Overview Not enough rest, too much too soon, repetitive motions and simple wear and tear can result in pain and injuries that put the kibosh on your workouts. In fact, a study of college athletes published in the Journal of Athletic Training shows overuse injuries (repetitive motions involved in sports and workout routines, such as long-distance running, swimming and rowing) account for nearly 30 percent of all injuries. Inflammation, general stress and tendinitis were the most common overuse injuries reported. High-speed, full-body-contact sports most often resulted in acute injuries. Here are the most common workout injuries, how they can occur and tips for staying safe.
Twisting an ankle doesn’t just happen running outdoors. Jogging on a treadmill can also result in an ankle sprain, says Cindy Trowbridge, Ph.D., associate professor of kinesiology at the University of Texas at Arlington. “The biggest problem running indoors on a treadmill is losing your focus and accidentally stepping half on and half off the treadmill while the belt’s still moving.” This forces you to jump off the treadmill quickly. If you land awkwardly, your ankle may roll in an unnatural direction. “It’s more likely to happen if you’re wearing new shoes and aren’t yet used to them,” says Trowbridge. Running outside on uneven terrain or up and off curbs also increases the risk of an ankle sprain. HOW TO STAY SAFE: Most treadmills have a clip you attach to your clothes that stops the machine if you fall. “Use it,” says Trowbridge. “If you run outdoors, stay on level sidewalks or at a park, versus running where you have to go up and down off a curb.” Look for paved, even walkways because uneven terrain and potholes can be problems. Keep in mind that parks have shared trails, so be aware of other people cycling past you, which can startle you and cause you to run up or down a curb.
Pain along the inner edge of your shinbone (tibia) may be a sign of medial tibial stress syndrome, more commonly known as shin splints. Common in runners, shin splints can also develop in exercisers who participate in running sports or jumping. “It’s muscle inflammation and can occur even after just a couple of workouts,” says associate professor of kinesiology Cindy Trowbridge, Ph.D. “Plus, some people are predisposed to getting shin splints.” You’re at greatest risk of shin splints if you’ve recently increased the intensity or frequency of your workouts. Uneven ground, running uphill or downhill or on hard asphalt also increases the risk of shin splints, as does wearing worn-out shoes. HOW TO STAY SAFE: Wearing proper shoes and gradually increasing your workout intensity (no more than 10 percent a week) goes a long way toward preventing shin splints, says Trowbridge. Also avoid running or jogging right away. Slowly warm up first by doing jumping jacks to get your blood moving and your muscles warm, she says.
A sudden, sharp twinge in your lower back during your workout could be a sign you’ve overdone it. “Squats or deadlifts with improper form wreaks havoc on the lower back,” says associate professor of kinesiology Cindy Trowbridge, Ph.D. “You can suffer strains or, even worse, nerve compression and disk herniation.” Twisting motions or sideways bends can also strain your lower back. HOW TO STAY SAFE: Beginners should first learn how to maintain a neutral back, says Trowbridge. To find your neutral spine, lie on your back with your knees bent and feet flat on the floor. Your spine should touch the floor under your neck and lower back, which allows the natural curves of your back to absorb shock during exercise. “Get your form correct first before adding weight. Beginner weightlifters should do the leg press or hip sled first before trying squats.” If you’re unsure of proper form, ask a qualified personal trainer for advice.
Rotator Cuff Injury
Four main muscles (supraspinatus, infraspinatus, teres minor and subscapularis) comprise the rotator cuff, which surrounds and stabilizes the shoulder joint. Shoulder pain when you reach behind you, overhead or out to the side may be a sign of a rotator cuff strain. “It typically results from repetitive overhead activity,” says Luga Podesta, M.D., sports medicine specialist at Podesta Orthopedic and Sports Medicine Institute. Activities such as swimming or throwing a ball and overhead shoulder movements like military presses can lead to rotator cuff strains when done repeatedly over time. HOW TO STAY SAFE: Strengthen your rotator cuff muscles as part of your upper-body program. Use good posture (a slouched posture makes you more prone to compression of the shoulder joint) and avoid repetitive overhead exercises with weight that’s too heavy and lat pulldowns behind the neck -- do pulldowns in the front instead.
These tiny, hairline fractures are usually the result of too much too soon or repetitive jumping in one place, says Luga Podesta, M.D. The majority of stress fractures occur in the bones of the foot, heel or shin. Pain around the site of the fracture that worsens with exercising, standing or walking is a symptom of a stress fracture. The area may also swell. Sports like track and field, basketball, tennis and gymnastics also increase the risk of stress fractures -- as does osteoporosis. If left untreated, a stress fracture may not heal properly and can lead to chronic pain. HOW TO STAY SAFE: Start new exercise programs slowly and progress gradually. Try to progress by no more than five to 10 percent in exercise volume each week, says John P. Higgins, M.D., director of exercise physiology at Memorial Hermann at the Texas Medical Center. “For example, if you are jogging 10 miles a week, don’t do more than 11 miles the next week. If you are doing 10 reps of 50-pound biceps curls this week, next week do 11 reps of 50 or 10 reps of 55 pounds.” Cross-training by mixing up activities can also help.
