How to get fit without getting hurt.

By Colette Bouchez
WebMD Weight Loss Clinic - Feature

Reviewed by Louise Chang, MD

You've finally made the commitment to get in shape, or maybe to take your physical fitness to the next level. Eager to start seeing results, you jump into your new routine, feet-first. And the next sound you hear is "ouch," as a workout injury derails your healthful plans.

Why does it happen? Experts say there are many reasons.

"Sometimes it's a matter of doing the right activity too much or too often; sometimes it's a matter doing the right activity wrong; and sometimes it's a matter of choosing the wrong activity for your particular body type or physical conditioning," says Gerald Varlotta, DO, director of sports rehabilitation medicine at New York University's Hospital for Joint Diseases and the Rusk Institute of the NYU Medical Center.

But don't get discouraged just yet. Experts who spoke to WebMD shared tips on how to work out smarter and avoid some of the most common fitness injuries.

6 Steps to Avoiding Workout Injuries

1. Know Your Body

It seems so basic, but experts say it's often overlooked: One of the best ways to avoid fitness injuries is to know your body's limitations.

"This isn't just about avoiding certain fitness activities until you're in better shape -- though that's part of it -- but it's also about knowing what your weak areas are and then avoiding the type of activities that are going to push hard on that weakened area," says orthopedic surgeon Kenneth Plancher, MD, associate clinical professor at Albert Einstein College of Medicine in New York.

For example, if you know you have knee problems, Plancher says, you don't want to use a stepper, run on a treadmill, or do leg presses, all of which can aggravate an already weakened knee.

"Instead, you want to try a stationary bike or even an elliptical machine, which does not cause any pounding on the knee joints," says Plancher.

Likewise, he says, if you have a bad back, you should avoid doing back stretches on a stability ball; if you have weak wrists, weight lifting may not be your sport; and hip problems may preclude you from joining a spinning class.

"The point is that you have to acknowledge the weakest areas of your body, and if you can't slowly build them up, then, to avoid injury, you have to avoid the activities that stress them," says Plancher.

2. It's All About Sex!

No, not the kind you have on Saturday night -- we're talking gender! It may not be politically correct, but doctors say gender does play a role in workout injuries.

"Both men and women have specific gender-related physiologic issues that can set them up for injuries when they do specific types of workouts," says Plancher.

While this doesn't mean either gender should avoid certain activities, it just means taking a few precautions when you do, Varlotta says.

So what's the gender breakdown?

"In general, men function better in activities requiring a rigid plane of motion -- like weight lifting in a restricted format, push-ups, Nautilus machines," says Varlotta. "Women, who have certain flexibility issues, do better at activities requiring multiple or diagonal planes of motion, like Pilates, yoga, a stair stepper, or spinning -- activities during which men are more likely to be injured."

That said, women are at greater risk for ACL (anterior cruciate ligament) injuries. The ACL is a ligament that holds the knee in place. As such, Varlotta says, women should exert greater care when participating in activities requiring quick "twist and turn" leg motions, such as skiing, basketball, and racquet sports.

"Studies also show that women are more prone to fitness injuries during their menstrual cycle since hormones can increase the looseness of the joints and make injury more likely to occur," Plancher tells WebMD.

Being careful during this time of the month, he says, may help you avoid injury.

3. Hire a Pro

"One of the best ways to avoid injury is to take a few lessons with a certified trainer," says Plancher. This will help ensure your body is in proper alignment while you're working out, which can go a long way in protecting you from exercise injuries, he says.

Getting expert advice can also keep you from doing the wrong workouts for your body type and help you moderate your routines so you don't do too much, too soon, says personal trainer Alex Schroeder.

"A trainer will aid in the appropriate progression of exercises, weights, and rest periods. The right program will allow muscles to heal properly, which in turn helps avoid some of the more common injuries," says Schroeder, a trainer at Form and Fitness, a rehabilitation and workout center in Milwaukee.

While almost any pro can give you some pointers worth listening to, Plancher says you should make certain your trainer is aware of your personal parameters, including your age. "If your trainer is in their 20s and you're in your 40s, make sure he or she has some background in the natural degenerative processes of the human body. There is such a thing as a trainer pushing you too hard and that can increase the risk of injury," says Plancher.

