Exercise safety

Regular physical activity is vital for good physical, social, and emotional health. Any activity carries some risk of injury, but the benefits of staying active far outweigh those risks. You can lower your risk of injury by warming up, using good technique, and listening to your body.

For advice on exercising safely, you can speak with your doctor, a sports medicine doctor, a physiotherapist, or an exercise physiologist. A sporting association can also help with correct technique and equipment.

General safety guidelines#

Use pre-exercise screening to find out whether you are at higher risk of a health problem during activity. This acts as a filter or “safety net” to help you weigh the benefits against the risks, and it is worth working through a self-screening checklist before starting any new program.

When judging whether an exercise is safe, consider the technique and the load involved as well as your personal circumstances, such as any previous injuries and your current fitness level.

• Be guided by a qualified fitness instructor.
• If you have a pre-existing injury or medical condition, consult a sports medicine doctor, exercise physiologist, or physiotherapist.
• Increasing the speed of an exercise can increase the risk of injury, so add speed cautiously.
• Avoid or modify any exercise that causes pain or discomfort, and don’t ignore signals of fatigue, discomfort, and pain.
• Cross-train with different sports and exercises to avoid overtraining.
• Take at least one recovery day a week, preferably two. Injuries need rest, and trying to “work through” pain damages soft tissue and delays healing.

Pregnancy#

Pregnancy brings many changes, including changes in body shape and size, that can raise the risk of injury. Because every pregnancy is different, it is essential that pregnant women discuss their exercise plans with their doctor.

When to stop immediately#

Stop exercising and seek medical help if you have symptoms such as:

• chest pain, or other pain that could signal a heart attack, including pain in the neck, pain travelling down the arm, or pain between the shoulder blades
• a very rapid or irregular heartbeat during exercise
• severe breathlessness, dizziness, or fainting

Exercises that can be harmful#

Some movements, especially fast or repetitive twisting or sustained held positions, are best avoided because they can cause damage. Safer alternatives are described below.

Bouncing while stretching#

It is a myth that “bouncing” as you stretch (ballistic stretching) helps muscles stretch further. Sudden overstretching triggers the stretch reflex, making the muscle contract harder to protect itself. Bouncing can also cause small tears that you feel as soreness or tenderness. Instead, ease into a slow, sustained stretch, and once the muscle feels comfortable, gently increase the stretch and hold again.

Standing toe-touches#

Avoid standing toe-touches. Bending down to touch your toes with straight legs can overstretch the lower back and hamstrings and stress the vertebrae, discs, and muscles of the lower back. Adding a twist makes it worse and can damage the joints. Safer alternatives include:

• Place one foot on a low bench or chair with both legs slightly bent (to avoid stressing the knees), keep your back straight, and gently reach forward with your arms.
• For a hamstring stretch, lie on your back with both knees bent, then straighten one leg towards the ceiling with the knee slightly bent, supporting it by clasping both hands behind the knee. You should feel the stretch in the back of the thigh of the straight leg. Repeat with the other leg.
• For a lower-back stretch, sit cross-legged, then slowly lean forward with a straight back, reaching your arms out towards the floor.

Deep (full) squats#

Full squats push the knee joint past 90 degrees. With or without weights, this can strain the ligaments, cartilage, and muscle of the knee and lower back, and cause problems with how the kneecap tracks. Instead:

• Perform half-squats (about a 45-degree bend of the knee).
• Use a mirror to check when your knee reaches 90 degrees, or ask someone to watch you, or get instruction from a qualified fitness professional.

Sit-ups#

Two common but potentially harmful sit-up variations are anchoring the feet (having a partner hold them) and keeping the legs straight along the floor, with the hands behind the head or neck as the upper body lifts. These strain the lower back and work the hips and thighs more than the abdomen. Avoid this style of sit-up. Instead, do abdominal curls: lie on your back with knees bent and feet flat, arms folded across your chest or by your sides, then breathe out and curl your ribcage towards your pelvis.

Double leg raises#

Raising both legs at once while lying on your back puts enormous stress on the lower back. Lying on your stomach and lifting both legs at once is also harmful. Instead, work one leg at a time, keeping your hips stable throughout and the other leg bent with the foot on the ground.

