When you end up in a physical therapist’s office, it’s usually because you’ve veered too far to one extreme: too much movement or not enough. That pain in your hip could be from back-to-back tennis games over the weekend or from too many hours on a couch.
In many cases, it’s not the bouts of sitting or the burst of activity that started the problem, but the accumulation of daily habits.
“I just wish people would understand that too much too quickly causes injury,” said John Gallucci Jr., a New Jersey-based physical therapist. “They get off the couch, off the chair, out of the office or out of their car and run to a pickleball court.”
Here are six things physical therapists say you can do to shake up your routine to keep moving while preventing or avoiding injury.
Treat your physical therapist like your dentist.
Most people wait until they have pain before calling a P.T. But Amy Kimball, a physical therapist and an assistant professor at the University of Iowa, recommended yearly checkups for everyone to assess how you feel and get advice. Depending on your insurance plan, you may not need a doctor’s referral to see a physical therapist.
For example, if you want to run a 5K, a P.T. can evaluate your stride or offer a strength training routine, Dr. Kimball said. Your physical therapy plan should also evolve as your strengths and weaknesses change, said Heather McGill, a physical therapist in San Francisco.
“If you’re still doing the same five exercises that you were doing five years ago,” she said, “something’s not working.”
Practice HIIT in moderation.
High intensity interval training can be very good for you, and it’s become popular in recent decades. But doing it many days in a row doesn’t give your body enough recovery time, which can lead to injury and burnout.
“If people would stop doing boot camp five to seven times a week, I would not have a job,” said Julia Rosenthal, a physical therapist and orthopedic specialist in New York City. “You’re persistently stressing out your nervous system without any ability to recover, and then you’re wondering why you don’t feel so good.”
She recommended doing high intensity classes no more than a few times a week.
When starting something new, build gradually each week.
Alyssa Skala, a professor of physical therapy and orthopedic surgery at Wash U Medicine in St. Louis, said she’s seen too many people rupture their Achilles’ tendon when they go from a sedentary life to an intense game of basketball one Saturday.
“They’re jumping, they’re sprinting to go get the ball,” she said, and “their tissue is not just not ready for that load.”
If you’re embarking on a new exercise program or sport, start slowly and increase gradually, Dr. Skala said. Her rule of thumb is 10 percent per week, whether that’s distance, frequency or weight.
“Let your joints, your muscles and your flexibility adjust,” Dr. Skala said.
Use your non-dominant hand for everyday tasks.
Another simple suggestion that Dr. McGill gives to her patients is to increase how much they use the non-dominant side of their bodies. If you’re right-handed, try holding your phone or your mouse in your left hand.
That’s because your dominant hand isn’t just stronger than the other, it’s also under more strain and so at greater risk for injury, she said. Using the other side of your body shares the work. Dr. McGill has found it especially helpful for people experiencing wrist or elbow pain — common among golfers.
Approach chores like a workout.
When autumn rolls around and people start cleaning their gutters, Dr. Gallucci knows he will see people with hamstring and Achilles strains from going up and down a ladder. He recently got a call from a 61-year-old friend who’d spent his Saturday planting more than a hundred flowers.
“His knee hurt, his back hurt,” Dr. Gallucci said, “his wrist hurt from twisting the shovel.”
A better approach, he said, would be to treat chores like a class at the gym, and divide them up over time — four or five days for a bigger job — to let your body become accustomed to the work.
Think about which muscles the task will use and the length of your typical exercise session and plan to work for no more than an hour or two at a time without a break.
Don’t rely on stretching to fix muscle tightness.
Many people think when their muscles feel tight, they need to stretch more. While there’s nothing wrong with a little stretching to loosen up in the morning, it often doesn’t address the underlying issue. (Plus, most experts recommend a dynamic warm-up instead of static stretching before exercise.)
In fact, in some cases, it could lead to more tightness, said Dr. Rosenthal. Some people who are especially mobile might feel tight because their muscles are working hard to provide stability. For others, the discomfort might be caused by fatigue or from the muscles tightening around an injured area, called muscle guarding.
“Stretching alone doesn’t fix that and can sometimes increase irritation,” Dr. Rosenthal said.
She said if stretching feels good, you can do it after a workout, but if your muscles constantly feel tight it might be better to check in with a physical therapist or work on strength training.
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