How to avoid common (and uncommon) exercise injuries

Image: A runner laces her shoes
Knee pain is a super common running injury, but there's a surprising culprit behind it — your hips. Copyright suedhang Getty Images/Cultura RF
Copyright suedhang Getty Images/Cultura RF
By Emily Pandise with NBC News
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Before you jump into that new workout routine, arm yourself with these expert tips.

Spinning, barre, and HIIT — these words that didn't mean much a few short years ago are becoming part of our everyday vocabulary, thanks to the growing popularity of boutique fitness classes nationwide. But for all the emphasis that's put on staying fit, there are some harmful side effects to intense exercise — especially for those who aren't doing it properly. The boom of boutique fitness classes (and a boom it is, indeed — in 2016, 55 million Americans visited over 180,000 fitness clubs, according to the International Health, Racquet, and Sportsclub Association), has also led to an increase in trips to the hospital.

But high-intensity classes aren't the only thing that can cause injury — more common forms of exercise, like running, weight lifting and yoga, can be problematic if done incorrectly. So we asked the experts how to identify these common (and not so common) injuries — and how to prevent them in the first place.

You must know where you are individually before you jump into any kind of exercise, regardless of its intensity.

1. Running

If you're a runner, fledgling or professional, you've probably experienced an injury or two. Our experts pinpointed a few issues that can afflict the road warriors hitting the trails, streets or sidewalks.

Rachel Straub, MS, certified strength and conditioning specialist and author of Weight Training Without Injury tells us that knee pain is super common, but there's a surprising culprit behind it — your hips. Straub says it's the most common injury seen in sports medicine. "It can be from just walking or running or it's fairly common with improper exercise technique, or with poor strength, particularly in the hip." Straub suggests strengthening your hips because that can put you in a better position to avoid injuries.

According to Dr. Armin Tehrany, an NYC-based orthopedic surgeon and founder of Manhattan Orthopedic Care, another common but more serious injury is a meniscus tear, which affects the cushion that protects the kneecap. "The reason [so many runners] get that tear is because they've done so much repetitive heavy impact activity that over time the meniscus cushion just wears out and tears," he says. Tehrany suggests "running in opposite directions, switching directions (so as to not overuse one group of muscles) and maintaining the right balance of strength and flexibility."

2. Yoga

So many of us say "om" on a regular basis for relaxation and strengthening muscles — but don't let yoga's calming nature get the better of you. You still have to use caution to prevent muscle and joint injury.

Dr. Tehrany says that it's "important for people to understand that if they're loose jointed naturally, some of the provocative yoga positions can cause the joints to sublux, which means to slip in and out, or even dislocate." He says to be cautious when it comes to your problem areas, and "to warm up the body so it will be loose enough to handle the stretching and avoid tightness."

3. Swimming

Swimming is a generally safe form of exercise, but Dr. Tehrany advises to be careful not to overextend joints. "The patients that are loose jointed have a tendency to get an overuse injury to the rotator cuff, especially when they're doing the freestyle crawl or overhead stroke. Or, they run the risk that the shoulder may become unstable," Dr. Tehrany explains.

Dr. Tehrany's other tip for swimming safely may not be so obvious: "There's the issue, believe it or not, of dehydration. If someone's working out hard enough, just because you're in the water doesn't mean you're hydrated well enough, especially if it's warm water or it's in the summertime," he says.

4. Weight training

Rachel Straub has literally written the book on how to stay safe when weight training, and she advises to be careful that you keep good form, especially when adding weight. "In terms of using weights, when you're putting that additional stress on your body, if you're not doing it properly it just compounds the risk and the damage that you're doing," she says.

Straub is mindful that gym workouts can become routine, and when you're in a rut, that's when to be most careful. "People get bored; there are ten ways to do a squat, but they don't really understand how deep should they go, how their feet should be placed, so all of these variables impact the loading of the joint," the exercise physiologist explains. "So you really have to be knowledgeable or be working with someone who is knowledgeable on these factors in order to stay safe."