IT Band Syndrome
An overuse injury common in runners and cyclists, iliotibial band syndrome (ITBS) occurs when the IT band, a ligament that runs along the outside of the thigh from the hip to the shin, becomes tight and inflamed. “Cycling can trigger this flare-up, which causes pain on the outside of the knee,” says associate professor of kinesiology Cindy Trowbridge. This can also occur in runners who wear worn-out shoes, run on uneven or banked surfaces, run downhill, do the same run in the same direction too many times or simply from overuse as a result of running too many miles. In cyclists, ITBS can occur from muscular imbalances from using an incorrect cycling position or a saddle that is too tall. HOW TO STAY SAFE: If you’re a cyclist, make sure the seat height is appropriate -- not too high or low -- says Trowbridge. In a cycling class, ask the instructor to help you adjust the height of the seat as well as find the right location that places your torso in an ideal position. “You want to be able to just reach the bar without feeling all bunched up,” she says. Runners should do a short walking warm-up before starting to run and make sure they replace worn-out shoes. Also, avoid running on concrete and, if you run on a track, change directions regularly.
Pain under the kneecap that worsens from running, walking down stairs or sitting with bent knees for long periods of time could be a sign of patellofemoral syndrome, also known as “runner’s knee.” You may also hear a crunching, creaking or grating sound. “You can get this from running, jumping or squatting,” says Luga Podesta, M.D. A change in activity level, such as an increase in running mileage, can contribute to pain. Patellofemoral syndrome occurs when the bones in the lower leg are not lined up perfectly, which causes an abnormal gliding between the patella (kneecap) and femur (thigh bone). This misalignment can lead to wear and tear between the cartilage and surfaces of the bones, causing pain. HOW TO STAY SAFE: Keep knees healthy with exercises that strengthen quadriceps and hip flexors. Seated and lying leg raises are often prescribed for strengthening the quadriceps. Also avoid kneeling or squatting repeatedly.
Pain in front of the shoulder and upper-arm weakness may be a sign of tendinitis, an overuse injury that typically occurs from repetitive motions, although in some instances it can happen as the result of a sudden injury to the tendon. Weightlifting, swimming, tennis and golf can all cause biceps tendinitis. Biceps tendinitis refers to the inflammation of a tendon that attaches your upper biceps muscle to the bones of the shoulder. “Impingement and rotator cuff damage often accompanies biceps tendinitis,” says David Geier, M.D., orthopedic surgeon in Charleston, South Carolina. You’ll feel pain and tenderness in the front of the shoulder that worsens with overhead lifting. Pain may also move down the upper arm bone and you may feel an occasional snapping in the shoulder. HOW TO STAY SAFE: Cross-train by varying your activities to avoid repetitive overhead movements, and make sure to take enough rest time between workouts. Check your posture, since poor posture increases the risk of biceps tendinitis, says Geier.
Losing control of a dumbbell or barbell during a heavy bench press or performing dumbbell flies with too much weight can lead to a tear in the pectoralis muscle -- a serious injury. “You’ll feel a tearing sensation, and the chest and upper arm often turn black and blue,” says orthopedic surgeon David Geier. “Sometimes a defect in the muscle is visible or palpable. You should see an orthopedic surgeon within a few days to determine if the injury needs surgery.” HOW TO STAY SAFE: Make sure you can control the amount of weight you’re lifting, says Geier. “If you’re trying to lift a very heavy weight, have a spotter present to help control it so that you don’t drop it or lose control.”
Glenoid Labrum Tear
Clicking sounds and uncomfortable catching sensations deep in the shoulder during bench presses or military (overhead shoulder) presses may be symptoms of a glenoid labrum tear, says orthopedic surgeon David Geier. “This refers to a tear in the cartilage bumper that surrounds the glenoid, the socket of the ball-and-socket joint.” Labral tears can result from overuse or a direct injury to the shoulder, such as falling and landing on an outstretched hand. An unstable shoulder that slips and dislocates can also cause a labral tear. HOW TO STAY SAFE: It may not always be possible to prevent a labral tear, says Geier, but any uncomfortable popping or pain deep in the shoulder is worth checking out. If the pain does not improve, seek a diagnosis from an orthopedic surgeon to determine the cause and treatment options. “Modify exercises to avoid pain as well,” says Geier. “Often you can still get a good shoulder or chest workout even if you have to avoid specific shoulder or chest exercises.”