Daily exercise is something that medical professionals recommend for nearly every individual. However, as there is with any form of activity, there is always a potential for injury. These injuries can vary from the most common and acute forms such as strains and sprains to more serious injuries that often have long-term consequences such as fractures and tendon rupture. The good news is that most people can minimize their risk of injury, notably with proper preparation and by simply listening to one’s body. Listed below are a few simple steps to keep you injury-free during your workout.

One of the most frequent causes of workout injuries occurs when someone foregoes a “warm up” and “cool down” period before beginning and when ending an exercise routine. Allowing the body to warm up before exercise allows your blood to begin flowing which increases circulation to your muscles and loosens joints. Doing this prepares the muscles for the activity that will follow, thus preventing injury. Warming up the body can be done by simply exercising at a slow pace for the first few minutes of the workout followed by a gradual increase. A low-intensity exercise like walking is not only an excellent way to warm up, but it is also a great way to allow the body to cool down after a period of exercise. The “cool down” period allows your heart rate and body temperature to safely decline and eventually return to its normal resting state.

Perhaps the most widespread workout myth that attributes to workout injury is stretching cold muscles to begin a workout routine, in place of a proper warm up. It is important for one to work on flexibility, stretching at least twice a week. However, one should always stretch after their warm-up or following a period of exercise. These are excellent times to not only prevent injury but to also gain flexibility. Just remember to hold stretches for no longer than 30 seconds and do NOT bounce while you stretch. This form of stretching can result in a pulled muscle (or muscles) if you accidentally stretch the muscle too far, too fast. It is unsafe and should be avoided.

Choosing to perform certain types of lower-intensity exercises, particularly for beginners, is less likely to cause injury than more difficult, higher-intensity workouts such as running, heavy weight lifting, or contact sports. Don’t push your body too hard, too quickly. Doing an exercise that is too strenuous for your fitness level will most certainly result in an injury.

Remember to always utilize safety equipment (helmets, mouth guards, proper footwear, etc.), be certain that all equipment fits properly, and is the appropriate equipment for your sport or activity in order to greatly reduce your risk of injury. You wouldn’t wear open-toe sandals to play a game of soccer! Furthermore, be sure to always read and follow any directions found on exercise equipment.

Do not disregard the importance of proper exercise form. Learning the right way to do an exercise or sport is key to preventing injury. Consult an exercise professional if you are unsure about how to perform a particular exercise or are performing an exercise for the first time.

Microtrauma injuries result from repeated use, otherwise known as overuse, of muscles, tendons, ligaments, joints, and bones. These injuries involve small tears in the fibers and tissue of the muscles, as well as overstretched tendons, sprained ligaments, and strained muscles. Many overuse injuries can be extremely serious and lead to chronic, long-term health issues. To help prevent these types of injuries, switch up your workouts, allowing yourself to use a different set of muscles each day. Even within the same workout, be sure to avoid repeating the same motion too many times.

While becoming physically fit requires one to push themselves in order to build strength and endurance, it is important to push yourself slowly and gradually. If you are feeling fatigued, try to limit the number of days in which you exercise, the intensity of the exercise, or the length of time in which you exercise. Don’t forget to rest between workouts! You should never feel pain when exercising and if you do, stop the workout right away and contact your doctor. Get to a hospital or call 911 right away if you feel any pain in your chest during or after exercise or feel you have any other serious injury such as a broken bone, bleeding, or dislocated joint.

Don’t forget, if you have not been active, have a health condition or any other concern, always talk with your health care provider before beginning an exercise routine to ensure that you are healthy enough for exercise. Additionally, ask your doctor about the types of exercise that would be best for you and your individual needs.

Daily exercise is something that medical professionals recommend for nearly every individual. However, as there is with any form of activity, there is always a potential for injury. 

You push off the ground to sprint, or you change directions too quickly and you feel a snap in the back of your leg. The pain is extreme and you cannot continue. This brief moment where you took your body passed its limits may have resulted in a hamstring strain.

