Just because you have done the same thing over and over dozens of times with no problem doesn’t mean you can never get hurt. A recent study showed that there are several factors that might help to pinpoint the trigger that leads to an episode of acute back pain. Forget about the obvious culprits like a bad mattress or heavy lifting.

Manuela Ferreira, Ph.D., associate professor at the George Institute for Global Health at Sydney Medical School in Australia, and author of a research study published in Arthritis Care and Research, stated, “Psychological and lifestyle factors play a far greater role than people realize. Perhaps our most surprising finding is that even a brief exposure to certain factors can trigger a problem, whether you have a history of low back pain or not.” Getting regular exercise to stay strong and limber can help prevent lower back pain. But, when you do exert yourself, know about these risk factors for injury:

1. Distraction

Watching television or chatting on the phone while working out can lead to inattention and potential injury. Ferreira stated, “When you exert yourself and don’t pay attention, chances are you will do something that is not biomechanically correct, such as carrying a load too far from your body or not distributing your body weight appropriately.” Being distracted while exerting yourself may increase your risk of back pain by nearly 25 times the normal amount.

2. Fatigue

When you are excessively tired, it’s not always a good idea to work out. Fatigue can cause your muscle tone to be lower and it can also compromise your core strength. Wolf Mehling, M.D., associate professor in the department of family community medicine at University of California at San Francisco states, “Muscles may also not be as quick to adjust to your movements.” This can make your back vulnerable to injury, because you are lacking support and stability. Take some time to rest when you are exhausted, rather than pushing through a workout.

3. Too early

During the hours we are sleeping, the discs located within our spine will swell with fluid. This helps to explain why our backs may be more vulnerable to pain and strain in the morning. Although this is not a good reason to skip the morning workout, you should be very careful about your form and make sure you are stretching and doing a good warm up and cool down.

4. Are you being cautious enough?

As it turns out, older adults are less likely to get hurt while doing manual labour than younger folks. Mehling explains that this might be related to the fact that younger people tend to feel more invincible. He states, “One possible explanation is that young people have the general mindset that they can do anything. Older adults, on the other hand, may already know their limits and move more carefully.” Older adults may also have been instructed regarding proper lifting procedures and be more likely to use them. Ferreira states, “If you want to avoid a problem, you have to watch your posture and the weight of your loads no matter how brief your exertion is…no matter how old you are. Low back pain is the number one cause of disability in the world, and knowing its triggers is key to preventing it.”

So, while you already know some of the big things that can lead to back injury, be sure to keep these factors in mind when you are trying to avoid injury.