Exercise Injuries: How to Prevent Them and What to Do If They Happen
At this time of year, many people are exercising more, trying to keep up their New Year’s resolutions! Both recreational exercise and competitive sport come with their fair share of injuries. Don’t get me wrong— increasing your exercise is a wonderful New Year’s resolution and one of the best things you can do for yourself.
Exercise has a multitude of benefits, including improving mental health and mood, enhancing memory and brain function, improving sleep, assisting with weight management, improving physical health, and reducing the risk of many chronic diseases such as heart disease, diabetes, osteoporosis, and some cancers. It also improves muscle strength and balance and reduces stiffness, pain, and fatigue.
But here is an important tip: don’t go from zero to hero! Many injuries occur because people do too much, too soon. Sound familiar? I often repeat the phrase: “Start low. Go slow.” Give your body time to adjust to new challenges and adapt accordingly. This is how our bodies make the changes we want to see and feel.
A general guideline is to increase training load by no more than 10% per week. Only increase ONE thing at a time—whether it be frequency of workouts, distance, speed, or degree of difficulty. This is a rough guideline, and many people need to progress even more gradually, especially if they have recurrent or chronic musculoskeletal conditions, are older, have chronic health conditions, or have other risk factors.
Be sure to warm up, hydrate sufficiently, use appropriate footwear and equipment, refine your training technique, and give your body enough time to rest and recover. Cross-training (doing a variety of exercises) is particularly helpful, as it challenges different parts of the body in different ways. This leads to a more balanced athlete who is less bored and less prone to injury.
If you do sustain an injury, don’t panic. “Keep calm and let the Physio handle it.” It is distressing not to be able to do what you love, and our goal is to limit the extent of the injury, reduce or reverse the damage, and restore function and sporting capacity—ideally to the same, or even better, level than before.
Most people have heard of PRICE (Protection, Rest, Ice, Compression and Elevation). Although this approach is still useful, modern research has refined our understanding of early injury management. The injured area does initially need to be protected and relatively rested to prevent further damage and to help control pain and swelling. Protection may include strapping, bracing, or even using crutches.
Ice can be helpful in easing pain and excessive swelling, although it is now understood that icing should be used thoughtfully rather than excessively. Despite how good it may feel, heat is not recommended immediately after an injury, as it can increase bleeding and swelling. Elevation—ideally about 45 degrees above the level of the heart—can also help reduce pain and swelling. Compression may be useful when swelling is significant, but it has its own pitfalls, so professional advice is recommended.
More recent research has introduced the concepts of PEACE and LOVE, which emphasise not only protection and symptom control in the early phase, but also the importance of gradual, guided movement and loading as soon as it is safe to do so. While complete rest was once strongly recommended, we now know that early, appropriate movement often leads to better tissue healing and functional recovery. Similarly, the routine use of anti-inflammatory medication after injury is being reconsidered, as excessive suppression of inflammation may negatively affect tissue healing.
After a few days, the body begins repairing damaged tissue with new tissue, but this tissue is initially weak. If you do too much too soon, the new tissue may be damaged again. However, if you do too little, the tissue may not develop enough strength. Finding the right balance—applying the right amount of stress at the right time—is crucial.
Maintaining strength, flexibility, and cardiovascular fitness in the rest of the body, in ways that do not overload the injured area, is also important. Gradually, balance, coordination, flexibility, strength, and stability around the injured area need to be rebuilt.
After a couple of weeks, you can usually begin placing greater demands on the tissue, and more advanced and sport-specific rehabilitation can later be introduced. Signs of recurring pain or other symptoms often indicate that it is time to slow down or adjust the program. Everyone is different, so an individualised treatment plan is best.
A physiotherapist can assist you from day one through all stages of recovery and rehabilitation. They can also address underlying risk factors for future injury and help enhance performance.
I wish you all the best with your exercise and sporting goals this year. My final tips are to make exercise enjoyable, include friends or family, and keep track of your progress.
Juli-Ann Riley is a local physiotherapist with a special interest in the treatment of sports injuries. She loves being active herself and enjoys swimming, hiking, trail running, bodyboarding, scuba diving, snorkelling, and paddling. She has completed two single Dusis and loves exercise that is fun and takes her out into nature.