A hamstring strain can range anywhere from the detachment of a few muscle fibers to the complete rupture of the muscle.1 The hamstring is divided into three muscles on the back of the thigh: the semimembranosus, the semitendinosus, and the biceps femoris. The hamstrings begin in the glutes and descend down the back of the leg and cross the knee. The hamstrings assist in hip extension and knee flexion. A hamstring strain is one of the most common injuries in the thigh, and the head of the biceps femoris is the usually the site of injury.

There are three levels of a hamstring strain. A grade 1 hamstring strain is characterized by a tear of less than 20% of the fibers in the hamstring.[1] A grade 2 hamstring strain occurs when approximately 70% of the hamstring fibers are torn.1 Finally, a grade 3 hamstring strain is the result of a tear of greater than 70% of the hamstring fibers.[1]

Sports Commonly Associated with Hamstring Strain:

Hamstring strains can occur due to quick movements, changes of direction, or over-stretching. The sport most commonly associated with hamstring strains is sprinting in track and field. Soccer, gymnastics, football, basketball, running, hurdling, and plyometrics are all sports associated with hamstring strains.

Quick movements that accentuate the muscular imbalance between the quadriceps muscles and the hamstring muscles have been known to cause hamstring strains. The hamstrings should be 60-70% of the strength of the quadriceps muscles.1 Additional causes of hamstring strains include tired muscles, poor posture, leg-length discrepancy, or tight hamstrings.

The hamstring muscles function to help decelerate the leg during high kicks or the beginning of a sprint. Sudden changes of directions or beginning exercises too quickly are often causes of hamstring strains. Additionally, a lack of flexibility or a lack of warm up can predispose and individual to this condition.

The symptoms of hamstring strains are dependent on what level of injury has occurred. Grade 1 hamstring strains present with muscle soreness during movement. They also demonstrate point tenderness. Often times these strains cannot be identified until after activity and are characterized by muscle spasm and pain.[1]

A grade 2 hamstring strain is a moderate hamstring tear and is characterized by a snap, tear, or pop. Severe pain and a loss of function along with an inability to flex the knee will be evident in this type of injury. This strain will be very painful and can be identified nearly immediately after occurring.[1]

A grade 3 hamstring tear results in temporary disability and bruising. There is extreme swelling, tenderness, loss of function, and there will be a large balling up of the muscle or a palpable gap in between the muscle fibers.[1]

The best way to prevent hamstring injury is to warm up completely prior to activity and to participate in a regular stretching routine. Warm up prior to activity should be in the form of a 5-10 minute cardiovascular exercise at a mild intensity along with dynamic stretching (or stretching while moving). After activity, the athlete should participate in static stretching.

The other way to prevent hamstring injury is to complete strengthening exercises in order to maintain a balance between the strength of the hamstrings and the quadriceps. This balance allows the body to move in a more efficient manner and limits the stress between the eccentric and concentric contractions.

The initial treatment of a hamstring strain is to prevent swelling and bruising. The use of ice can help to decrease cell metabolism and therefore limit swelling. An Ace-Bandage can be used and wrapped from the knee up toward the hip, over-lapping each portion of the bandage by half.

Gentle stretching is important for the healing of the hamstring strain. Initial stretching can be done with the athlete lying on his or her back with a strap of a towel wrapped around the foot of the injured leg. The athlete can then use the ends of the towel to gently pull the leg into the air until a stretch is felt. The stretch should not be painful. After the initial phase of healing, stretching can become less conservative.[2]

Hamstring strengthening should not begin until the injury is outside of the initial healing phase and strengthening should not cause additional pain. In order to limit the reoccurrence of hamstring injury, strengthening can occur as a preventative measure. A single leg RDL (Russian Deadlift) can be completed by standing on one leg and, while keeping the back straight leaning forward and lifting the other leg behind. This exercise can be done with and without weights. Other exercises such as glute bridges and deadlifts can be used to strengthen the hamstrings.

