There are a couple of times each year when plenty of people start or restart their fitness journeys (just after New Year’s or right before swimsuit season ring any bells?). But when taking the plunge back into fitness, there may be some new aches and pains that come with it.
Maybe you’re not as young as you used to be or it’s been a while since you’ve really pushed yourself physically. You’re finally using that gym membership or you just signed up for a new fitness app and you’ve worked out three days in a row, but now your back is a bit more tender. Your abs are really sore. Your shins hurt with every step. And your whole body is just one big aching muscle.
Either way, you did it and now you’re dealing with the consequences.
Sometimes, it can be difficult to differentiate between the body’s normal response to strenuous exercise versus what may be early signs of injury.
As a physical therapist, my job is rehabilitative as well as preventative. I’ve had plenty of patients who’ve come in for new onset injuries due to a recent increase in their activity level.
I’ll go over some common injuries that I’ve come across while working with patients, and the best ways to manage them.
Do You Have an Injury or Something Else?
There are plenty of ways to hurt yourself with too many diagnoses to list. When it comes to thinking about injuries that are fitness related, they generally fall under two categories: traumatic and overuse.
Traumatic injuries can be pretty clear when they happen. There’s usually a precipitating action that results in sharp and immediate pain. An example would be if you were running, then performed an abrupt change in direction and felt a sudden “pop” or “twist” and now you can’t walk and your knee is swollen. There’s a very clear-cut action in this scenario that resulted in physical trauma.
Overuse injuries are more difficult to pinpoint, as they usually sneak up on you. These are the aches and pains that linger from workout to workout in the same place and don’t ever seem to go away after a while. Imagine that you picked up a new sport like pickleball, where you’ve been playing several times a week for three weeks straight and now the inside of your elbow hurts. That part of your elbow has been overworked and the strain has built up to the point that now you can’t ignore the pain any longer.
Who Should You See if You Have an Injury?
In the case of a traumatic injury, you should go to a physician for a follow-up. They can prescribe medications to help with pain and swelling, especially in the early stages, as well as perform any necessary imaging to ensure that nothing is torn too badly or worse yet, broken.
If, for whatever reason, you don’t feel comfortable with going to a physician, then a licensed outpatient physical therapist (PT) is a reasonable alternative since we have a battery of physical tests that could point you to an appropriate diagnosis as well.
Fair warning though, the PT might also refer you to your physician for imaging, depending on the results of the tests they perform, just like your physician might refer you to physical therapy once you’re medically cleared.
When it comes to overuse injuries that develop over time and with repetitive activity, you might as well go straight to an outpatient PT. There are some medical quick fixes like steroid injections for pain and inflammation, but those can have side effects, especially when used long term. Depending on what state you live in, PTs have access to short-term techniques that can provide pain relief as well.
6 Most Common Injuries & How to Manage Them
Honestly, there are just so many kinds of injuries out there. And they are dependent on what new activity you decide to pick up. Weightlifting and powerlifting are fundamentally different to running and HIIT classes.
That said, here are some of the more common overuse injuries that occur across a number of different physical activities that I’ve seen most often.
Shin splints, also known as medial tibial stress syndrome, has been the bane of existence for walkers, runners, cyclists and anyone who has to do a lot of jumping or plyometrics. They generally develop with repetitive and intense stress, which is why it happens to runners and jumpers. The pain usually begins at the front of your lower legs, occurring in both legs at the same time, and worsens with continued activity.
When they first occur, the best way to treat shin splints is with rest and ice. Analgesic gels and massage or myofascial release may help as well. Instead of stopping all activity after they happen, it’s better to simply cut back on the intensity or duration of what you were doing.
For example, if running two miles resulted in shin splints, then alternately walking and running the next time would be a good alternative.
Long-term management mostly revolves around strengthening, stretching, and addressing muscular imbalances of the entire lower half of the body, from your glutes down to your calves since they all participate in managing the amount of force carried through your lower leg. An additional route would be to have specially-made orthotics that are molded to your feet to help cushion or direct how your ankles and feet move during high-impact activities. I’d try the strengthening route before diving straight into orthotics, since they can be costly.
Watch this video routine of shin splint stretches and strengthening exercises (hint: skip to 6:00 into the video to see the strengthening exercises) for a visual how-to.
Patellofemoral pain (PFP) usually occurs gradually, although it can come on after particularly intense leg exercises, such as squatting, running, jumping, or even stair climbing. The pain is often generalized, surrounding the top of the knee cap, underneath it or even on the sides. Activity tends to make symptoms worse, where the pain can eventually become another hurdle to your fitness journey.
Diagnosing PFP can be difficult, as there are a number of contributing sources. You can go to an MD for pharmaceutical pain relief, steroids for inflammation, or imaging to see if there is any underlying arthritis. It’s also common for an MD to prescribe physical therapy for specialized treatment such as running gait retraining, exercise therapy, needling, taping, and more.
