Sports and exercise have indisputable benefits: stronger bones and muscles, reduced risk of many diseases, improved mental health and mood, socialization, fun — and more. But they also come with the risk of injury.
“Realistically speaking, we can’t completely prevent injury. If we start to focus on mitigating our risk of injury, we have a better pathway for success,” says Dave Granito, MS, ATC, director of recovery and injury prevention at Mass General Brigham’s Center for Sports Performance and Research. “The way we do that is to look at things that might lead to injury. Then we try to adjust certain factors to keep the risk low.”
Granito is a former athletic trainer for professional football teams, including the New York Giants, New England Patriots, and Detroit Lions. He offers several tips for people at all levels of fitness who are interested in preventing injury.
It’s important to visit your doctor before you start a new activity, and as you ramp up. “They can examine you, look at how you move and say, ‘These are some of the things we need to do before you get there,’” Granito says. Your provider might recommend weight loss, offer nutrition advice, address underlying health issues, and treat previous injuries.
Other professionals you can consult include:
Qualified personal trainers
Strength and conditioning coaches
Experts in proper equipment, such as footwear
The number one reason people get hurt is because they continuously repeat bad movement, Granito says. If you run, do you sit back in your stance or lean forward? How do your legs move? If you row or play a throwing sport, are your movements sequenced and timed properly so you don’t overstress one area of the body? The more you repeat a bad movement, the higher the risk for injury.
Think of a car with wheels out of alignment: You may be able to drive for a while without noticing a problem. But if you drive thousands of miles like that, you’ll damage the car.
Granito recommends that you research proper form for the activities you do and then think critically about your own form. If you’re uncertain, consult an expert for an objective assessment of your movements.
Whether you’re a weekend warrior aiming to stay active or a high-level athlete chasing a championship, goals take time to achieve.
“If a person doesn’t take time to build up to longer workouts or higher levels of intensity, their body won’t be ready to handle the demand, and that can cause injury,” Granito says.
For example, when planning to run a race, consider how far you’ve run before and your overall cardiovascular fitness. If 3 miles is the furthest you’ve ever run, choose a shorter race as your first goal. Or realistically calculate how to gradually build from 3 miles to a longer distance. If you simply want to start playing basketball or pickleball on the weekends, start with shorter or fewer games.
Before every workout, you have to get your body ready. In particular, powerful, explosive movements such as jumps and sprints can cause injury if tissues are not warm and elastic.
“Warming up increases blood flow, and blood flow makes tissues more elastic,” Granito says. “Instead of a time-based guideline for a warm-up, I recommend warming up until you start to sweat.”
Before beginning a workout, he has athletes:
Bike for 5 minutes to begin to sweat.
Perform some explosive movements such as skips, jumps, and lateral movements.
After activity, Granito recommends doing your warm-up routine in the opposite order to slowly bring your body back to pre-exercise levels.
Cross-training helps prevent overuse injuries in athletes who consistently put a lot of stress on a particular part of the body. For example, runners can bike to improve aerobic capacity without putting stress on the knees and ankles. Similarly, cyclists can swim, and throwing athletes can take a few days off from throwing to lift weights.
“In terms of mitigating injury risk, cross-training is a great way to take stress off of the parts that you’re trying to rest while still making progress,” Granito says. “It’s especially helpful in people who really focus on one sport.”
The core is the foundation of almost all athletic movement. “Most people think of core strength as just their abs. But the core is essentially everything from our knees to our nipples in the front and from the back of our knees to our shoulder blades in the back,” Granito says.
A weak core forces you to use other parts of your body with more force, which can cause an injury. Imagine a tennis player with a core that’s not strong enough to hit the ball forcefully. They may try to draw more power from their hips, shoulder, or elbow, which can hurt the joints or surrounding muscles and tendons.
An effective way to test and build core strength is to hold a well-defined plank and side plank:
Hold your body still in the position that you would use to start a pushup.
Start with a regular plank. Then rotate your entire body so your chest opens to the side, bringing your arm or elbow toward the ceiling.
In both positions, keep your body perfectly straight like a plank of wood, with your butt and hips low. Your arm(s) should be straight up and down, with your elbow(s) and wrist(s) stacked directly under the shoulder(s).
Granito suggests a goal of holding a plank for 30 seconds or more. “If you can maintain a plank in good form for that long, your core is efficient and is helping to prevent injury,” Granito says.
When we exercise, we create tiny tears in our muscles. It’s important to allow those tissues to recover. Rest or low-level activity helps your muscles heal and allows your body to eliminate waste and byproducts created during exercise.
“If you don’t recover well from one day to the next, then your effectiveness the next day goes down. And if we continue that day after day, not recovering between workouts, you increase your injury risk,” he says.
A rest period doesn’t mean being completely inactive. You can do low-impact activities, such as walking and swimming, and incorporate stretching to prevent injury and increase flexibility. Good sleep habits and nutrition are also important to rest and recovery.
Mass General Brigham’s Center for Sports Performance and Research (CSPAR) designs personalized programs for injury prevention for athletes. Our experts assess your health and your movement, then design exercise programs to improve performance and mitigate the risk of injury.
Learn about Mass General Brigham Sports Medicine services