Consider my patient Kathy Muglio, 45, from Brewster, N.Y., who took a hard landing on the concrete poolside surface while teaching Aqua Zumba two years ago. She felt pain in the soles of her feet, and over time developed severe plantar fasciitis (an inflammation of the connective tissue in the feet). Her condition worsened because of the prolonged standing required by her day job as an operating-room nurse, and she came to see me. She decided to drop Aqua Zumba and stick with the regular version and continues to teach it four times a week.

But she’s aware of the potential health hazards.

“Zumba often attracts women who have never worked out before,” she says. “Some are overweight, and many have never learned how to squat or lunge properly. They don’t always lift their feet in the dance steps, so their hips or knees go in one direction while their feet stay put.”

Indeed, some of the more common Zumba injuries are meniscal tears of the knee, which occur when the knee joint moves in one direction but the foot remains behind. “The twisting movement takes a degenerative meniscus and causes it to tear,” explains Joel S. Buchalter, M.D., a clinical assistant professor of orthopedic surgery at the New York University Hospital for Joint Diseases and co-director of the Orthopaedic Institute at Putnam Hospital Center, both in New York. His practice has also seen a number of patients—including three Zumba instructors— with knee injuries requiring surgery, tears in the hip labrum, hip bursitis, ankle sprains, shin splints, heel spurs, and lumbar strain injuries from Zumba moves.

How to stay safe

So what can you do to avoid the risks and still have some fun? Here are 10 tips.

1. Prepare for class. Zumba instructors select dance steps from a variety of styles, including salsa, samba, merengue, hip-hop, tango, and belly dancing. Take a prep class that teaches the basic moves or a beginner’s Latin-dance session before you show up at your first class. And if you’re a baby boomer, try to find a Zumba class geared toward your age group.

2. Find an experienced instructor. Any enthusiast can receive basic certification after completing just a one-day course. Before signing up, research your teacher’s experience and the extent of his or her fitness or dance certification. Muglio, for example, is a licensed Zumba instructor who is also certified by the National Academy of Sports Medicine as a personal trainer and by the Aerobics and Fitness Association of America as a leader in group exercise. You’ll find licensed Zumba teachers at Zumba.com, where you can also search for classes by ZIP code and day of the week.

3. Wear the right shoes. Shoes for Zumba should have few or no grips on the soles so you can pivot easily without sticking to the floor. Dance shoes with pivot points allow multidirectional movement, Muglio says. Don’t wear running shoes, which are made for forward—not side—movement, Buchalter notes. People who wear them for Zumba are at a higher risk for hip, knee, and ankle injuries. It’s also important to find flexible shoes with the right amount of arch support.

4. Avoid the wrong floors. Makeshift Zumba studios have sprouted in converted church basements, school auditoriums, office buildings, and strip-mall storefronts. But not all floor types work well. Be wary of unforgiving surfaces such as concrete, concrete covered with a thin layer of wood, or floors with hard tiles, and avoid carpeted surfaces. Muglio, who used to teach on a carpeted surface in a small gym, saw her share of twisted ankles and torqued-knee injuries from shoes sticking instead of gliding on the floor. Hardwood floors, which provide a certain amount of give, offer a good venue for Zumba. But they still can get damp from sweat, humidity, or wet soles. (I found that out the hard way when I fell flat on my butt doing a merengue!) Be sure to test your glide before you start, and mop up your area if needed.

5. Ditch the crowds. Zumba requires a healthy amount of physical space so that people don’t injure others with high-velocity movements like boxing punches or chorus-line kicks. Crowded classes can lead to injuries, bumps, and falls. Check out multiple facilities and various times of the day to find which classes are least congested.

6. Stretch after your workout. Recent research suggests that stretching before a workout may actually hinder performance. The best time to improve flexibility and posture is after class, when your muscles are warmed.

7. Warm up and cool down. A good warm-up will help raise your body temperature, work your muscles, and reduce soreness afterward. A brief cool-down consisting of of lighter physical activity will help bring down your heart rate, respiratory rate, and body temperature. Zumba instructors often use music with a slower beat (as in the first half of “Proud Mary” vs. the last) as the initial and final song to accomplish those goals.

8. Hydrate. You’re likely to perspire a great deal and can become dehydrated quickly. So bring a bottle of water and stop for frequent sips. Humidity can add to your risk of passing out. Watch for lightheadedness and stop if you feel faint.

9. Modify those moves. Use common sense and avoid dangerous moves, even if the teacher and your neighbors are doing it. I avoid any ones that involve high leaps (it’s called an “insanity diamond jump” for a reason!). And if my heart rate gets too high or I feel short of breath, I substitute low-impact side-to-side or front-to-back moves. A good instructor will demonstrate lower-intensity alternatives and tailor the class to participants’ level of performance.

10. Consult your physician. As with any high-intensity cardio exercise, it’s best to see your doctor before you begin, especially if you have heart disease or kidney disease, asthma or emphysema, high blood pressure, arthritis, osteoporosis, or disk herniations.