Sports injuries don’t all happen “by accident”. Read this before you sign up for a race, join the latest trending group class, or go all out at HIIT.
When it comes to fitness, the “no pain, no gain” mantra doesn’t apply when the pain is sharp and/or debilitating. You may have progressed from “I’m too lazy to work out” to “What workout should I do today?” – good on you! – but always remember to err on the side of caution especially when in doubt. That usually happens when you’re trying something new or challenging. Below are three real case studies of women who have injured themselves through various sports and workouts, complete with physios’ perspectives and advice on how to minimise sports injuries.
Doing a race? Respect the training journey
In 2013, *Chloe made a New Year’s resolution to complete one race a month. As a hobby triathlete, the challenge would keep her training regularly and help her instill a work-life balance. She completed all races without a hitch, but a couple of weeks later, she found herself with a strained IT band after a routine trail run.
She brushed it off as punishment for not cooling down, but the pain lingered for weeks. After numerous physiotherapist sessions, an MRI was ordered and a hip labral tear – the soft tissue covering the socket of the hip – uncovered. *Chloe had two choices: continue physiotherapy to manage the pain and increase strength, or undergo surgery if her goal was to remain active. She chose the latter. After a month on crutches, she started exercising again, this time with a focus on doing strengthening work to support her injured hip and long-term fitness goals.
As it turns out, *Chloe’s injury was part structural – the MRI revealed her left hip socket to be compromised possibly since young – and part degenerative from excessive activity, coupled with weak glute strength. What didn’t help were her sporadic (often solo) training sessions which left her ill-prepared, overcompensating and struggling to finish some of the harder races.
Her story is not unusual. With the popularity of endurance sports, HIIT workouts and obstacle races, working out is no longer solely about fitness – it’s become a lifestyle where the fun and social elements can take precedence over actual physical capability. “People forget that exercise is a stressor and recovery is equally, if not more important,” cautions UFIT’s senior physiotherapist David Lee, who advises being realistic and gradually working towards one’s goals.
“Building slowly also gives you the opportunity to add other aspects to your training. Recreational athletes, particularly endurance athletes, tend to neglect the strength and conditioning. By upping your volume and intensity slowly, you can add sessions such as swimming for cardiovascular fitness without the load on joints/tendons, or weight training to strengthen muscles, joints and tendons.”
What *Chloe could have done differently: Part of the fun of endurance racing is the community aspect, pre-and post-race. Joining a dedicated group like Coached, UFIT and MetaSport will keep one (beginner or otherwise) accountable and motivated to train more consistently, plus it’ll likely be at a pace that’s comfortably challenging. Also, having the proper guidance from coaches (many of them ex-pro athletes) will help to reduce the chances of injuries happening.
Going for group classes? Know your limits
While injuries are more likely to occur when engaged in more intense exercises, it can happen to anyone especially if there’s a hidden pre-existing condition. David singles out achilles and gluteal tendinopathy, plantar fasciopathy and lateral knee pain (or ITB syndrome) as some of the most common injuries he’s seen, conditions which often go undiagnosed.
For *Jo, wearing grippy socks to a barre class (instead of sports shoes that were required) combined with “weak muscles and tendons” – as pointed out by her physiotherapist, post-injury – and a warm-up exercise that required jumping resulted in a torn anterior cruciate ligament (ACL), a key ligament that stabilises the knee joint.
Post-surgery, *Jo’s weekly physical sessions now focus on rehabilitation exercises – knee extensions, leg presses, heel raises, shoulder bridges, and cycling on a stationary bike – to “regain quad and hamstring control and strength” as part of a long term ACL-regeneration and recovery process.
While her accident was one-off, according to Chng Chye Tuan, senior principal physiotherapist at Core Concepts, individuals should pay attention to the intensity level of any exercise, especially if they’re new to the sport. “When engaging in sports, it is important to ensure that the intensity increases gradually. A good guide would be an increment of roughly 10 to 20 per cent each week – intensity is generally affected by factors such as frequency, duration, type of exercise and resistance level,” says Chye Tuan.
What *Jo could have done differently: As it was a barre class, *Jo’s decision to wear socks was not incorrect. Had she known she was predisposed to an ACL injury, she would have opted out of the warm-up exercise, or asked the trainer for a modification. A good way to gauge if a class is suitable for your physical abilities is to sign up for a trial class or foundation session, as the pace will be tailored for beginners so the core, basic moves and safety procedures can be mastered and observed.
Class-hopping? Watch your form
The popularity of boutique gyms, fitness festivals, and subscription options like ClassPass means there’s now ample (and sometimes free) opportunities to try all sorts of exercises, regardless of ability. While variety is a plus, it inadvertently leads to class and exercise hopping, which can distract you from establishing proper form – be it in a pilates class, CrossFit or a HIIT session.
While not new to exercise, *Lea injured her lower back during a HIIT class. “During the kettlebell lift, I did not bend my knees as I was rushing. That resulted in the weight and pressure going straight to my lower back instead,” shared *Lea, who eventually discovered she had a mild lower disc tear. Three years on, she exercises regularly but observes a low-impact workout routine, avoiding classes that involve high-impact moves to reduce the chance of a repeat injury.
“Your body needs to be conditioned to a state where it can cope with the physical stresses placed on it. If stressed too much or too fast, the body may fail to cope, resulting in injury,” says Chye Tuan, adding that poor form is a signal that the individual is struggling to cope with the activity.
“Understand that your body’s fitness levels may not always be the same, so avoid rushing into training when your body may not be ready. An attempt to compensate for poor strength with other muscle groups can lead to altered movement patterns which can cause injuries and complications over an extended period.”
What *Lea could have done differently: While it’s hard not to feel overwhelmed by countdown screens and timers, focusing on the quality of a rep instead of the quantity will reduce the chance of injury. For beginners, it’s best to avoid scale-up options, and to go at your own (slower) pace till you’ve become familiar with the exercises.
The last word on sports injuries
So, is the solution to stay on the couch in order to dodge injuries? “The difficulty when it comes to injury prevention is there is no one proven factor. You can reduce chance, but not prevent,” says David.
“Exercise should be a lifestyle choice, very similar to dieting. If you want to try something new, great, but take your time. If someone was starting from scratch to run a marathon I would often recommend building for 12 to 18 months or even longer. It is not to say they couldn’t do the marathon earlier, but the slow build in your chronic load would likely reduce the risk of injury.”
*Names of the interviewees have been changed for privacy issues.