Even if you’ve never had an exercise-related injury, you’ve at least heard a story or two: the runner friend who trained themselves right into a stress fracture, the co-worker who strained a shoulder while trying to show off at the company softball game. It’s understandable to think of these stories as cautionary tales — after all, you don’t want to be the one who pushes themselves too hard and ends up hobbling around on crutches.
But caution can easily morph into something more like fear, driving people away from activities that they enjoy doing and toward things that seem less risky. And much of the time, less risky means more tedious, which, in turn, means more likely that you’ll end up forgoing the workout altogether. Sure, you’re more likely to get a little roughed up during a game of touch football than you are logging time on the elliptical — but if only one is actually fun enough to get you off the couch, well, that’s the one you should go for. The prospect of injury can seem scary, but letting it deter you from being active may actually be the bigger threat to your health.
Sports psychology consultant Gregory Chertok says that in his experience, fear can be a powerful force in motivating people to avoid certain behaviors. “A fear of injury will cause someone to change their habits, surely,” he says. “Maybe they only work out with someone else, or do nothing other than basic yoga, as an example.”
That’s not a knock on yoga, but if you’d rather be running around on the basketball court than planted on your mat, research suggests that you’ll have a hard time sticking to your second-choice activity, no matter how “safe” it is. “We’re likely to sustain an activity when it’s inherently pleasurable,” Chertok explains. “We keep up with activities when we enjoy doing them, rather than because we think we ‘have to’ or we feel forced into it.”
The fear of exercise-induced injury or pain may be greatest among those that most stand to benefit from regular exercise — those with chronic conditions like diabetes or back pain. In one 2011 study in the journal Diabetes Care, people with diabetes walked less than people without the disease, and were also more likely to name fear of injury as a barrier to a more active lifestyle.
Of course, the young and fit aren’t immune to similar fears, particularly people coming off a significant injury. A review paper, published last year in the journal Sports Health, found that a fear of reinjury was the most common reason why people stopped playing sports after getting hurt, even after they’d fully recovered.
The logic there is simple: We avoid things we think will hurt. And exercise can hurt even when it doesn’t lead to injury. Of course, for the novice exerciser, it may be difficult to distinguish between the regular discomfort of a workout and something more serious, like a heart attack. But research shows that the odds of actually having a heart attack during a bout of physical activity are pretty low (one study estimated that around 5 percent of all cases of cardiac arrest happened while the victim was exercising). Others may subscribe to the idea that vigorous activities like running can raise the chances that you’ll develop a joint condition like arthritis. But unless you’re a competitive runner who does more than 50 miles a week, running regularly actually lowers your risk.
According to Chertok, exercise fears can also become a self-fulfilling prophecy: If you’re stressed about your workout, you’re more likely to experience increased muscle tension and mental distraction, which can make you more prone to injury.
One key to beating that fear of injury, then, might be a better understanding of how warranted it really is. “It is important to determine if the fears are real or imagined,” says Michael Fredericson, a sports medicine physician at Stanford University. “For example, if someone has had a previous injury or known arthritis, then the fear may have a reasonable basis. If there is no clear basis for the fear, then I encourage patients to work through [it].”
Chertok believes that a little taste of success goes a long way, too. “Then you’re intrinsically motivated to set more challenging goals moving forward, goals that may help you face your fears,” he says. A little bit of anxiety in exchange for the longer-term payoff of having a workout you actually enjoy — it seems like a pretty good trade.