It's really not about the fitness level of the individual, it's really about whether or not they've done the activity beforehand.

Weekend Warriors, Beware

For those who take advantage of tougher weekend workouts, our experts are wary of an uncommon but serious condition called rhabdomyolysis.

Dr. Todd S. Cutler, a hospitalist at New York-Presbyterian/Weil Cornell Medical Center, is one of the writers of a study that looked at the spike in cases of rhabdomyolysis from 2010 to 2014 among the patients at his institution. The condition, often called "rhabdo" for short, is caused by extreme exercise in unfamiliar conditions, especially among those who are not necessarily trained for that specific exercise, Dr. Cutler says.

"Essentially, the way that people seem to get exercise-related rhabdomyolysis tends to be when they're doing first time activities, especially high-intensity activities, like spinning or multi-modality exercises like CrossFit. The type of patients that we see are pretty young, and in pretty good health."

The symptoms can range from muscle aches to serious pain and changes in urine color that signal muscle breakdown in the body. "And then, two days, three days later, they notice that their muscles are aching, usually the group that they were using the most, and when they come to the hospital it's usually because their urine has turned brown. And they get freaked out, appropriately so," Dr. Cutler says of the patients he's seen with the condition.

How to Prevent Common Injuries and Exercise Safely

So, how do you prevent these common (and uncommon) injuries? Our experts weigh in on what to do to stay safe, healthy and fit.

  • Talk to an expert. Dr. Tehrany says the time to see a trainer or physical therapist is before a problem starts. "It might be a good idea to see a physical therapist or a personal trainer to make sure that they have the proper balance of their musculature, and be taught proper form," he says. Tehrany recommends being completely aware of your physical condition before jumping into something strenuous like CrossFit. "It's a great idea to even try to get one session with a trainer or one session with a physical therapist, especially a physical therapist if the person already has an ailment," he advises. "We want to try and prevent injury."
  • Know what works for you. Straub says to be careful even when working with experienced professionals, and don't necessarily jump right into what your gym buddy is doing full speed ahead. "Trainers don't necessarily know everything," she says. "Sometimes what's appropriate for one person isn't appropriate for another. So I have seen people who say, 'My friend XYZ can do this, so I should do it too,' and they do it, and they blow out a disc or they hurt their knee."
  • Beware of group exercise mentality. Dr. Cardone, an expert on sports related injury, says that a strong group mentality, though a big mental motivator, can sometimes be too much on our bodies."The great example is kids for example — if you send them out in the park from 6am to 6pm and they're playing, they never get overuse injuries," he explains. But Cardone says if you add a coach, that all can change — even for adults. "Now if you have somebody standing in front of a class saying, 'More, more, more, crank the resistance, you can do better,' and now they're going well beyond their comfort zone, so some of the body's internal warning messages, they might be ignoring that and just keep pushing, pushing, pushing," he says. Straub agrees that listening to your body's warning signs is super important for staying safe. "If someone recommends you do something, you don't just automatically do it," she says. "If it doesn't feel right, you should stop."
  • Start from the ground up. Every expert stressed the same point — you must know where you are individually before you jump into any kind of exercise, regardless of its intensity. Dr. Cutler says a condition like rhabdomyolysis can afflict even the toughest of the tough. "You can take the most elite athlete and expose them to an exercise regiment that they've never done before, that they've never been exposed to, and you could find a way to give them rhabdo if you were creative and pushed them hard enough," he says. "It's really not about the fitness level of the individual, it's really about whether or not they've done the activity beforehand and whether they're properly trained to begin at a higher intensity level."
  • Don't be shy about your health. Dr. Cardone emphasizes the importance of speaking up and taking care of yourself if something doesn't feel right. "If somebody in any way suspects that they have [an exercise related injury], they should not be shy or bashful. The easy thing to do is always go to the emergency room or to your primary care provider," he advises.

NEXT: How to match your workout to your personality type

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