have touted digging in the dirt as a top way to stay in shape. And indeed an hour of hoeing, pruning and planting can burn more than 300 calories.
Still, doctors say the whole-body workout leaves some green enthusiasts with sore backs, swollen knees, tight shoulders and stiff necks. "A lot of patients say,‘Gardening gets me in shape.' They realize they get exercise from it but if they aren't ready for it, they can hurt themselves," said Anders Cohen, chief of spine surgery at The Brooklyn Hospital Center.
The problem stems from gardeners who spend most of the winter sitting at a desk or working out little only to throw themselves into a spring day of squatting and digging. Days later, they land in doctors offices with complaints of back ache and other ailments.
Hugh Janow, a 68-year-old lawyer from West Nyack, NY, knows his push for perfect roses exacerbates his back ache but can't help himself from gardening each spring. "Gardening brings me exercise, creativity and satisfaction. There's a wow factor when people come to my house and see what I've grown," said Janow.
Doctors agree that gardeners don't need to ditch their planting passion, they just need to consider the following rules to stay injury free.
* Warm up with a short walk and stretch before you hit the garden.
* Wear sturdy sneakers as you would with any exercise and save flip flops for the beach.
* Start out slow, meaning don't decide to plant a vegetable garden for eight hours after a winter of no exercise.
* Change positions. Don't stay hunched over or kneeling for too long, positions that put too much stress on joints.
* Lift fertilizer bags or heavy plants by squatting from the hips and knees, same as you would an air conditioner or sofa.
* Ice any mild muscle soreness for 15-20 minutes but see a doctor if pain persists after a few days.