How to prevent tweaks, strains and tears caused by tennis, running and other popular workouts

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One thing that holds people back from physical activity – aside from busy schedules, family obligations and aging – is the fear of getting injured. For any weekend warrior, an injury can be a major setback not just to their workouts but everyday life as well. Back pain at the office makes it hard to sit for extended periods. A bad knee makes it difficult to stay mobile. Shoulder injuries cause challenges when picking things up.

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Wanting to avoid injury is understandable, but being too sedentary also has its health impacts.

A paper from the Canadian Fitness and Lifestyle Research Institute and the Canadian Parks and Recreation Association noted that physical inactivity in Canada accounted for an estimated $3.9-billion in direct and indirect health care costs in 2022. Canadian Partnership Against Cancer reported that physical inactivity contributed to nearly 11,000 new cancer diagnoses in 2021.

According to Statistics Canada, less than half of adults are getting the recommended 150 minutes of “moderate to vigorous aerobic physical activities” suggested each week. Weighing the pros and cons of potential health risks against potential injuries, it’s obvious we should all be trying to move more. And safeguarding yourself against some common injuries while exercising is easier than you think.

Here, medical experts and trainers from across the country share their best practices for preventing and recovering from common tweaks, strains and tears caused by some of our favourite workouts.

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Swimming and shoulder injuries

Swimming for distance or speed requires strength in your upper and lower body, decent cardio and a bit of technique. While exercising in the water is gentle on your joints – and small studies have suggested it may be good for recovery, with a swimming-based recovery session enhancing athletic performance the next day among triathletes – pushing too hard or breaking from your form can lead to unwanted results. Particularly when it comes to the shoulders.

“When things are feeling really good people build confidence. But it doesn’t necessarily mean your body can actually handle that next level of intensity,” said Ronald Castro, a registered massage therapist with Swimming Canada. A study in the Journal of Athletic Training found that shoulder pain was a major issue for competitive swimmers, with 91.3 per cent of adolescent participants reporting problems. Rates were lower in adults, but the problem can persist. “It’s easy to just go at it when swimming, but you also have to create programs where you can strengthen and stabilize muscles,” said Castro.

Since 2009, Castro has worked as an RMT with Canadian swimmers in 19 different countries, including stints at the Pan American Games. The baseline advice he gives to top performers also applies to amateurs: Break down the stroke into smaller movements to ensure proper form and to address smaller muscles to ensure nothing is straining or overly compensating.

Standard exercises to get and keep your body strong for swimming include external and internal rotations. “Those just really help stabilize the humerus inside the shoulder blade,” said Castro. That looks like holding your elbow at a 90-degree angle and turning your arm away from or toward the body. He also suggested negative push ups, neck stretches and using a foam roller for your lats. For anyone who has already experienced a shoulder injury, on a broad stroke level, those exercises can also help when trying to rehab, though it’s always best to consult an expert, such as a sports doctor or RMT, to assess and help treat consistent pain.

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Knee strain while running

Running is one of the most accessible forms of exercise. It requires next to no equipment and you can do it basically anywhere. But that simplicity can also lull people into a false sense of security that running is always easy.

“People don’t think about running as the final product,” said Dr. Dinah Hampson, a physiotherapist who worked as part of the core medical team during the 2016 Olympics and recently served as Canada’s chief therapist for the World University Games. “You need the ingredients there. You need proper footwear. You need proper strengthening. You need proper links of muscles in order to accomplish good running.”

Issues while running can manifest as knee pain, something that often arises from overuse. Hampson suggests anyone new to running should start out with a walk/run program. Canada Running Series offers a Couch to 5K plan, which starts by alternating between walking for one minute and running for one minute. While you get in motion, add strength training to target the hip musculature.

“The knee falls victim to being above the ankle and below the hip. … If there’s any deficiency above or below, it’ll impact the knee in the middle,” she said. According to the doctor, working the gluteus medius muscles can help safeguard against injury. “If they’re not strong, then what happens is you collapse into the hip. Then the knee internally rotates and you end up with knee problems.”

Workouts targeting hip abduction are a good place to start. A simple exercise to add in is crab walks, putting a small elastic loop band around the knees and walking from side to side. To avoid injury, gradually ramp up the speed and distance rather than immediately jumping into the proverbial deep end. And if you’re hurting, don’t push it.

“Pain should go away within 24 hours. If it doesn’t and you wake up the next day with things still painful and it’s swollen, that’s a really good time to reach out to your local health care practitioner.”

Tennis elbow during racquet sports

A 2018 study from the Mayo Clinic showed that playing tennis resulted in a nearly 10-year increase in life expectancy compared with a sedentary lifestyle. Even participating on an amateur level has an upside. It’s great for cardio. It’s social. It requires balance, co-ordination and reflexes. Still, anyone who’s suffered from prolonged tennis elbow might be less keen to sing its praises.

“Tennis elbow happens because of the repetitive strain that is concentrated over a relatively small surface area,” said Dr. Rob Wang. Wang has a specialty in orthopedic sports medicine and serves as the co-chief tournament physician for the National Bank Open. Tennis elbow causes pain on the outside of the elbow, forearm and back of the hand. The injury is common in many racquet sports including pickleball and squash.

Overuse is the major cause, said Wang. But things such as technique and your equipment are also factors.

Because of how the racquet absorbs the ball and how much energy you’re exerting by holding your equipment, the weight, balance and rigidity of a racquet can all contribute to injury. Any specialty tennis store will be able to suggest a good racquet based on your habits and playing style. For example, a racquet with a slightly heavier handle can help with shock absorption. If there isn’t a specialty store in your area, a number of online surveys, such as Findmyracket.com, are available.

Wang said that players should be conscious of the frequency and intensity of their sessions, making sure to get a good warm-up. Wrist rotations and towel twists – twisting a towel in opposite directions like you’re wringing out water – can be helpful to prep your muscles for activity. Rehab generally involves a lot of rest and limiting activities that exacerbate the pain, which can include time away from the courts.

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Back pain after weightlifting

Strength training is one of the best things we can do for ourselves as we age. It helps maintain muscle mass and contributes to fighting obesity. But the gym can be intimidating, especially if you’re not familiar with how to use free weights or machines. Lifting too heavy or picking something up the wrong way can be a major strain on your back.

“More often than not, it’s someone kind of jumping in and doing a movement that they’re not necessarily ready to or haven’t been exposed to for very long,” said Alex St. Pierre, a former strength and conditioning coach for the University of Toronto lacrosse team and practising chiropractor. St. Pierre notes that deadlifts and squats are major culprits for back injury, owing to improper form or lifting weight you’re not ready for.

He’s not suggesting that folks avoid these exercises. But finding the right trainer and investing in some lessons in the weight room can help protect your back. If there’s a cost barrier, look at small structured classes with individualized attention, such as Powerlifting Club at Toronto’s Bang Fitness or Intro to Powerlifting at Vancouver’s Sweat Co. Prices range between $15 to $45 a session.

For both rehab and warm-up, St. Pierre leans toward active mobility exercises including “bringing yourself through easy movements and working on all the ranges of motion through the hip.” Hip flexion, internal and external rotations, and hip abduction work all help support the lower back.