1. Prentice, William E. Principles of Athletic Training: a Competency-Based Approach. McGraw-Hill, 2014.

2. Higgins, Michael. Therapeutic Exercise: from Theory to Practice. F.A. Davis Company, 2011.

Although walking happens to be one of the safest forms of exercise, it can sometimes result in injury. Although most people are under the impression that walking has a very little potential of resulting in injury, both beginner and avid walkers often suffer from ailments ranging from sore muscles and feet to more debilitating conditions like broken bones and torn muscles. According to a University of Pennsylvania Medicine study, women over the age of 65 happen to have a greater risk of injury while walking. Regardless of if you are walking for health, for leisure, or for competition, many of the injuries that can occur while walking are avoidable with the proper knowledge and awareness.

Perhaps the part of the body that is most affected by walking and exercise are the feet. As the absorbers of our weight, our feet can cushion up to one million pounds of pressure during a single hour of vigorous exercise. While walking and running, they support nearly double our body weight! It is not difficult to recognize why our feet are highly susceptible to injury. 

The plantar fascia is the tissue that runs along the bottom of your foot from the heel to the toes. Plantar fasciitis, also known as walker’s heel, occurs when the fascia is strained and becomes painful where it is attached to the heel bone. The repetitive activity of walking puts stress on the heel and related tissue triggering pain. You may be experiencing plantar fasciitis if you find yourself feeling a stabbing sensation in the heel of your foot. Pain may also be experienced when the sole of the foot is stretched. You can test this by pulling your foot and toes back towards your chest.

Not to be confused with plantar fasciitis, when intense strain is placed on the Achilles tendon, the tendon that connects the calf muscle to the heel bone, it may result in a condition known as Achilles tendinitis. Achilles tendonitis begins as an ache in the heel and gradually escalates to a more intense sensation, particularly in the area between and including the lower calf and heel. These types of injuries are more likely to occur if you walk on hill-like terrain. When walking either up or down hilly terrain, you are more likely to place greater emphasis on your forefoot to gain grip and control which pushes your heel to drop too low inside your boot. Pain that results from Achilles tendonitis can range from mild to severe and affects the sufferer even when performing day-to-day activities.

As with many other walking ailments, problems with feet often begin with the shoes. It is necessary for your shoes to fit properly in order to avoid blisters. Shoes that are too tight or too loose will almost always cause problems with the feet. To ensure that shoes fit properly, be sure that there is a half-inch space between your longest toe (usually the first or second toe) and the end of your shoe. Be sure that slight movement of your toes is still possible inside of the shoe. Your heel should not slip out of your shoe when you walk. Likewise, you should always wear socks that fit your foot properly, without being too tight or too loose. Choose soft wicking fabric and avoid cotton, as it absorbs moisture and can be quite rough in texture. However, if you do happen to find yourself with blisters, follow these tips to help heal as quickly as possible.

It is highly likely that every person has or will experience back pain at some point in their life. Lower back pain, in particular, is one of the main reasons for doctor visits. For adults over 40 years of age, it ranks third as a reason for doctor visits, only following heart disease, and arthritis. Thankfully, ninety percent of people who experience low back pain for the first time get better in a period of two to six weeks. Only seldom do people with low back pain develop chronic back problems. However, lower back pain, no matter the cause, can make walking uncomfortable. Disc injuries and muscle function issues can place pressure on the sciatic nerve which also may cause back pain while walking. It is necessary to have the root cause of back pain properly evaluated, as different injuries call for different treatments and approaches. While walking is sometimes recommended to relieve back pain, encourage weight loss, and improve posture, walking for any reason aside from necessity should be avoided until the underlying problem is determined.

Although walking is certainly easier on joints than many high impact activities; it is not without its own set of problems. Overexertion, overuse, walking on hard surfaces, and overpronation are some of the most common reasons for knee-joint pain. Overpronation occurs when your foot rolls inward after descending and continues to roll when instead, the foot should be pushing off of the ground, twisting the foot. Subsequently, this causes pain in the shin and knee. You can know if you happen to be overpronating because you will find that your shoes may show excessive wear on the inner side. Also, they will lean inward if you set them on a level surface.