There are different ways to manage PFP. Eccentric quad exercises would be a good place to start. Here are a few moves to try:
In the long run, adding eccentric leg exercises will help challenge your quads in a different way, allowing you to keep loading your legs and making gains while dealing with your PFP.
For quicker possible fixes when the pain is unbearable, you can:
get a store-bought knee brace
go to a physical therapist to show you how to tape your knee
get orthotics for your feet
Iliotibial Band Syndrome
Iliotibial band syndrome (ITBS) is just one of many causes of outer knee pain. The IT band itself originates up by the side of your hip and travels down the side of your thigh, passing along the side of your knee and finally inserting at the top of your outer shin. ITBS is common in runners, jumpers, and cyclists.
I bring up ITBS with PFP because, in my experience, one condition can be a contributing factor to the other. There is a sheath of fibrous tissue that surrounds the knee joint, which the IT band merges with. This junction can cause a back and forth interplay between the knee, quad, and IT band.
There are two particularly tender spots along the IT band: One is located along the outer aspect of the hip and the other is located just above the side of your knee.
For managing ITBS, I prefer active stretching in abduction of the hip (opening your hip) rather than passive stretching. I also recommend abduction-focused exercises. Foam rolling and static stretching are options as well, but I find faster relief from performing the action that the IT band is responsible for, which is abduction and external rotation of your hip.
Plantar fasciitis is another common injury seen in walkers, runners, jumpers, and people who play fast-moving sports. It comes from repetitive stress to the bottoms of your feet and tight calves, and presents with pain through the heel or sole of your foot.
The more common treatment options include rolling the bottom of your foot on a tennis ball or frozen water bottle, which can help ease the tension that has built up. You can also stretch and massage the calf.
Long-term management involves specific exercises, particularly eccentric calf raises with slow and controlled eccentric portions to load the calf and soles of your feet in a slightly different way.
Muscle strains are a broad category and can happen pretty much anywhere in your body. While the strain is dependent on the kind of exercises and activities that you perform, there are specific areas that I see more than others — namely the lower back and hamstrings.
These strains usually occur when muscle fibers rupture during the eccentric phase of highly forceful activities: think powerlifting or team sports. Age plays a factor as well, though the frequency of this type of injury between athletes in their 20s or 30s versus their 60s is less than 0.01 percent.
Your best chance of lowering your risk of muscle strain is warming up sufficiently for whatever activity you’re planning to do.
If you strain a muscle, rest and ice are the immediate go-to solutions, with elevation if it happened to one of your limbs. Analgesic gels can help but the underlying issue is the ruptured muscle fibers.
There’s a timetable for recovery with this as opposed to PFP, ITBS, or plantar fasciitis. In the first few days and up to the first two weeks after a strain, there will be general swelling in the area. After that, the fibers need to knit back together, which can take another two to four weeks beyond that, putting the total time for healing at four to six weeks. You’ll need to adjust your activity for that period of time by either reducing the intensity of your workouts or modifying specific exercises.
Of course, you can always just push through the pain, but be warned that doing that will put you at higher risk for making the strain worse — and possibly tearing the muscle altogether.
Epicondylitis, both medial and lateral, is irritation either in the inner or outer surface of your elbow. Most people can pinpoint exactly where their elbow pain starts.
These are both painful, inflammatory reactions centered around your elbow that occur with overuse, usually in activities that involve holding something like a racket, golf club, or even a barbell/dumbbell. They’re caused by stressing either the inside or outside of your elbow during activities that require high amounts of stabilization.
The fastest fix for either condition is to wear an elbow brace that supports whichever side is affecting you. There are plenty of golfer’s elbow braces or tennis elbow braces out there. If your pain has occurred through lifting a dumbbell or barbell, I’d suggest using an elbow sleeve that supports your entire elbow. These help to support the elbow and better manage the amount of force being loaded through the joint.
A more active management of your symptoms includes stretching your forearm, nerve flossing, and cross-friction massage. These can be used in conjunction with the elbow braces to tackle your condition from multiple angles.
As a physical therapist and a person on his own fitness journey, these are the most common injuries that I’ve come across with patients and myself. They’re not always debilitating, but when you work hard on your fitness goals, these kinds of injuries can have a tendency to set you back or even stop you altogether.
Part of my role as a clinician is to offer tools for patients to be able to manage these conditions themselves. There are far more injuries that can happen to new and recurring fitness enthusiasts that I haven’t covered here, but these six injuries tend to be the most common.
Ultimately, my advice for avoiding injury is simple:
Listen to your body and its aches and pains.
Warm up! And make it as activity-specific as you can.
Don’t get down on yourself if you have to modify your exercises/activity. And if you’re struggling with modifications, ask an expert, physical therapist, or certified personal trainer to point you in the right direction.
If you do end up with pain and it’s more than you can handle, go see a medical professional immediately. Your overall health is more important than pushing through a workout.