11 Most Common Training Injuries and How to Prevent Them

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Whether you enjoy tennis, swimming or Pilates, unfortunately, there is an injury for you. Pilates has lower back injuries, runners get runner's knee and then there's tennis elbow—all common injuries many fitness enthusiasts have experienced. While injuries can happen during any activity, many sports therapists, doctors and pros see the same injuries time and time again. Typically, injuries are caused by overuse, improper use of equipment, inadequate training or a combination of these.
The good news is, with a little knowledge, training and proper form, many of these injuries can be prevented. Should you fall prey to any dreaded damage during a run, a two-handed kettlebell swing or an overhead squat, know that with proper treatment and rest you will be back to working up a sweat in no time.


Most Common Injury:
Runner's knee is an umbrella term for describing one of several conditions involving the patella, or the kneecap, and includes patellofemoral syndrome (PFPS) and chondromalacia patella. Runner's knee injuries are largely due to what the simple act of literally pounding the pavement again and again does to the joint.  

"Runner's knee tends to happen because runners overuse their legs and often have relatively weak hip abductors. The injury is usually a combination of genetics, overuse, weak quads and an overly tight lateral retinaculum and iliotibial band" according to Dr. Armin Tehrany, orthopedic surgeon, shoulder and knee specialist and founder of Manhattan Orthopedic Care.

Additional factors that can result in PFPS include running with an upright trunk posture, allowing the pelvis to drop or the knee to cave inward, and having inadequate strength, particularly in the lower-extremity and core, according to Rachel Straub, MS, CSCS, an exercise physiologist and the co-author of "Weight Training Without Injury"

Treatment & Recovery:
To treat these running injuries, see a doctor or sports specialist to identify the particular cause of your ailment. Once that's known, treatments used might include hydration, RICE, stretching and physical therapy before you can hit the street or track again pain-free.

"You must identify the underlying cause. A running evaluation by an expert in biomechanics can aid in determining any abnormalities. For example, poor mechanics at the hip and pelvis—such as inward caving of the knee and pelvic drop, respectively—can exacerbate knee pain," says Straub. "Correcting such mechanics requires proper hip-strengthening exercises [including] single-leg step downs, wide-stance double-leg squats and fire hydrants."

Like the injuries themselves, recovery time varies. Make sure you do your exercises as prescribed. Foam rollers are also very helpful in massaging those hard-to-reach muscles. "Recovery depends on [both] the severity of the injury and the cause. Most individuals with PFPS have strength and biomechanical impairments, so successful, long-term recovery requires lifelong dedication to a well-designed injury prevention program which must include strengthening exercises," Straub says.
Straub suggests preventing runner's knee by maintaining lower-extremity strength at the hip, avoiding injury-causing positions (such as inward movement of the knee and pelvic drop) and using a forward-leaning trunk to minimize knee loading.

Dr. Armin also recommends alternating running in the opposite direction of your normal path or switching directions so you don't overuse one group of muscles and to ensure that you are maintaining the right balance of strength and flexibility.

Other ways to prevent running injuries including making sure you are wearing the right shoe, that your gear is appropriate for the season, that you warm up before you work out and cool down properly after.


Most Common Injury:
While walkers can also experience the symptoms of runner's knee to a lesser degree, most walking complaints revolve around calf stiffness and plantar fasciitis. Wearing ill-fitting shoes is mostly to blame for any walking soreness or injury you may experience.

"Shoes with elevated heels, [including] cross trainers as well as boots and high heels, shorten our Achilles tendon and limit our feet's natural ability to sense where they are in space. Movement compensations occur in the form of overpronation or underpronation. When these dysfunctions occur, the plantar fascia and the entire calf tends to get really tight, and never truly get a break," personal trainer Rui Li, NASM, C.P.T., C.E.S. says.

"Walking, just like running, requires the use of our body's natural shock-absorbing system; the joints must align and the entire leg, glutes, core and upper body all synchronize. When this does not occur, the calves and feet have to take on the duty of forward locomotion. Unfortunately, our feet and calves are tiny muscles compared to the rest of the system, so inevitably, they tighten up, and chronic ailments like plantar fasciitis and a shortened Achilles will occur. In severe cases, you will find people with stress fractures in the feet, or a snapped Achilles from too sudden of a movement," Li says.