Be careful when choosing a walking surface and be aware of your walking speed and intensity in order to avoid injury. The most ideal surfaces are even and firm, but not an overly hard surface such as concrete whenever possible. If you must walk on a harder surface such as concrete, be sure to wear well-cushioned shoes. Keep in mind that hilly terrain can also cause stress on the joints and hiking boots should be worn whenever walking on this kind of terrain. As for pace, a good key to remember is that your walking pace should cause you to feel winded while speaking but not so much that you begin to struggle for air. Always listen to your body and walk at a pace that is comfortable.

Similar to knee-joint pain, shin splints occur when a person dramatically increases their workouts or exercises on the pavement, making the injury common with avid walkers. Aching shins is a very common complaint for new walkers. It can also be a problem for walkers increasing their speed or distance. Shin pain is caused by too much stress on weak shin muscles. Symptoms can include throbbing, tenderness, and aching from below the knee to the ankle. The pain is normally worse early in the morning and at the beginning of your walk, and can gradually get better as your walk progresses.

To prevent shin splints, start all workouts with a warm up by walking at the beginning of each walk. You should also perform ankle circles by rotating the ankles and perform toe points by pointing the toes then flexing the foot in order to loosen your muscles. Do these exercises several times each day and stretch your calves, shins, and Achilles tendon after every walk. Don’t forget to replace your shoes as needed and as mentioned earlier, be sure to choose the right shoe and proper size for your foot. Additionally, avoid concrete when possible.

Perhaps one of the more serious injuries on this list is the hip and joint inflammation that some walkers experience, also known as bursitis. Bursitis is a painful condition that affects the small, fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near your joints as they move against each other. Bursitis occurs when these sacs become irritated and inflamed and put pressure on nearby tissue. Bursitis typically occurs near joints that perform frequent, repetitive motion or are overused, which is why this problem can be found in avid walkers. 

If you have bursitis, the affected joint might feel achy or stiff, feel tender when you move it or press on it. The area will often appear swollen and red. One may also feel a sharp pain when attempting to use the affected joint. Treatment for bursitis ordinarily involves resting the affected joint in order to protect it from further trauma. For most people, bursitis pain fades away within a few weeks with rest and proper treatment. To prevent bursitis, always remember to warm up, stretch, and take frequent breaks during exercise.

As is typical with any workout injury, if you ever feel you are experiencing any of the conditions listed above or any others, consult your doctor with your concerns or seek emergency treatment if you are experiencing severe pain or discomfort. Your doctor can help to ensure that you are exercising appropriately based on your personal health and medical history.

Although walking happens to be one of the safest forms of exercise, it can sometimes result in injury. 

Do you participate in a running or jumping workout routine? Has your knee pain gradually gotten worse? Does your knee hurt every time you push off the ground for the next step or leap? You might be suffering from patellar tendinopathy.

Patellar tendinopathy is a term that classifies most patellar tendon injuries including patellar tendonitis and patellar tendinosis. The patellar tendon sits just below the kneecap (patella) and helps to connect the kneecap to the top portion of the ‘shin-bone’ (tibia). The tendon allows the kneecap to move correctly and allows the knee to straighten efficiently.

Patellar tendinopathy occurs when the tendon becomes swollen due to an external force or overloading on the tendon. The swelling occurs as an attempt for the body to heal the tendon through extra blood rushing to the injured area. Unfortunately, in many cases, the patellar tendon lacks good blood supply and the tendon cannot receive the blood that it needs in order to heal. In this case, the tendon begins to degenerate.

