Doctors and physical therapists say they often see patients during the early part of the year with injuries—some of them serious—stemming from New Year’s resolutions. Not only can such injuries lead to expensive medical bills, they may also waste cash shelled out for fitness gear and gym memberships.

“People tend to get super excited when they make their resolutions,” said Dr. Derek Ochiai, an orthopaedic surgeon in Arlington, Va. “But going from zero to 60 in a workout regimen can set you up for a lot of problems.”

Injuries from exercise and exercise equipment sent 459,978 people to the emergency room in 2012, according to the Consumer Product Safety Commission.

The most common over-training injuries often relate to common foot and ankle tendinopathies which present with an insidious onset of pain over the affected tendon that worsens with sustained activity. Pain is usually described as dull at rest, and sharp with the aggravating activity.

Diagnosing Overtraining & Lower Limb Tendinopathies

Plain Radiography (X-ray) is recommended as the initial imaging study. Results are usually normal, but the study may reveal calcification of the tendon, osteoarthritis, or a loose body. Further imaging should be considered if the patient fails to respond to conservative management, the diagnosis remains unclear, or there is pain out of proportion to the injury. Musculoskeletal Ultrasonography can show areas of tendinosis and is useful for obtaining a dynamic examination. Magnetic resonance Imaging (MRI) also provides good images of tendon pathology, especially if surgical evaluation is being considered.

Some Top Tips to Prevent Tendinopathies:

• Choose the right footwear- In part, a big step is making sure you have the right shoes for the physical activity you perform. More than that, though, you want to pick models that cushion the heel and have robust arch support. These features will protect your feet from several common overuse injuries.
• Start out slow- When you begin a new workout program, or decide to increase the intensity of an existing one, make sure you do so gradually. Jumping into intense activity too quickly puts the body at risk for injury.
• Cross-train- Help avoid the risk of doing too much high-impact work by incorporating low-impact activities like swimming, cycling, and yoga into your weekly exercise plan. Besides lowering your injury risk, you will also develop better overall levels of conditioning.
• Warm up and stretch- Prior to physical activity, take time to warm up properly and do some dynamic stretching.
• Don’t push through injury- “No pain, no gain” is an antiquated idea. If you are hurt, give your body time to recover. This will keep you safe, prevent re-injury, and reduce the odds of developing a long-term problem.
• Ask for help- “Get a trainer to help you, or even just some advice from a gym employee on how to properly use the equipment,” said Dr. Shari Liberman, an orthopaedic surgeon at Houston Methodist Hospital in Texas. Bad posture or form while exercising can up the risk of injury, she said, as can using equipment set up for someone of a different height.