Treatment & Recovery:
For muscle strains, try RICE and an anti-inflammatory drug to keep swelling down. Your doctor may also suggest physical therapy depending on the severity of your strain. 
For plantar fasciitis relief, follow these tips from Dr. Matt Tanneberg D.C., C.S.C.S.:
  1. Get a tennis ball or frozen water bottle and roll it underneath your foot. You will find tender spots. Once you find them, hold constant pressure. This will break up adhesions in the fascia and allow it to heal properly. If you use a frozen water bottle, you will be able to break up the adhesions while also numbing the area.
  2. Stretch to keep the fascia flexible and pliable. There are basic stretches you can do on your own, including grabbing hold of your foot and taking it through a full range of motion, circling in each direction, then up and down.
  3. Kinesiology tape the bottom of your foot helps to promote the normal healing process and reduce pain.
  4. Rest. Giving your fascia and muscles time to heal is crucial for the healing process.
Much like running injuries, walking injury recovery time will vary, depending on the severity of your injury and treatment.
Wear proper running shoes or sandals with a contoured foot bed and that aren't too flexible in the middle. You can also purchase custom-made or off-the-shelf orthotic inserts to help keep your feet feeling comfortable during every walk. Also, always make sure to stop or slow down at the first sign of injury.<pagebreak>


Most common injury:
Much like runner's knee, this sport's most common injury is named after it. Swimmer's shoulder, which results from overuse, covers several shoulder injuries, including rotator cuff impingement, biceps tendinitis and shoulder instability, according to Stop Sports Injuries. Much like runner's knee, shoulder injuries such as these are the result of repeatedly using your arms in overhead swimming strokes.
Treatment & Recovery:
According to Dr. Matthew Cooper, a chiropractor and sports therapist based in South Florida, these types of swimming injuries "usually resolve with four to six weeks of therapy and [after taking] anti-inflammatory medicine." Therapy may include exercises, electric stimulation of the muscles, ultrasound or manual soft-tissue therapy.
If left untreated, the injury can lead to a rotator cuff tear which can require surgery and six to eight weeks of intensive rehab.
Stop Sport Injuries suggests learning and using good stroke technique; lessening the repetitive strokes that initially caused the injury; strengthening the core and incorporating cross training before the swimming season starts; incorporating other training techniques rather than swimming through an injury; rest; and focusing your rehab efforts on your shoulders to prevent future swimmer's shoulder injuries.


Most common injury:
According to Dr. Eric Eiselt at Mt. Lookout Chiropractic & Sports Injury Center, cycling is another sport in which overuse of a particular movement is the injury culprit. Poor posture over a long period of time can also come into play. Common cycling injuries include knee pain in the form of patellar tendinitis, and back and neck pain frequently occur from overuse.
Treatment & Recovery:
With proper treatment, injured cyclists will be on the mend in about four to six weeks. Dr. Eiselt recommends a combination of chiropractic adjustments, soft tissue release techniques (like the Graston Technique), Active Release Techniques and cupping therapy.
To prevent a cycling injury, be sure to regularly stretch your hips, especially your psoas major muscles and quads, and also take care to stretch that spine out with extension-type back exercises.

Weight Training

Most common injury:
Weight training or resistance training is a form of exercise that increases muscular strength and endurance through the use of various amounts of resistance (including bodyweight) and shouldn't be confused with weight lifting, which refers to lifting heavy weights with a maximum effort.
According to Straub, the most common type of injury she sees is low-back strain or chronic lower back pain. These types of injuries can occur with just about any weight training move. Take squats, for example: "The use of too much weight, leaning too far forward and squatting too deep, [especially] in the presence of impaired hip flexibility, can all injure the low back," Straub says.
Treatment & Recovery:
While some back injuries can heal within 48 hours, chronic low back pain can take several weeks to recover fully. For more severe back injuries, try icing the area (20-30 minutes every three to four hours, for two to three days) followed by heat after the two days of icing (and only if any swelling has gone down). Try non-steroidal, anti-inflammatory drugs such as ibuprofen to lessen your pain, and do any physical therapy as prescribed by your doctor.
Know your limits and work slowly toward your strength goals. "People generally tend to work past their limits, usually with bad form, and then either they feel something 'give out' instantly, or they will feel extremely sore and swollen the next day in one particular part of the body, usually in the side that is most dominant," Li says.
Straub says that learning how to use weights properly is essential, as just about every weight-training move can strain the low back when done improperly. In addition to improper use, muscle imbalances, impaired flexibility and generalized muscle weakness can all contribute to chronic low-back pain.
To prevent any future strains and sprains, be sure you're not neglecting any muscle groups when you train, mix flexibility work into your strength training routine, maintain good muscle tone in your abdominals and lower back muscles and be sure to give yourself time to heal between workouts.<pagebreak