Sports Commonly Associated with Patellar Tendonitis:

There are a variety of sports and workouts that can bring on patellar tendinopathies. It is common to see patellar tendinopathy in running sports, jumping activities, weight lifting, volleyball, cycling, basketball, gymnastics, and soccer. Out of all of these sports, jumping activities are the most common culprit for bringing on this type of knee pain.[1]

The main causes of this condition include a sudden increase in activity, repeated force on the knee, weak quadriceps muscles, weak gluteus muscles, and repetitive movements. The condition usually comes on over time and has a gradual onset. A blow to the knee or an external force exerted on the knee may cause a rapid onset of pain.[1]

Additionally, abnormal alignment or poor biomechanics may exasperate the tendon and cause a tendinopathy. A maligned extensor mechanism or a mal-tracking patellar are just a few examples of anatomical features that can predispose an individual to patellar tendinopathy.

There are many sources of knee pain. Understanding the symptoms is the first step to diagnosing the condition. Symptoms of patellar tendinopathy include pain on the tendon, pain when touching the bottom portion of the kneecap, painful and weak quadriceps, pain with the knee fully bent, and pain when extending the leg. Additionally, the tendon may appear slightly swollen and the patient might feel clicking or popping when bending and straightening the knee.[1]

MRI is the best way to diagnose a patellar tendinopathy. Diagnostic ultrasound can also be used in order to rule-in the condition. Extreme cases of patellar tendinopathy can be detected on X-ray images, however this is not common.[1]

The best way to prevent patellar tendinopathy is to be a well-rounded athlete. Spend time cross-training in order to develop the quadriceps, hamstrings, and gluteus muscles. It is also important to increase activity gradually and follow a progressive training plan. Icing the knee after workouts can help to limit swelling and ultimately delay the onset of the condition.

Ultimately the best treatment for this injury is rest. Most athletes, however, struggle with this concept. Ice will help reduce the swelling of the knee and help restore range of motion. TENS units have also been seen to reduce pain.

Some basic hip stretching includes the Thomas stretch and the Figure 4. The Thomas stretch can be completed by lying on your back and pulling one knee to your chest while keeping the other leg straight. The Figure 4 stretch is also done lying on your back. The athlete will bend one knee to 90 degrees and put the other ankle over the knee. The athlete will then pull the knee toward his or her chest.

The most important type of strengthening for patellar tendinopathy is eccentric training. Standing on a slanted surface with your toes pointing down the ramp, stand on the leg that is injured. Begin the exercise by lowering yourself down into a single-leg squat. When you feel that you have gone as far down as you can comfortably go, place the other leg on the ground and stand up using both legs.

Additionally, hamstring and gluteus strengthening can benefit the athlete with knee pain.2 One example would be to lay on your back with a Swiss ball under your feet out in front of you. Use your glute muscles to lift your back off of the ground. Once you are in a straight line with your shoulder blades touching the ground and your feet on the ball out in front of you, bend your knees so that the ball comes back and underneath you. Return to the starting position and continue the exercise.

1. Starkey, Chad, and Sara D. Brown. Examination of Orthopedic & Athletic Injuries. F.A. Davis Company, 2015.

Patellar tendinopathy is a term that classifies most patellar tendon injuries including patellar tendonitis and patellar tendinosis.

It’s happened to almost everyone. One wrong step and you might find yourself on the ground holding your ankle. Actually, an ankle sprain is the most common injury in the athletic population. Since it’s so common, it’s important to understand what it is and how to take care of it.

The ankle is a complex joint comprised of the tibia, fibula, and talus. Many ligaments help to connect one bone to another bone in order to give the ankle stability. There are ligaments on both the inside and the outside of the ankle. The most commonly injured of these ligaments is the anterior talofibular ligament.1 This ligament sits toward the outside and the front of the ankle and attempts to prevents the ankle from falling inward.

An inversion ankle sprain is the most common form of ankle sprains.1 These types of sprains occur when the foot falls inward and the ankle rolls outward Eversion ankle sprains (the foot rolling outward) are less common due to the fact that the fibula helps prevent this motion. Ankle sprains can also occur when the ankle is pointed or flexed beyond its normal limits.

Sports Commonly Associated with Ankle Sprains:

Ankle sprains can occur in any sport, which is one of the reasons they are some of the most common injuries. Ankle sprains occur most commonly when an athlete is performing on unstable surfaces. Ankle sprains are common in soccer, football, sand volleyball, lacrosse, field hockey, gymnastics, and trail running.

