Getting in shape is not without risk whether you swim, run, or lift weights. Accidents happen even when you take precautions. Sadly, head trauma from falling off a treadmill appeared to be behind the recent death of SurveyMonkey CEO David Goldberg, 47, according to news reports.
From strains and fractures to serious tears, the following injuries rank among the worst you're likely to experience.
Patella femoral overuse syndrome
This knee injury manifests as pain under the kneecap that worsens when running, going down stairs, or sitting for long periods of time with knees bent. It develops when the bones in the lower leg are not lined up perfectly, which creates an abnormal gliding between the kneecap and femur (thigh bone). "It's common among women who do a lot of squats and lunges," says Bert Mendelbaum, MD, orthopedic surgeon at Santa Monica Orthopedics and Sports Medicine Group in Santa Monica, CA. Increasing your running mileage too quickly can also bring about symptoms, as does jumping activities. Reduce your risk by easing into new routines slowly and strengthening the quadriceps muscles, as well as hamstrings and calves. (Try these 6 moves for stronger knees.)
Rotator cuff tear
This injury involves damage to one of the four rotator cuff muscles that keeps your shoulder socket in place and usually occurs over time, rather than in one motion. It typically makes itself known when reaching in the backseat of your car or when trying to hook your bra. "Repetitive overhead motions, especially a motion you haven't performed much recently, can strain the rotator cuff tendons in your shoulder," says David Geier, MD, an orthopedic surgeon in Charleston, SC. "If you have pain in your shoulder and upper arm, modify your workout to minimize that pain for a few days. If it doesn't improve, consider seeing a doctor."
Anterior cruciate ligament (ACL) tear
A hard hit from the side can injure this knee-stabilizing ligament. "While ACL tears usually occur in sports, it can also happen when performing exercise programs like hip hop aerobics or plyometric workouts where you land awkwardly from a jump," says Geier. Stopping suddenly, changing directions rapidly, and slowing down while running can also damage your ACL. "You might land or turn with the knee extended and feel a pop before your knee gives way," says Geier. Pain with swelling and tenderness indicate possible damage. To prevent it, always try to land softly on your toes with your knees bent.
Even if you're not a fighter, participating in boxing classes or other training programs where you punch pads held by a trainer or you pummel a heavy bag can result in a boxer's fracture, also known as a brawler's fracture. It usually affects the bones that connect the ring finger or little finger to the wrist. Swelling, discoloration, bruising, or deformity of the knuckle are signs of a boxer's fracture. Treatment and healing time depends on the severity of the fracture. "Stay safe by always wearing proper protection on your hands and making sure to hit the target properly," says Geier.
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A sudden sharp pain in the back of your thigh while sprinting or stretching (usually from ballistic stretching or "bouncing"), could be signs of a hamstring strain, also known as a pulled muscle. "Some hamstring strains can be mild and require only a few days or a week or two to heal, but others can take six to eight weeks or more," says Geier, "especially if the injury occurs near the buttock." To prevent this painful strain, make sure to warm up thoroughly and stretch prior to strenuous activity.
The same mechanism that can cause an ankle sprain—you land awkwardly and invert or "twist" your ankle—can cause a fracture of one of the bones around the ankle. "Ankle sprains can heal in as few as 2 to 4 weeks, but fractures can take months, especially if they require surgery," says Geier. "Ankle fractures can be hard injuries to prevent, but you should watch your surroundings." Safety measures include making every effort to avoid landing on uneven surfaces.
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Labral tear (shoulder)
Falling on an outstretched hand during a cardio class, a sudden pull trying to lift a heavy weight in CrossFit, or trying to stop yourself from falling can all result in this injury, defined as a tear of the cartilage bumper within the socket of the shoulder. "You can injure it by lifting a much heavier weight than you're prepared for in a military press (overhead shoulder exercise), bench press, or incline press," says Geier. Always pick a weight you know you can control and use proper techniques with each exercise.
Tiny cracks in the bone (hairline fractures) or severe bruising within a bone can occur from repetitive stress, such as back-to-back boot camps or jumping activities. These stress fractures usually take time to develop. "With continued stress on a bone, it can weaken and ultimately fracture," says Geier. You're most likely to experience a stress fracture of the foot, heel or shin bone (tibia). Pain around the injury that worsens with exercise, standing, or walking, sometimes accompanied by swelling, are signs you may have a stress fracture. Fortunately, they are largely preventable, says Geier. Never increase your workouts by more than 10% per week and vary your routines to avoid stressing the same areas every day.