Most common injury:
You would think that with all that bending, stretching and flexibility work, yoga would be an injury-free exercise. It turns out that even yogis frequently deal with hamstring tendon tears, according to health and wellness expert Tiffany Cruikshank, author of Meditate Your Weight and founder of Yoga Medicine.
Cruikshank says these injuries "Usually happen as a result of pushing too hard into forward-bending stretches and tearing the hamstring. There is this obsession with touching our toes or being more and more flexible in yoga, but for the health of the musculoskeletal system, a balance of strength and flexibility is key and extreme flexibility and/or pushing beyond the tissue limits can be detrimental to the body."
Treatment & Recovery:
Cruikshank admits a tendon injury is a tough one to treat as tendons have less blood supply and therefore heal more slowly. In order to heal this injury, avoid stretching the hamstrings all together. The pulling pain felt at the ischial tuberosity (the bones you sit on, often referred to as the "sitting bones") when you sit is in fact indicative of what is happening—every time you go to sit, you are literally re-tearing or pulling the tissues further.
"Recovery from a hamstring tear varies from individual to individual," Cruikshank says. "If you can avoid stretching this area (and the pulling pain and subsequent re-tearing) then it usually takes around one to four months, depending on the extent of the tear and the treatment. Acupuncture and/or physical therapy can be helpful to speed things up."
Cruikshank recommends listening to your body, easing into stretches slowly and avoiding sudden, jerky or fast movements when doing any deep stretching as it will be difficult to know your limits and respond in time.
"Respect your body’s limits and know that every person will have different capacities and proportions, making each pose unique to the individual. If you can adjust your mental expectations and outlook in a yoga setting and simply allow yourself to be wherever you are, it will change the therapeutic effects of the practice tremendously and prevent injury in the process," she adds.  


Most common injury:
Pilates shares a lot of commonality with yoga injuries in that overdoing the exercises or doing them improperly can lead to a range of strains and pains, particularly in the low back.
Ada Wells, P.T., D.P.T., suggests that several factors can cause these Pilates injuries. While group mat classes are a low-cost entry point for anyone wanting to experience the exercise, instructors cannot always see and correct all bodies. Plus, an inexperienced teacher may not recognize that there are certain conditions that need to have movement restrictions placed on them. For example, spine flexion (think crunches or child’s pose) needs to be absolutely avoided for those with low bone density, and caution must also be exercised with end-range rotation or side bending movements. 
In addition, when a student inadvertently tries to "power through" a movement, he or she misses out on the importance of creating control in the system before achieving a large movement and this is where injury can occur, particularly in the lower back, according to Wells.

Wells also suggests that another overlooked, but very real potential for injury in the Pilates reformer environment lies within the Pilates' apparatus itself. Because of the unstable surfaces and spring-loaded levers, the reformer can be very dangerous to use, particularly if there is a sudden loss of focus from either the teacher or the student. "For that reason, respected Pilates teacher training programs spend a great deal of time educating teachers about how to safely spot and set up equipment to avoid placing either the student or the teacher in danger," she says.

Treatment & Recovery:
Paige Larson, MPT and director of physical therapy at Eisenhower Desert Orthopedic Center in California, recommends, "A regimen of rest, exercise modification, ice, strengthening to the injured body part via physical therapy and a gradual return to exercise."
Wells recommends first trying Pilates in a private session or on an apparatus. Even though they are generally more expensive, the advantage is that faulty movement patterns can be more easily identified and corrected by using the apparatus to support or challenge the system, depending on the skill of the Pilates teacher and ability of the student. This information goes a long way with regard to the student being able to eventually translate this new knowledge and learned patterns in a class environment.


Most common injury:
Based on its intense reputation, it might come as no surprise that CrossFit practitioners have an injury just for them, too. According to Straub, "CrossFit shoulder," or shoulder pain due to anterior instability, is a common injuries she sees in this sport, with males shouldering the majority of this particular injury.

Because CrossFit combines a variety of exercises (including bodyweight, gymnastics, Olympic weightlifting and running), shoulder pain from anterior instability is generally caused by high-level movements (such as the snatch, shoulder press or pull-up), which when done improperly, place the shoulder at an extreme range of motion, suggests Straub.
Treatment & Recovery:
Treatment for CrossFit shoulder depends on the level of instability in the injury, says Straub. "In its most severe form, dislocation results. In a less severe form, subluxation occurs. Regardless, proper strengthening of the shoulder musculature (both the rotator cuff and scapular muscles) is imperative to improving shoulder stability and reducing pain. In addition, overhead movements that place the shoulder in at-risk positions (such as the "high-five" position) should be avoided. The safest exercises keep the elbows in front of the shoulders.