Ankle instability is the main cause of ankle sprains. While ligaments work to limit movement, sometimes ligaments become relaxed and cannot perform their normal function. Additionally, after one ankle sprain, the ligaments have more laxity and the likelihood of chronic ankle sprains increases. About 1/3 of all first time ankle sprains become chronic due to the increase in laxity of the ligaments.[1]

In addition to instability of the ankle, uneven surfaces often lead to ankle sprains. Uneven surfaces force the ankle into positions that cause greater instability. Objects such as stray athletic equipment are also known for excessive sprains as athletes will step on the equipment and their ankle will be forced into an unnatural position.

The symptoms of an ankle sprain are pain around the anterior talofibular ligament, pain when pointing the toes and pointing the toes inward. The athlete may report the sound of a pop when the injury occurred. There will be swelling and bruising all throughout the ankle.[1]

An ankle sprain will best be diagnosed with an MRI (magnetic resonance image). Ultrasound imaging may also be used in order to rule out other injuries. If the athlete is still experiencing pain after two to four weeks of treatment, the athlete should request an X-ray.

The best way to prevent an ankle sprain is to strengthen your ankles. While the job of ligaments is to prevent motion beyond the body’s normal limits, ligaments can stretch and fail. The musculature surrounding the ankle assists the ligaments in keeping the ankle stable and in the correct place. Strengthening can occur naturally by completing your sport or workout. It can also be done through specific exercises and workouts.

Another way to prevent ankle sprains is to tape your ankle. While many people do not advise taping your ankle for every workout because it hinders the natural strengthening process, taping your ankle for competition or only when exercising on unstable surfaces can prevent ankle sprains and therefore prevent laxity within the ankle capsule.

Modalities are especially important in the acute phase of an ankle sprain. The goal of the initial treatment plan is to decrease pain and inflammation. This can initially be done with ice in order to decrease cell metabolism. A contrast bath (switching the ankle from hot water to cold water) can help to create a nature pump within the body through the dilation and constriction of blood vessels. Additionally, an ACE-bandage can be applied to the area beginning the wrapping at the toes and move up passed the ankle.

Stretching should not be completed until pain is limited and most of the swelling has been removed from the area. Stretching of the ankle can be completed by looping a towel or strap around the ankle and pulling back toward the body. Stretching of the calf and muscles on the back of the leg should also be completed by stepping into a lunge and leaning into the forward foot.

Strengthening after an ankle sprain can begin as soon as the athlete feels capable. The pain with strengthening should not be excessive, however, the athlete can begin very soon after injury. In the initial phases of strengthening the athlete can simply point and flex the foot slowly in order to strengthen and restore range of motion. As strengthening progresses the athlete can add some sort of resistance such as a Thera-Band and move the ankles in all directions. Finally, in the end stages of rehabilitation, the athlete can complete balancing exercises such as standing on one leg in order to increase strength and proprioception.

Ankle sprain is the most common injury in the athletic population. Since it’s so common, it’s important to understand what it is and how to take care of it.

If you workout you’ve probably heard the term “shin splints” at some point or another. How do you really know if you have shin splints or if you’re just sore or suffering from some other affliction? This condition has some very telltale signs that can serve as instant red flags that you might be doing something wrong in your workout routine. Read on to find out if you might actually be suffering from this all too common condition.


Technically speaking, ‘shin splints’ is a common term used to describe “nondescript leg pain.”[1] It is very broad and doesn’t narrow the scope of injury to a great degree. Shin splints can be associated with lower leg tendinopathies, periostits, tibial stress fractures, fibular stress fractures, exertional compartment syndrome, inflammation, entrapment, muscular tear, deep vein thrombosis, or medial tibial stress syndrome. [1] This being said, if you have officially been diagnosed with ‘shin splints’ you need to seek a more official and narrower diagnosis. Medial tibial stress syndrome is one of the most common injuries that fall under the colloquial phrase ‘shin splints.’

