Sports medicine Surprise guide: why your joint aches and what to try

Check what you can still do without sharp pain

Notice whether you can walk, reach, grip, or push in your usual way. Stiffness is one concern; a joint that gives way needs closer attention.

Look for warmth, swelling, bruising, or soreness that wakes you. Those details help the doctor or nurse during an exam.

Don't keep testing a motion that brings sharp pain each time. Gentle movement may feel better than keeping the joint still all day.

Try less of the motion that starts the soreness

Cut back on the painful task while keeping easier parts of your day. A short walk or gentle bend can help the joint stay loose.

Warmth may make morning stiffness easier to move through. Cold can feel soothing after activity when the joint seems warm or puffy.

If soreness rises during an activity, stop before it becomes sharp. You won't lose all your progress by giving the joint a quieter day.

Ask what the exam says about your soreness

Bring the date the ache started and describe the movement that causes it. Old X-rays, your medicines, and care you've already tried can also help.

Ask the doctor or nurse which exam results explain the soreness. Then ask what each care choice costs and how much time it takes.

Seek quick help for a change in joint shape or weakness that comes on suddenly. Fever, chest pain, trouble breathing, or fainting can't wait for a regular visit.

Sources

1. Tendinopathy is described in the Nature Reviews Disease Primers review as a complex, multifaceted tendon pathology - disorganised collagen fibres, increased microvasculature and sensory nerve ingrowth, dysregulated matrix homeostasis, increased immune cells and inflammatory mediators, and enhanced cell apoptosis - most commonly affecting the rotator cuff, the medial and lateral elbow epicondyles, the patellar tendon, the gluteal tendons and the Achilles. The authors state plainly that management consists of exercise and loading programmes, therapeutic modalities and surgery, and that their effectiveness 'remains ambiguous'.

   Millar NL, et al. — Tendinopathy.. Nat Rev Dis Primers, 2021. DOI: 10.1038/s41572-020-00234-1.

2. Biopsies from 891 spontaneously ruptured tendons were compared with 445 tendons taken from people who had died accidentally. NOT ONE ruptured tendon had a healthy structure, and 97% of the changes found were degenerative. The same degenerative changes appeared in 34% of the control tendons - far less often - and the authors concluded that degenerative change is common in the tendons of people over 35 and is associated with spontaneous rupture.

   Kannus P, et al. — Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients.. J Bone Joint Surg Am, 1991.

3. A ten-year analysis of the US National Electronic Injury Surveillance System covering adults aged 55 and over in 12 popular non-contact and limited-contact sports found 5,561 cases, a national estimate of 287,255 injuries. Golf (22.8%), pickleball (17.0%), tennis (13.4%) and weight lifting (12.9%) accounted for most of them. Sprains and strains were most common overall (56.9%), but fractures predominated in pickleball, tennis, baseball and soccer, fracture risk rose steeply with age, and pickleball injuries increased 925% since 2014, overtaking golf as the highest-incidence sport in recent years.

   Qi A, et al. — Sports-Related Orthopaedic Injuries in the Older Athlete: A 10-Year NEISS Database Analysis.. Orthop J Sports Med, 2025. DOI: 10.1177/23259671251360439.

4. A NEISS analysis of pickleball injuries from 2012 to 2021 found 53,649 weighted cases. Players aged 65 and over accounted for 83% of injuries, though the younger group's annual rate of increase was higher. Slips, trips, falls and dives caused 64.3% of injuries. Older players were about three times more likely to sustain fractures (OR 2.96) and to be injured by a fall (OR 2.75); younger players were more likely to sustain strains and sprains (OR 1.86) from sudden stops and lunging.

   Kulkarni R, et al. — Epidemiology of pickleball injuries by age group treated in emergency departments in the United States.. Phys Sportsmed, 2025. DOI: 10.1080/00913847.2025.2539062.

5. The training-injury prevention paradox argues that non-contact soft-tissue injuries are not caused by training as such but by an inappropriate training programme - specifically by excessive and rapid INCREASES in load - and that athletes accustomed to high chronic training loads have fewer injuries than athletes training at lower loads. Under-training may itself raise injury risk. The paper proposes the acute:chronic workload ratio as a way of capturing that.

   Gabbett TJ — The training-injury prevention paradox: should athletes be training smarter and harder?. Br J Sports Med, 2016. DOI: 10.1136/bjsports-2015-095788.

6. In 25 randomised trials covering 26,610 participants and 3,464 injuries, STRENGTH TRAINING reduced sports injuries to less than a third (RR 0.315, 95% CI 0.207-0.480) and proprioception training roughly halved them (RR 0.550, 0.347-0.869), while STRETCHING showed no protective effect at all (RR 0.963, 0.846-1.095). Overuse injuries specifically were nearly halved by exercise programmes (RR 0.527, 0.373-0.746).

   Lauersen JB, et al. — The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials.. Br J Sports Med, 2014. DOI: 10.1136/bjsports-2013-092538.