Avoiding exercise injuries

Most exercise injuries come from doing too much too soon, from poor technique or from tired muscles. A gradual build-up, a warm-up and enough rest prevent the majority of them, and most minor injuries can be treated at home.

Preventing injury

• Build up gradually: distance, weight and intensity are increased a little at a time over weeks, and only one of them at once.
• Warm up: at least six minutes of gentle movement before harder effort, as the NHS recommends.
• Learn the technique: a session with a qualified instructor or coach when taking up weights, running or a new sport.
• Wear the right shoes: footwear suited to the activity and replaced when worn.
• Rest: at least one easier day after a hard one, and enough sleep. Tired muscles are a common cause of sprains and strains.
• Vary the activity: mixing different kinds of exercise spreads the load across the body.
• Use protective equipment: helmets, pads, mouthguards and lights where the activity calls for them.

Soreness or injury?

A dull ache and stiffness in the muscles one to three days after unaccustomed exercise is normal and passes without treatment. The motto "no pain, no gain" is misleading. Pain that is sharp, comes on suddenly, is felt in a joint, or persists and worsens during activity is a signal to stop.

Exercise is stopped at once, and medical help sought, for chest pain or tightness, severe breathlessness, dizziness or faintness, or palpitations.

Sprains and strains

A sprain is a torn or twisted ligament, common at the ankle, knee, wrist and thumb. A strain is an overstretched or torn muscle. Both cause pain, swelling, bruising and weakness. For the first two to three days the NHS advises the steps known as PRICE:

• Protection: guarding the injury from further harm, with a support if needed.
• Rest: stopping the activity and keeping weight off the injury.
• Ice: an ice pack or a bag of frozen vegetables wrapped in a tea towel, for up to 20 minutes every two to three hours.
• Compression: a bandage around the injury during the day.
• Elevation: keeping the injured part raised on a pillow as much as possible.

Heat, alcohol and massage are avoided for the first couple of days, since they increase swelling. Once the pain allows, the area is moved gently so that it does not stiffen. A pharmacist can advise on painkillers and on ibuprofen gel.

Most sprains and strains feel better within about two weeks. Strenuous exercise such as running is avoided for up to eight weeks, and a severe injury can take months.

When to get help

• 999 or accident and emergency: a crack was heard at the time of the injury; the limb is misshapen or at an odd angle; it is numb, tingling, cold or discoloured.
• NHS 111 or an urgent treatment centre: the pain or swelling is severe or getting worse; the injured leg cannot take weight; there is a high temperature or shivering.
• A GP or physiotherapist: the injury is not improving with home treatment.

Head injuries

Anyone who may have concussion after a blow to the head stops playing immediately and does not return that day, however well they feel. Loss of consciousness, repeated vomiting, confusion, a fit or worsening headache after a head injury need emergency care.

Returning to exercise

Activity is resumed at a lower level than before and built up again in stages. Returning too soon is the commonest cause of repeat injury. Fluid needs are covered under hydration and exercise, and warm-ups under stretching and flexibility.