4. Act Your Age

It starts out as a simple desire: You just want to get more exercise. But somehow, a kind of "fitness amnesia" takes over. Before you know it, you've blocked out the years -- or sometimes decades -- since the last time you exercised.

The end result is that you do too much, too quickly, for too long, with too much intensity -- and injury is often the end result, Plancher says.

The shoulders, he says, are among the body parts at greatest risk when old athletic dreams die hard.

If you repeat a motion that puts too much strain on your shoulder joint, or force the muscles to work in a misaligned way, Plancher says it's hard not to end up with a fitness injury.

5. Warm It Up and Take It Slow

Whatever type of fitness activity you're doing, experts say you're less likely to get injured if you warm up before every session and slowly build the pace of your workout over time.

"The warm-up helps the muscles to handle stress, so they are less likely to be injured, and the pacing is just the commonsense way to avoid injury," says Plancher.

So, if, for example, you're new to weight training, start with weights you can lift for 8-12 reps, and do no more than three sets. When that gets easy, increase the weight by just 2% (and no more than 10%) at your next session.

"Overestimating your [strength] will lead to improper technique and recruitment of auxiliary muscles," says Schroeder. Translation: A higher risk of injury.

Plancher says this same moderation principal applies to almost every fitness activity: "Whatever you think you can do, or think you should be doing, dial it down a notch. Almost everyone thinks they are in better shape than they are, which is how and why injuries occur."

6. Don't Overdo It

While doing one exercise over and over will certainly help you perfect it, experts say it can also set you up for a workout injury.

When we repeat the same muscle movements, says Schroeder, it leads to "overuse and repetitive use injuries, such as shin splints, tendinitis, and never-ending muscle soreness."

The way to avoid problems, he says, is to vary your workouts -- for example, running on a treadmill one day, and the next, lifting weights.

It's also important to give muscles adequate rest between workouts.

"It's OK to work out every day, as long as you're not feeling the pain. But if you are, remember that tired muscles are an invitation to injury, so give yourself adequate time to rest and recover," says Varlotta.

Schroeder adds that the best way to keep a small injury from becoming a larger one is to rest the sore muscle. "It's the best avenue to a speedy recovery," he says.

Workouts Made Safer

Here are some tips for avoiding injury while performing six types of common exercises.

1. Activity: Jogging

Potential injuries: Knee and foot problems, including torn meniscus or cartilage injury.
How to avoid them: Wear good shoes, rest between sessions, don't work through the pain; ice your knees.

2. Activity: Ski machines and air-walking devices (like the Gazelle)

Potential injuries: Hip, leg, lower back problems due to hyperextension; knee injuries due to locked in position.
How to avoid them: Don't pull your legs apart farther than you would during a natural stride. Try to keep some flexibility in the knees -- don't lock them tight.

3. Activity: Yoga

Potential injuries: Wrist sprains and hip problems.
How to avoid them: Don't put excess weight on your wrists; reinforce them with supports; don't let anyone "push" your body into a position it doesn't go into naturally, without pain.

4. Activity: Leg extension exercises and leg press machines

Potential injuries: Kneecap dislocation or bruising; aggravation of arthritis in knee; disc problems, tendinitis
How to avoid them: Never lock your knees. Don't put your foot under a bar or other rigid equipment that forces your leg into an unnatural position.

5. Activity: 30-minute circuit training workout (like at Curves)

Potential injuries: Torn rotator cuffs, shoulder damage from doing too much, too soon.
How to avoid them: Don't feel obligated to do the whole 30-minute routine when starting out, especially if you feel pain. Stop, rest, and don't push down too hard.

6. Activity: Assisted dips

Potential injuries: Shoulder, elbow, wrist dislocations, muscle strains, ligament tears
How to avoid them: Don't use a dip machine that requires you to drop down so low that your shoulders come up to your ears.

Medically Reviewed May 19, 2008.

SOURCES:
Kevin D. Plancher, MD, orthopedic surgeon; sports, associate clinical professor in orthopedics, Albert Einstein College of Medicine, New York.
Gerald Varlotta, DO, director of sports rehabilitation medicine, New York University Hospital for Joint Diseases and the Rusk Institute of
Rehabilitation Medicine at NYU.
Alex Schroeder, certified personal trainer, Form and Fitness Rehabilitation and Fitness Center, Milwaukee.

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