Fact: Exercise is one of the most beneficial things a person can do for their mental, physical, and emotional health. Still, there is some risk of injury—and research shows that the risk stands whether an individual is working out on their own or in a group, lifting weights or hitting cardio machines.
While it’s important to be aware of this reality, it doesn’t mean injury is an inevitable outcome for anyone who regularly hits the gym. On the contrary, knowing which injuries are most common amongst exercisers, and how to prehab against them, can help keep you safe and sweating without interruption for years to come.
Ahead, experts break down the four most common workout injuries they see—and share the exercises, stretches, and lifestyle changes that can help protect you against them.
1. Shoulder Injury
Most exercises that target the shoulders (think jerks, shoulder presses, strict presses, and thrusters) require that you press your arms overhead. Unfortunately, not every athlete gunning for boulder shoulders has the prerequisite shoulder mobility to safely press weight overhead, according to exercise physiologist and certified strength and conditioning coach Sharon Gam, Ph.D., C.S.C.S.
If you cannot easily access the range of motion necessary to go overhead, your body forces itself into suboptimal positions in order to allow you to complete the movements you’re trying to complete. Over time, this can lead to shoulder injuries, such as shoulder impingements or rotator cuff tears, which account for up to 7.5 percent of all athletic injuries each year.
The good news: It is possible to improve your shoulder mobility, and thus help protect yourself from shoulder injury, through end-of-range of motion work. Incorporating the “I’s, Y’s, and T’s exercise,” which involves laying on your belly, hovering your arms up over the ground, and moving them through those varying positions, into your warm-up is a good place to start, says Gam. She recommends completing 10 rounds of the three-shape sequence before getting to work.
Read More: 6 Ways Bad Posture Affects Your Body Long-Term
Incorporating three sets of 10 scapular pull-ups and 30-plus-second bar hangs a few times a week can be helpful, too, Gam adds. Both exercises target the tiny, often under-utilized muscles in the shoulders that support both strength and mobility.
Since the phrase “if you don’t use it, you lose it” definitely applies to mobility, it’s also important to get in the habit of accessing your full shoulder range of motion as often as possible, Gam says. Meaning, even outside of the gym. “A simple strategy for this is to mark a ‘reaching spot’ in a doorway in your home or work,” says Gam. “Put a sticky note at the top of the doorway and reach up to touch it every time you pass through. Make sure to use both arms or alternate arms each time you reach up to touch the spot.”
2. Shin Splints
All too many runners—roughly three million each year—are familiar with the sharp, stabbing sensation that marks shin splints. A condition caused by the inflammation of the muscles, tendons, and other connective tissues along the shin bone (the tibia), shin splints are painful, and in some cases debilitatingly so.
Shin splints are typically caused by a variety of sub-optimal running conditions occurring at once, according to online performance and nutrition coach Seamus Sullivan, C.S.C.S. “Running too far, too fast, striding with suboptimal form, wearing improper footwear, and cross-training with additional types of high-impact exercises all increase your risk for exercise-induced shin splints,” he says.
If you’re returning to running after a reprieve, do not jump (or sprint!) right back into it. “Make sure to create a good foundation before starting to log lots of mileage,” Sullivan says. As a general rule, you shouldn’t increase your weekly mileage by more than 10 percent at a time. “You also want to make sure you have shoes that are well-suited for your feet,” he adds.
Beyond that, Sullivan also recommends prepping your body for your run by walking backward for two to three minutes before each workout. “When you walk backward, reach back with your toe and roll through your foot to your heel,” he explains. This primarily works the shin muscles. By calling on these muscles and their surrounding tissues to work in a low-intensity setting, you promote blood flow to the area, which can help protect it from injuries like shin splints once you turn up the heat.
After your backward walk, he suggests walking 50 yards on your tiptoes, walking the same distance on your heels, and then doing three sets of 10 tibialis raises (which involve leaning your back against a wall in a quarter-squat and raising your toes off the floor while keeping your heels planted). “Tibialis raises strengthen the tibialis anterior muscle, which runs along the shin bone,” explains Gam. This sequence should prime your body well for the work ahead.