Medial tibial stress syndrome (MTSS) is inflammation of the periosteum on the inside of the tibia (shinbone). [1] The perosteum is a thick and fibrous covering of the bone and is rich in sensory nerve endings. The large amount of nerve endings can make the periosteum extremely painful. Additionally, if MTSS is left untreated it can progress into stress reactions, and finally stress fractures.

Sports Commonly Associated with Medial Tibial Stress Syndrome:

Running is the sport most commonly associated with this form of shin splints. In fact, medial tibial stress syndrome account for nearly 15% of all running injuries.[1] However, MTSS is a chronic or overuse injury and can be associated with any weight bearing sport. Other sports that are commonly associated with MTSS or shin splints are soccer, football, basketball, hockey, or volleyball. Repetitive jumping or conditioning on inclines and declines can also flare this condition.

Shin splints an overuse injury and is caused by an overload in training beyond that of which the body can regenerate. It is often caused by training on hard surfaces such as asphalt or gymnasium floors. It is also caused by increasing training load too quickly, shoes with poor support, or structural abnormalities.[1] Women are more likely to experience medial tibial stress syndrome than men and are more likely for it to develop into stress fractures. Stress fractures, while occurring due to a variety of factors, can be linked to disordered eating, amenorrhea, and osteoporosis (female athlete triad).

Additionally, an athlete with overly pronated feet is predisposed to medial tibial stress syndrome or shin splints. [1] Foot pronation is a condition that occurs in individuals with flat feet. When the foot is weight bearing the arch of the foot collapses and causes the ankle to shift inward. This biomechanical abnormality causes increased strain on the tibia and increases the likelihood of developing this condition. Foot pronation can be observed, tested in the navicular drop test, or even be directly measured by a professional.

An individual experiencing shin splints will describe a gradual progression of pain without a specific moment of onset. The pain will cover an area along the inside of the shinbone (tibia) of greater than 5 cm.[1] If the individual has a stress fracture, the pain will be much more pin pointed. Repeated pointing of the feet or flexing of the toes will reproduce symptoms. Stretching the toes may also cause pain.[1]

The progression of MTSS generally follows a routine pattern and can be the main sign or indicator of the condition. The pain will first appear at the beginning of the workout but subside during activity and return after.1 Over time, the pain will continue to bother the athlete at the beginning, during, and after the workout. The pain may eventually even occur at rest and in most severe cases will continue during the night.

Prevention of shin splints is fairly simple and can be accomplished through appropriate rest and equipment. Training should progress at a comfortable and steady pace. An athlete should avoid huge training shifts and jumping into increased mileage too quickly. As a general rule of thumb, a 12% increase of training per week is the most an individual should ever attempt, however, each individual is different and should work directly with a coach or physician for more individualized training plans.

Working out on softer surfaces such as tracks, dirt, or grass can also limit the chances of developing shin splints. An athlete should be proactive about purchasing new shoes and should not allow the support of the shoe to diminish before switching to a new pair. Finally, an individual with over pronation should seek out orthotics or shoe inserts.

In addition to rest and exercise modification, modalities with antiinflammatory properties can benefit the athlete. Ice is the easiest way to decrease inflammation. The use of an ice pack or ice frozen in a Dixie cup for ice massage can work wonders for the athlete with shin splints.

The athlete with MTSS should stretch the muscles of the back of the lower leg.[2] This can be done using a slant board. With the toes facing up the board, allow the heel to touch the ground. This should be done with the legs bent and straight as to target different muscles. The same stretch can be accomplished with a lunge stretch or the ‘downward facing dog’ stretch.

Strengthening exercises for MTSS and shin splints can be controversial because this is an overuse injury. Non-weight bearing strength exercises such as ankle pumps or ankle 4-way using plastic tubing or a therband are the best way to continue strengthening without causing more symptoms. The athlete needs to listen to his or her own body and only participate in strengthening exercises that do not reproduce symptoms.