Behind-the-neck press#

Avoid the “behind-the-neck press” and the “lat pulldown behind the neck,” especially if you have been told you have instability at the front of your shoulder.

Warming up and cooling down#

Stretching, warming up, and cooling down were once thought to prevent injuries, but there is limited evidence that they do. There is some evidence that warming up and cooling down may reduce muscle soreness afterwards, even if they don’t prevent injury, and many people find a psychological benefit too: getting into the right frame of mind beforehand and relaxing afterwards. Careful stretching can be part of your warm-up and cool-down.

• Your warm-up (about 5–10 minutes) should gradually raise your muscle and body temperature and involve the main muscle groups you are about to use. Start with a low-intensity activity such as brisk walking or jogging.
• Stretch only once the muscles are warm, since stretching cold muscles is less effective.
• To cool down, slow gradually to a light jog or brisk walk over the last five minutes, then finish with 5–10 minutes of stretching focused on the muscles you used. This helps reduce soreness and stiffness.

Staying hydrated#

You can lose around one and a half litres of fluid for every hour of exercise. One of the first signs of dehydration is fatigue, which sharply reduces performance and can also lead to cramps, heat stress, and heat stroke. Suggestions:

• Don’t start exercise dehydrated; drink plenty of fluids for several hours beforehand. If you are well hydrated, you should pass a good volume of clear urine in the hour before exercise.
• Drink at least 500 ml (about 2 cups) in the hour before exercise.
• Drink at least 150 ml every 15 minutes during exercise, and use any break in play to have a drink.
• After exercise, keep drinking until you are fully rehydrated. Clear, pale urine is a good sign you are drinking enough.

Exercising in hot weather#

Hot weather puts extra strain on your body. Heat-related illnesses such as heatstroke happen when your body can’t keep itself cool, and sweating alone is not always enough. Symptoms can include cramps, irritability, general discomfort, weakness, headache, and nausea. To reduce the risk:

• Drink plenty of water before, during, and after exercise.
• Wear lightweight, light-coloured, loose-fitting clothes, and protect yourself from the sun with a long-sleeved top, full-length trousers, a hat, and sunglasses.
• Exercise in the cooler parts of the day.
• Reduce your exercise intensity.
• Take frequent breaks and drink every 15 to 20 minutes, even if you don’t feel thirsty.
• Avoid alcohol, tea, and coffee before or after exercising, as they promote fluid loss.
• If you have travelled to a hotter climate, allow about 10 days of exercising to acclimatise fully.

Exercising in cold weather#

In cold weather, muscles are more prone to injury. Safety suggestions:

• Wear appropriate warm clothing; several thin layers trap more body heat than one bulky layer.
• Spend more time warming up and stretching, and do a thorough cool-down.
• Keep up your fluid intake, as cold weather also causes fluid loss.
• Don’t forget sun protection: you can be sunburnt even in cold weather, especially at high altitude or on clear days.

Equipment and technique#

Most sports rely on equipment such as shoes, bicycles, or racquets. Protective gear such as mouthguards, shin pads, and helmets can significantly reduce injury by absorbing the impact of falls or collisions. Suggestions:

• For handheld equipment, use the right grip; for example, holding a tennis racquet incorrectly can raise your risk of tennis elbow (tendonitis).
• Make sure equipment suits your sport, size, and age.
• Wear appropriate shoes for your sport and replace them before they wear out.
• Wear protective equipment during training, not just for competition.
• Check equipment regularly and replace it when worn. If you are unsure how to maintain or check it, ask your coach or sporting association.

Injuries can also result from incorrect form or technique. Consult your gym instructor, coach, sporting association, exercise physiologist, or physiotherapist for help improving your technique.

Key points#

• The benefits of regular activity far outweigh the risks, and you can reduce injury risk with good technique, warming up, and adequate recovery.
• Pre-exercise screening is a safety net to help you weigh the benefits against the risks before starting.
• Pregnant women should discuss their exercise plans with their doctor, as each pregnancy is different.
• Increasing the speed of an exercise increases the risk of injury.
• Avoid or modify any exercise that causes pain or discomfort, and stop and seek help for chest pain, an irregular heartbeat, or severe breathlessness.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).