Lowering the risk of sports injuries

No routine can remove all risk from sport, but public health guidance returns again and again to the same handful of habits: warming up, building up gradually, allowing rest, using equipment that fits, and mixing up activities. This page gathers those ideas in one place.

Where injuries tend to come from

The American Academy of Orthopaedic Surgeons, in its OrthoInfo page on sprains, strains and other soft-tissue injuries, observes that injuries often occur when people suddenly increase the duration, intensity or frequency of their activities, and that many soft-tissue injuries can be prevented through proper conditioning and training. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, in its overview of sports injuries, lists risk factors that include poor technique, overtraining, increasing intensity too quickly, playing the same sport all year, hard surfaces, unsupportive shoes, missing equipment, a previous injury and poor flexibility. Almost every habit below is simply one of those risk factors turned around.

Warming up and cooling down

MedlinePlus, in its overview of sports injuries, names not warming up or stretching enough among the causes of injury. A warm-up usually means a few minutes of easy movement that gradually raises the heart rate and moves the joints through the range the sport will use: a gentle jog before a run, easy rallies before a match, light swimming before hard lengths. Cooling down with easy movement after exercise is the same idea in reverse. How long and how elaborate a warm-up needs to be depends on the activity and the person.

Building up gradually

The single most repeated idea in this area is gradual progression. Starting a new sport, returning after a break, or training for an event are all moments when enthusiasm can outpace what the muscles, tendons, bones and joints are ready for. People who build up steadily usually increase one thing at a time, whether distance, speed, weight, frequency or difficulty, rather than all of them at once, and they treat a new sport as new even if they are fit from another.

The first sessions of a season deserve particular care. The first round of golf, the first long bike ride or the first match of the year is a classic time for a strained back or calf, because the body has not done that particular movement for a long while.

Rest and recovery days

OrthoInfo explains that overuse injuries happen when an activity is repeated so often that the soft tissues do not have enough time to recover before they are put under stress again. Rest days, easier sessions between hard ones, and enough sleep are the everyday ways people build in that time. Alternating activities that load the body differently, such as running one day and swimming or cycling the next, is another.

Balanced fitness

OrthoInfo recommends aiming for balanced fitness, with a programme that includes cardiovascular exercise, strength training and flexibility, and adding new activities and exercises cautiously. NIAMS lists playing the same sport all year among its risk factors. Variety spreads the load across different muscles and joints, and strength work for the trunk, hips and legs is common ground for many sports. A physical therapist, coach or qualified trainer can suggest what suits a particular sport and body.

Technique

Poor technique concentrates load in the wrong places: a tennis stroke driven by the wrist rather than the body, a lift with a rounded back, a running stride that lands heavily. Lessons from a qualified coach, especially when learning a new sport or returning to an old one, are a common way to build good habits early.

Equipment that fits

• Shoes. OrthoInfo suggests replacing athletic shoes as they wear out, and NIAMS lists unsupportive shoes as a risk factor. Shoes made for the sport and the surface make a difference to how the feet and legs take the load.
• Protective gear. Helmets, pads, mouthguards and eyewear exist for particular sports, and NIAMS lists not wearing the proper equipment among its risk factors.
• Clothing. OrthoInfo recommends comfortable, loose-fitting clothes that let you move freely and release body heat.
• Size and set-up. A bicycle of the right frame size with the saddle at a sensible height, or a racquet with a grip that suits the hand, changes how the body is loaded over many repetitions.

Surfaces and conditions

Running or jumping on hard surfaces appears in NIAMS's list of risk factors. Mixing softer surfaces such as grass or trails into running, taking care on wet or uneven ground, and paying attention to heat and water on hot days are all part of the same picture.

Listening to early warnings

Overuse injuries usually announce themselves gradually, as an ache that appears during or after activity and lingers a little longer each time. Easing off at that stage, rather than training through it, is a habit experienced athletes often describe. MedlinePlus's advice after an acute injury is equally direct: if you get hurt, stop playing. The common sports injuries page explains the main kinds of injury, and the When to see a doctor page lists the signs that mean an injury should be checked promptly.