If you workout you’ve probably heard the term “shin splints” at some point or another. How do you really know if you have shin splints or if you’re just sore or suffering from some other affliction?

Do you have back pain? Do you experience a sharp and shooting pain from your back all the way down the back of your legs? Is the pain the worst in the morning? You might be experiencing a herniated disc.

In the spinal column, each vertebra is cushioned with a pad or disc that cushions the joint. Each disc has an annulus or a thick outer portion with multiple rings of cartilage and a gel-like center called the nucleus. The discs function as shock absorbers and allow for movement. A herniated disc occurs when a small part of the disc’s nucleus pushes out through a tear in the outer-layer.

Herniated discs can occur anywhere in the spine, however, it mostly commonly occurs in the low back between lumber vertebrae 4 and 5.1 There are three types of herniated discs. A prolapsed disc occurs when the disc moves completely through the outer portion. An extruded disc occurs when the disc moves far enough out of the joint space that it comes into contact with the spinal cord. Finally, a sequestered disc occurs when the disc breaks apart and begins to migrate.[1]

Sports Commonly Associated with Herniated Discs:

The sport most commonly associated with herniated discs is weight lifting due to the stress placed on the spine while bending. Other sports associated with herniated discs are basketball, volleyball, throwing (in track and field), golf, hockey, football, field hockey, and gymnastics.

Herniated discs often occur when an athlete bends forward and twists.1 Forward bending places a stress on the front of the disc as the spine compresses the disc. Twisting places a shear force and compression on the side of the disc, therefore pushing the disc in the opposite direction. Finally, an added load, from addition weight, or excess body fat can cause axial compression.

Herniated discs are often associated with the saying “lift with your legs and not with your back.” When an athlete lifts using the muscles of his or her back it can cause a muscular strain, a sprain, or a herniated disc. Herniated discs can progress over time.

Herniated discs result in sharp, centrally located pain.1 The pain may be present on only one side of the body and it will go down the buttocks and down the back of the leg.[1] The pain will be the worst in the morning when the patient first steps out of bed.1 The initial loading from going from a horizontal to vertical position will increase the pressure on the disc and cause pain. Bending forward and sitting for long periods of time will cause pain. Bending backwards will limit pain.

The athlete will have a posture that is slightly bend forward and the athlete will bend to the opposite side of the disc herniation. The area around the vertebrae will be painful to touch. Actions that cause a Valsalva manuveur (coughing, sneezing, or bowel movements) will increase pain.[1]

The best way to prevent a herniated disc is to maintain proper core strength. All athletes should participate in core exercises that help to strengthen from the hips all the way up through the shoulders. Proper time should be spent to strengthen the abdominal muscles, the back muscles, and the oblique muscles. Through the development of core muscles, pressure is taken off of the back and the chances of a herniated disc decrease.

Additionally, extra care should be taken while lifting heavy objects. The athlete should bend from the knees and lift by standing rather than moving their back. The athlete should also avoid twisting while under load.

Modalities are best used for herniated discs in order to limit pain and increase functionality.[1] Ice will help to reduce inflammation and cause an analgesic effect. Electrical stimulation through a TENS unit will help to limit pain through the activation of the Gate Control Theory and turning off pain receptors. Traction will also help to create space between the vertebrae and reduce pain.

Stretching can be very helpful to reduce pain and improve the condition. Stretching can be achieved through extension exercises. The most basic of these exercises is the cobra stretch. The athlete should lie on his or her stomach and push up using his or her hands. This will cause back extension and help to open space between the vertebrae.

Strengthening can help to both prevent and heal herniated discs. Strengthening that causes pain should not be completed. Bird-dogs are among some of the best exercises for athletes with herniated discs. The athlete should begin in the quadruped position and lift the right arm and the left leg straight out while maintaining balance. This can be completed in repetition. Another exercise that is beneficial for herniated discs are dead-bugs. The athlete will lay on his or her back with their arms and legs straight up in the air. The opposite arm and leg will then be lowered in opposite directions.

Workout Injuries