3. Pulled Hamstring
If you want to get fast or strong, odds are you’ve added explosive movements like box jumps or posterior chain exercises like deadlifts into your lower-body day rotation. No doubt, these exercises are a great way for building power and speed, as well as overall athleticism. However, they are also the exercises during which an individual is most likely to pull a hamstring, according to Gam.
Pulled hamstrings—which make up 12 to 16 percent of all injuries in athletes—occur when the massive muscle on the back of your thigh gets stretched beyond its capacity, explains Gam. Certain movements inside the gym can exacerbate the risk of this injury, but so can the amount of time people spend sitting outside of the gym. “Sitting puts your hamstring in an extended position at the hip,” she says. “Over time, this changes your pelvic tilt angle and can cause your quads and hip flexors to get tight, your glutes to become inactive, and your hamstrings to become overstretched and overworked.” Combine that with trying to explosively contract your hamstrings during a workout and you’re on the fast track to injury.
Read More: Do’s And Don’ts For Dealing With A Pulled Muscle
The solution here is not to forgo compound lifts and explosive movements. Instead, Gam recommends adding more movement to your non-gym hours and spending more time warming up ahead of your workout. These days, most fitness trackers and watches can be programmed to remind you to get up and move (with a little buzz), so getting one could be a good investment for someone trying to live a more active lifestyle, she says.
From there, “before you lift, sprint, or do other plyometrics, you want to warm up properly,” says Gam. Warming up will help prepare your body to access a greater range of motion so that you’re less likely to be pushed past the range of motion you can safely access in the heat of your workout. “Standing leg swings and inchworms are both good movements for warming up your hamstrings,” she suggests. Leg swings involve simply standing on one leg and swinging the other forward, then repeating on the opposite side. Inchworms, meanwhile, involve bending over into a forward fold, walking your hands out into a high plank position, and then walking them back in. Gam recommends doing 10 reps of each exercise before training.
4. Knee Pain
The knees are another common site of exercise-induced injury, with a whopping quarter of adults complaining about knee pain. The knee is an intricate joint, surrounded by a number of ligaments, bones, and muscles that work together to allow you to move and groove, stand and sit, and more. As such, there are a number of things that contribute to knee pain and injury, according to Gam.
“When trying to figure out what the issue with the knee is, it’s best to start by looking at the quadricep muscle,” which is the muscle along the front of the upper leg, she says. When the quadriceps muscle is tight, it can create a pulling sensation on the patella, known colloquially as the kneecap. During and after exercise, this pulling can create knee pain, Gam explains. Meanwhile, if the quadricep muscle is too weak to complete the exercises you’re trying to complete, the body forces the knee to compensate, which can also lead to inflammation in the knee joint.
Read More: The Importance Of Supporting Your Joints—At Any Age
Thankfully, “there are a lot of different quad exercises that an individual can add into their warm-up and workout routine to help with knee pain and prevent knee injuries, such as wall squats and isometric squat holds,” according to Gam. In both movements, you’ll get into the bottom of a squat and hold— ideally for up to a minute each. By keeping the muscles used during squat variations (like the quads) under tension for a long period of time, these movements contribute to greater strength gains following recovery, explains Gam. Typically, “the stronger the quads are, the less likely an individual is to have knee pain,” she says.
Gam also likes quarter-squats with leg reaches, which help strengthen the quads, glutes, and calves all at once. To try them, start standing with your feet turned slightly out and your core activated. Lower yourself into a shallow quarter-squat position. (You can hold onto something solid for balance if you need to). Holding that position, shift your weight onto one leg, then reach the foot of your other leg forward and tap the floor directly in front of you. Then tap the floor out to your side, then behind you. Repeat for a total of 10 to 15 rounds, then do the same with the other leg, she instructs. From there, your quads should be primed and better able to protect your knees throughout whatever workout lies ahead.