If you play pickleball three mornings a week, run the Ravenel Bridge on weekends, or still suit up for a rec league, you've probably had a tweak, strain, or nagging ache that cost you a few weeks. Most active adults respond the same way: stretch more, rest more, and hope it doesn't happen again.
There's a better-supported answer. Strength training is one of the most effective, well-researched ways to reduce sports injury risk. Across randomized controlled trials, programs built around strength work cut sports injuries to roughly a third of what untrained groups experienced, and more strength training was linked to more protection. For active adults over 35, it's also one of the best ways to slow the age-related loss of muscle and tendon capacity that makes injuries more likely in the first place.
The goal isn't to stop playing hard. It's to build a body that can handle playing hard.
What the Research Says About Strength Training and Injury Prevention
Injury prevention research has tested a lot of approaches: stretching, balance training, warm-up programs, and strength training. When researchers compared them head to head, strength training came out on top.
Strength training reduced injuries the most. A meta-analysis in the British Journal of Sports Medicine pooled 25 randomized controlled trials with more than 26,000 participants. Strength training reduced sports injuries to less than one-third, and exercise programs overall nearly halved overuse injuries. Balance (proprioception) training also helped. Stretching did not show a meaningful injury-prevention effect.
More strength training meant more protection. A follow-up meta-analysis by the same research group looked specifically at strength-based prevention programs in more than 7,700 athletes. It found that a 10% increase in strength training volume reduced injury risk by more than four percentage points, and the authors described the programs as safe and consistently effective across different sports and injury types.
Targeted strength work protects specific tissues. A meta-analysis of 8,459 athletes found that injury prevention programs including the Nordic hamstring exercise, an eccentric hamstring strengthening drill, reduced hamstring injuries by up to 51% across multiple sports.
Stretching still has a place. It can help you feel looser and maintain range of motion. But if the goal is fewer injuries, the evidence points most strongly toward getting stronger.
Why Stronger Bodies Get Hurt Less
Most sports injuries happen when the load on a tissue exceeds what that tissue can handle. That load might come from one fast cut on the pickleball court, or from thousands of repetitions over a summer of running. Strength training raises the ceiling.
Muscles absorb and control force. Stronger muscles can decelerate a lunge, a landing, or a change of direction with less strain on the joints and connective tissue around them.
Tendons adapt to load, too. Tendons aren't passive cables. A systematic review and meta-analysis in Sports Medicine – Open found that tendons in healthy adults become stiffer and more robust in response to training, and that higher loading intensities were more effective than lighter ones. Interventions lasting 12 weeks or longer tended to produce larger changes. That matters for Achilles, patellar, and elbow tendons, which take a beating in running, court sports, and golf.
Capacity protects against spikes in activity. In a widely cited review on training load and injury, sport scientist Tim Gabbett described how athletes accustomed to higher, well-progressed training loads tend to get injured less, while sudden, rapid jumps in activity are linked to many non-contact soft-tissue injuries. Under-training can also increase risk. For active adults, that "spike" often looks like a tournament weekend, a new running goal, or the first warm weekend of the season.
Strength training builds the buffer that lets you absorb those spikes.
Why This Matters More After 35
Strength doesn't disappear overnight, but it does decline with age, and it often declines faster than muscle size. The National Strength and Conditioning Association's position statement on resistance training for older adults notes that resistance training can counteract many of these changes and improve strength, power, mobility, and resistance to injuries and falls. It recommends training two to three times per week and states that well-designed programs with proper instruction are safe for healthy older adults.
In other words, the active adults who most need strength training are often the ones most likely to skip it in favor of "lighter" routines. As our post on why active adults benefit from strength and mobility training explains, the answer usually isn't doing less. It's training smarter.
What an Injury-Reducing Strength Program Looks Like
Not every strength program reduces injury risk equally. The research and clinical experience point to a few common features:
Progressive load. The body adapts to what it's asked to do. Weights, reps, or difficulty should increase gradually over weeks and months, rather than staying the same indefinitely.
