For many families, playing touch football on Thanksgiving is as much a part of the holiday as feasting on turkey. However, sports medicine specialists warn, when out-of-shape revelers peel themselves off the couch and amble onto a makeshift backyard gridiron to do battle with younger relatives, it can be a recipe for a world of hurt.

Doctors say with the annual Turkey Bowl tradition comes a predictable spike in injuries, including sprains, contusions, fractures, pulled hamstrings and ligament and ACL tears (injuries to the anterior cruciate ligament, the elastic band of connective tissue that makes the knee joint stable).

If kids get injured, they tend to wind up with wrist or ankle fractures. Middle-aged men who aren't used to jumping, cutting and running, particularly on wet and uneven surfaces, are more likely to suffer ACL injuries, according to Pietro Tonino, MD, chief of sports medicine at Loyola University Medical Center in Chicago.

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“We see a lot of people injured because they're doing something they would never envision doing the rest of the year,” says Tonino. “They are getting together with their families, trying to impress them with how athletic they are, when they aren’t athletic the other 364 days of the year.”

For would-be Thanksgiving football players ready to take the field, doctors say using common sense is the best way to keep from getting hurt.

“Understand your limitations and don’t drastically increase the level of activity you are doing,” said Nirav Pandya, MD, assistant clinical professor of orthopedic surgery at the University of California, San Francisco. “It’s not a good idea to play football for two hours if you are someone who works out for 30 minutes once a week. Go out, have fun, be physical with your family. Just don’t overdo it.” Here's what else he and other safety experts say will prevent you from being sidelined.

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Train for the game. If you know you’ll be playing football on Thanksgiving but you've been a couch potato lately, start preparing at least several weeks before game day. “A professional baseball player who hasn't played for three months isn't going back into the game without doing anything,” said Charles DeFrancesco, a personal trainer, author and education director for the National Federation of Personal Trainers. “He’s going to work out for a few weeks before he plays again. If he doesn’t, the first time he runs down the firs tbaseline he’s going to pull his hamstring.”

Warm up. The one way weekend warriors should emulate professional football players is by taking the time to warm up: This will help reduce the risk of injury. Jog or walk at least 15 minutes before playing. (Some experts also advise stretching, although it's unclear whether this prevents injuries.)

Suit up properly. Wear loose shirts and sweat pants you can move freely in. In cold weather, add layers you can peel off as your body heats up.

Survey the field. Uneven surfaces, stray rocks and holes can be a source of injuries. Before the game, walk the field and identify any potential hazards. Remove them if you can; if not, find a safer place to play.

Save drinking for after the game. Don’t drink beer or other alcoholic beverages before or during the game. Stick to water or Gatorade, which will keep you hydrated and won’t fuel bad decision-making. Alcohol can cloud your judgment and give you an inflated sense of your athletic ability, which might lead to injury.

Don't be tempted to tackle. The hard hits of tackle football will increase your risk of injury, particularly if the strapping young men of the family try to imitate what they see on TV.

Skip the heroics. If you do get hurt, walk off the field and call it a day. Playing while injured can turn a minor injury into something major. If you haven't had enough football for the day, there’s always the video game console. But before you play, remember to stretch your thumbs.

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Daniel S. Levine is an award-winning journalist who heads the Levine Media Group and hosts The Bio Report and RARECast podcasts. He was an editor of The Burrill Report and worked for the Oakland Tribune, Adweek, the San Francisco Business Times and other publications.