Even if exercise is one of the most beneficial things you can do for your health, there's still a risk of injury. It may be a simple pulled muscle or soreness that requires rest, while other more serious injuries can cause you to make a trip to the doctor’s office.
Christian Glaser, DO, doctor of sports medicine at MedStar Health at The St. James, and Dr. Michael C. Schwartz, MD, Chairman of the Department of Orthopedics and Sports Medicine at ProHEALTH Care, both say they see a variety of exercise-induced injuries in their exam rooms every day.
The most common culprits? Shoulder and low-back injuries, says Glaser. Dr. Schwartz agrees, and also adds knee injuries to the list.
We’re breaking down these common injuries, including how to know when your injury is worth a trip to the doctor's office (and what treatment may look like) and how you can prevent them in the first place.
Schwartz says that rotator cuff injuries are among the most common workout-related injuries seen by orthopedists and sports medicine specialists. “These injuries usually occur from common training errors. Performing shoulder-related exercises too frequently without giving the muscles and tendons a chance to heal between workouts is usually the most common cause,” he says. “In addition, rather than increasing exercise gradually, working out vigorously can strain the rotator cuff causing inflammation and injury.”
Schwartz says no one is immune. “In my practice, I have seen many patients both young and old who have presented with the chief complaint of an audible ‘pop’ with acute pain and swelling in their shoulder, which resulted from lifting heavy weights particularly overhead,” he says. “MRIs in these cases often confirm the diagnosis of an acute rotator cuff tear, which requires surgery in most situations to reattach the tendon to the bone to allow healing and improvement in function.”
Glaser explains that treatment for both injuries varies on the degree and severity. Smaller tears may require anti-inflammatory medication, injections or physical therapy, while complete rotator cuff tears commonly require surgery.
To avoid shoulder and rotator cuff injuries in the first place, I advise my personal training clients to focus on proper form and avoid over-lifting with dumbbells. Here are some tips to keep in mind:
- When doing a bicep curl or a tricep extension, keep the shoulder heads under the ears in proper alignment.
- Avoid rounding the shoulders forward or hunching them up and keep them in a neutral, relaxed position as you perform the arm exercise.
- Make sure that the weight is not too heavy and therefore pulling your shoulder out of alignment.
- Always start with a lighter weight and perfect the form in upper body exercises before increasing the load.
Low back injuries
Like shoulder injuries, most low back injuries occur because of working out with too heavy of a weight and/or with poor technique and form, Glaser explains. “Low back injuries can occur to a variety of structures: muscles, discs and bone,” he says. How do you know if you’ve injured your low back? It could present itself as soreness or feel like a pulling or dull ache. Luckily, “injuries in the lower back while working out are usually acute in nature,” Glaser says. “A common occurrence is the muscle strain, which often times can be seen at the end of a workout, trying to get just one more repetition in. The athlete is not only fighting the workout load, but also some muscle fatigue, which then results in injury. Injuries can become more complicated if there is a rotational force involved, which can damage a disc or even bone. Treatment for back injuries include physical therapy, NSAIDs, a variety of back injections and surgery.”
So how can you avoid these low back injuries? Glaser provides a few tips:
- No lifting or bending over at the hip; instead you should squat down and lift from the legs.
- When lifting objects off the floor and squatting, make sure that knees do not go past the toes.
- Keep legs shoulder-width apart during exercises.
- No twisting/turning motions when carrying heavy objects.
- Work on building up good core strength to help protect the back.
Speaking of building core strength, as a Pilates instructor, I highly advise my clients work on abdominal exercises like planks or Pilates roll ups to help keep the core in check. Then, when you start performing the aforementioned exercises like lifting, bending, squatting, etc. your core will engage and can help support and protect your low back.
Schwartz says that meniscus injuries are one of the most common exercise-related injuries in both younger and older individuals. “The meniscus is a c-shaped cushion within the knee, which is made of a rubbery structure known as fibrocartilage. They function as a cushion or shock absorber for the knee, protecting the adjacent smooth cartilage of the knee while also providing stability,” he explains. “The meniscus is very vulnerable to injury due to the fact that it is generally very thin, similar to a wafer, and it has limited blood supply."
To minimize the risk of this kind of injury, Schwartz advises to avoid doing deep squatting exercises in which the hips go below the knees. “Also, performing exercises which involve considerable twisting should be performed very carefully and with proper technique since this movement places considerable stress on the meniscus,” he advises.
A wide range of treatments are available for this type of injury, including rest, anti-inflammatory medication, ice, physical therapy and injections. Schwartz says persistent symptoms including pain and loss of range of motion may require surgery.
The most common form of exercise that Schwartz sees as a culprit for knee injuries? HIIT, or high intensity interval training. “While these exercises have been shown to significantly improve conditioning and lead to reductions in body fat mass, they do require strict technique to complete the workout effectively and safely,” he explains.
The good news is you don’t have to give up your HIIT workouts. Here are a few ways to protect your knees while training:
- When you're jumping, land with soft knees. This means that the knees are bent slightly when you land instead of landing standing up straight with locked knees. This helps absorb the shock and weight of your body on your knee joints as you land.
- Eliminate jumps and bouncing completely by simply doing the act of a jump (bend the knees, stand up and reach the arms up) instead of doing the jump with impact.
- Do not let the knee reach forward over the toes in a lunge or in a squat. Look in a mirror to make sure that your knees don’t go past 90 degrees in a lunge. When returning to a standing position from a squat or lunge, press down through the heels to work the backs of the legs instead of pressing down through the toes, which has the potential to put too much pressure on the knee caps.
More ways to prevent injury
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