Multi-joint strength. Squats, hinges, lunges, step-ups, presses, and rows build strength through the patterns you actually use in sport.
Eccentric work. Exercises that strengthen muscles while they lengthen, such as the Nordic hamstring exercise or slow lowering phases, help tissues tolerate the braking forces of running, cutting, and landing.
Single-leg strength and balance. Most sports happen on one leg at a time. Single-leg work builds control in the positions where many injuries occur.
Enough intensity to matter. Light bands and high-rep circuits have their place, but tendons and muscles adapt best to meaningful load.
Work that eventually looks like your sport. As strength improves, training should progress toward the speeds, directions, and demands of the activities you play, so your body is prepared for what your sport actually asks of it.
There's a difference between exercising and training. Exercising keeps you moving. Training is a progressive plan aimed at a specific outcome. If you want to dig into that distinction, read Exercising vs Training: How to Maximize ROI with Your Workouts.
Already Dealing with Pain? Strength Training Still Has a Role
A lot of active adults put strength training on hold the moment something hurts. Rest can be useful in the short term, but long stretches of doing nothing often lower your capacity and leave you more vulnerable when you return to your sport.
At Smith Performance Therapy, the approach is different: clients lift weights from Day 1, at a level that fits where they are. That might mean modified exercises, lighter loads, or working around a painful area while the rest of your body keeps training. The goal is to keep building capacity while you work back to a pain-free baseline, not to start from zero once the pain is gone. If your current routine seems to keep you stuck, our post on why your exercise program is keeping you hurt covers common reasons.
Strength Training for Active Adults in Mt. Pleasant and Charleston
Active adults in Mt. Pleasant, Daniel Island, and the greater Charleston area can play outdoors almost year-round, from pickleball and tennis to running, cycling, golf, and paddle sports. That's great for staying active, but without a natural off-season, it's easy to keep adding activity without ever building the capacity to support it.
Dr. Kevin Smith, PT, DPT, OCS, COMT, TPI Certified, is a Board-Certified Orthopedic Clinical Specialist who works with active adults and athletes across Mt. Pleasant and Charleston who want to keep doing what they love without the cycle of getting hurt, resting, and starting over. He evaluates how your body moves and builds a strength plan that fits around your sport, your work, and your life.
Frequently Asked Questions
Does strength training really prevent sports injuries?
Research strongly supports it. A meta-analysis of 25 randomized controlled trials found that strength training reduced sports injuries to less than one-third, making it the most effective prevention strategy studied. No program eliminates injury risk entirely, but strength training lowers it substantially.
Is stretching or strength training better for injury prevention?
For reducing injuries, strength training has much stronger evidence. In the same meta-analysis, stretching did not show a meaningful injury-prevention effect, while strength training and balance training did. Stretching can still help with comfort and range of motion.
How often should active adults strength train to reduce injury risk?
The National Strength and Conditioning Association recommends resistance training two to three times per week for older adults. Research also suggests that more strength training volume is associated with greater injury protection. The right dose for you depends on your sport, schedule, and recovery.
Is it safe to lift weights after 35 or 40?
For most healthy adults, yes. The NSCA states that well-designed resistance training with proper instruction is safe for healthy older adults. Starting with an assessment helps make sure your program fits your body and any injury history.
Should I stop strength training if something hurts?
Not necessarily. Many people can keep training with modified exercises or loads while they address the painful area. A physical therapist can help you decide what to adjust so you keep building capacity instead of losing it.
Where can I find strength training for injury prevention near me in Mt. Pleasant or Charleston, SC?
Smith Performance Therapy offers movement assessments, performance physical therapy, and strength training with Dr. Kevin Smith, PT, DPT, OCS, COMT, TPI Certified, for active adults and athletes in Mt. Pleasant and Charleston, SC.
Build a Body That Can Handle Your Sport
If you're tired of the cycle of getting hurt, resting, and losing ground, it's time to train for the activities you want to keep doing. Book an assessment with Dr. Kevin Smith, PT, DPT, OCS, COMT, TPI Certified, at Smith Performance Therapy, serving Mt. Pleasant and Charleston.