Recovery time will depend on the severity. With minor pain, sometimes it's enough to simply avoid the positions that place the elbows behind the shoulders while the injury heals.

Be sure to learn proper form before you try CrossFit. Many gyms require you to take beginner classes to learn the proper form and exercises before you can do the workouts. Another good rule is to not increase your weight without mastering the form first. <pagebreak>


Most common injury:
At this point, you're probably expecting to hear that tennis elbow is the most common tennis injury, right? Right! According to the Mayo Clinic "tennis elbow" or lateral epicondylitis involves an overuse of the tendons in the elbow, caused by repetitive motions of the wrist and arm as the tennis ball bounces off the racquet.
According to Nic Bartolotta, a physical therapist and chief clinical officer of the Rolflex, this injury occurs as, "Tightness in the forearm muscles creates constant pulling and irritation where those muscles connect in and around the elbow. To play tennis means you have to hold and grasp your racket constantly, and it’s your forearms muscles that make that happen. If you play often and long enough, your forearm muscles will get tighter with increasing latent, under-the-radar tension. At some point, these overly tightened muscles will create obvious, debilitating pain at the elbow."
Treatment & Recovery:
For best results, treat the symptoms of tennis elbow as soon as they appear. This will include rest, ice, anti-inflammatory medicine and taking time off activities that exacerbate your injury. Depending on the severity of your injury, time off can range from a couple of weeks to a couple of months.
You can prevent tennis elbow with proper strengthening of the forearm muscles and other surrounding muscles and by making sure to properly warm up your arms and elbows to decrease the likelihood of injury. Make sure you choose an appropriately sized racquet, and pay attention to and learn proper technique.


Most common injury:
High-intensity interval training, or HIIT, is a specific type of interval training, which includes alternating between low-moderate exercise and high-intensity exercise at near maximal levels. That said, "The most common injuries from HIIT training are usually ankle and knee overuse injuries," according to NASM-certified personal trainer Alexander McBrairty of A-Team Fitness.

According to Lisa Corsello, a certified personal trainer and the founder and creator of Burn, "These issues could be rooted from improper form. Lots of attention should be paid to the foot position, the way the knee tracks relative to be second and third toes, and the hips. Working harder and faster can lead to lots of great results, but it can lead to aches, pain and even severe injury if not done correctly."
Treatment & Recovery:
The best way to treat this injury, as in most overuse injuries, is to employ rest, ice the affected area and take over-the-counter anti-inflammatories as needed to reduce swelling. Make sure you are using proper form when executing intense movements, such as interval running or biking.
Recovery periods vary, so be sure to seek treatment as soon as you suspect an injury to assure the fastest route to healing.
"HIIT training can increase the overall risk of injury for individuals who are not fit enough to attempt it, and should be reserved for those who are more experienced with exercise, [though] this does not mean regular interval training cannot be used with the general population or even the at-risk population," according to McBrairty. "The best way to prevent overuse injuries, particularly with HIIT training, is to ensure proper rest in between bouts of HIIT exercise. True HIIT training shouldn’t be completed more than a couple times a week."


Most common injury:
One of the most common kettlebell injuries is lower back strain, from improper usage when handling the cast iron weights.
"This injury seems to affect both men and women similarly, and is mostly caused by poor lifting technique." according to McBrairty. "This lack in technique is caused by a few different factors: Lack of knowledge in technique, lack of mobility or lack in overall strength."
Treatment & Recovery:
The recovery period for a lower back injury depends on how badly it's injured, so think a few days to a few weeks for a complete recovery. Treat lower back strain with sufficient rest, ice and heat to help relax muscles. Non-steroidal anti-inflammatories can also be taken to help with any swelling.
"The best way to prevent lower back injury during kettlebell exercises is to both learn proper technique prior to intense exercise and ensure you include mobility work in your program. While it may be tempting to advance to more intense moved quickly, taking care to progress at an appropriate rate to ensure you aren’t doing anything above your current capabilities will help keep your body safe," McBrairty adds.
Don't let the fear of injury keep you from working toward your goals. Whether you try a variety of exercises to keep your body moving or you like to work toward singular-sport mastery, the key in staying injury-free in any activity is to learn the proper movements and techniques of the sport. Make sure you train all your muscle groups and work on your flexibility so you're less likely to sprain or strain anything while enjoying your favorite activities. As always, check with a doctor first before trying anything new, and always seek medical attention if you suspect an injury.