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Torn ligaments. muscle pulls Overuse injuries. With every new exercise routine comes a new risk of injury, whether it’s a sprain from lifting, a sore knee from running, or a torn tendon during a calisthenics session. With an estimated 8.6 million sports and recreation-related injuries in the United States each year, these fears are not unfounded.
But before you let this fear keep you from starting an exercise routine, the good news is that most of these injuries “are related to overuse, not trauma, which means they usually don’t require surgery,” said Matthew Matava, an orthopedic surgeon and sports physician at Washington University in St. Louis.
With the proper precautions, you can complete a well-rounded exercise routine that maximizes benefits and minimizes risk of injury. To learn the exercises that make you especially vulnerable to injury, we’ve turned to sports doctors, physical therapists, and athletic trainers to get their consensus on the most common mistakes people make and how to prevent them.
Don’t round your back when lifting weights.
Rounding or rounding your back is one of the most common mistakes when lifting weights.
Start in a squat position with your spine neutral, meaning your back isn’t too arched or hunched.
The deadlift, an exercise in which the lifter begins in a squat position and pulls a weighted barbell to a fixed, upright position, is one of the most common lifts. However, its simplicity is deceptive. “Deadlifting is one of the best tools, if done correctly, and one of the most dangerous things to do if done wrong,” says Cameron Apt, an athletic trainer at the University of Rochester.
One of the biggest mistakes people make is rounding—or hunching—their backs. The deadlift begins with the lifter in a squat position, with a neutral spine (meaning the back is neither arched nor rounded), from which the weight is pulled to the thigh. During this movement, even slightly curving your spine can put excessive pressure on your lower back muscles, which in turn could make your back hurt or worse.
“It’s not even necessarily that people are in bad shape, it’s that people underestimate how dynamic and hyper-focused the deadlift is,” said Femi Betiku, a physical therapist at Riverdale Physical Therapy Center of New Jersey. “They don’t pay attention for a split second and then their back curves a little bit and then ‘Boom!'”
For those with less experience, there are a number of alternate exercises that offer similar benefits with less stress on the lower back. For example, the hex-bar deadlift, in which the wide, hex-shaped bar that surrounds the lifter reduces pressure on the lower back.
For those who want to deadlift, paying close attention to form is essential. When working with beginners, Apt often has them practice the movement without weights. “We see people for weeks before giving them weight,” she said.
It’s also key to listen to your body and adjust when necessary, especially if fatigue starts to affect your form. “There’s nothing wrong with lifting to exhaustion,” Betiku said. “It’s about being aware that ‘I’m fatigued, I have to focus on my form 100 per cent’.”
Watch your posture on bench presses to protect your shoulders and pecs
A common mistake is to slouch your shoulders and lift the bar above your head or neck, rather than across your chest.
To avoid injury, make sure your arms are shoulder-width apart, shoulder blades are tight, and lower the bar to mid-chest.
When most people think of weightlifting, perhaps the first thing that comes to mind is the bench press, in which one leans back on a bench, pressing the weight up. The bench press is so familiar that comedians from Chris Farley to YouTube star Mike Tornabene have used it to make fun of bodybuilders. But if done incorrectly, it can lead to rotator cuff injuries.
The rotator cuff is especially vulnerable because many tendons, ligaments, blood vessels, and nerves run through a narrow path, called the subacromial space, between the shoulder blade and the humerus. “It’s a very small space that’s almost like a track,” says Lauren Shroyer, an athletic trainer for the American Council on Exercise, who specializes in chronic injuries.
A common mistake is to slouch your shoulders up, almost like slouching in a chair, which can put enormous strain on this area. Shroyer says this can lead to subacromial impingement syndrome, a painful condition caused by the shoulder blade rubbing against the rotator cuff. The same can happen if the bar is lifted over the head, instead of across the chest. To avoid this, he advises making sure your arms are shoulder-width apart, shoulder blades tight, and lowering the bar to mid-chest.
Another common problem is lifting too quickly, which can lead to an acute injury, such as a torn pectoral muscle. When this happens, the lifter feels a snap, loses control of the weight, and now “one nipple points one way and the other points the other,” Matava said. “We see it a lot,” she added, often in inexperienced lifters trying to lift more weight than they can actually handle.
Pectoralis muscle tears are excruciating and tend to occur when lowering the weight to the chest. Although lowering a weight or lowering your body may seem like the easiest part of an exercise, it also creates a higher risk of injury because muscles contract and lengthen. This risk of injury is also increased because lifters feel like the hard part is done and they’re less focused, says Michael Maloney, a sports medicine physician and orthopedic surgeon at the University of Rochester. Other examples of these types of risky moves include lowering the bar to the ground during a deadlift, walking or running downhill, lowering your body during a pullup, or returning your torso to the ground during a squat. To avoid this, work to stay focused throughout the exercise.
Take into account how often you run
In his practice, Matava most often treats injuries from weightlifting and running. “Of the two, probably the one I watch the most is running,” he says. Most of these injuries are related to overuse. “In the case of running, it’s about the ‘too much’ rule,” Matava said. “Too many miles, too many climbs, too little rest.”
Strength training can help prevent running injuries. Single-leg squats (like in the video, on top of a box, for example) strengthen the quads, hamstrings, and glutes, and improve lower-body alignment and motor control. That yes: the knee must remain aligned with the foot and it is not necessary to exceed.
A common problem in runners is knee pain, specifically patellofemoral pain syndrome, often called “runner’s knee.” Runner’s knee is believed to be a nerve irritation caused by a muscular imbalance between the quadriceps, hamstrings, and hip muscles that shifts the patella. To prevent this, build up your mileage slowly and do regular strength training. The good news is that while runner’s knee is a problem, research shows that running helps strengthen the cartilage in the knees, to the point that runners are less likely to develop arthritis than their non-running peers.
For some people, it helps to warm up before running. The high knees exercise is great for speed training. But even the best warm-up routine won’t protect you from runner’s knee if you try to go too far too fast. Gradually increase the distance and take rest days.
Another very common overuse injury among runners is stress fractures. This often happens when a runner tries to put on too many miles too fast without taking enough rest days. The impact of running causes microfractures in the bone, which, when given time to heal, lead to stronger bones. But if a runner starts running longer without taking rest days, these microfractures accumulate to the point of injury.
Both injuries usually happen because the runners “did something out of the ordinary compared to what they were trained to do,” says Matava. Typically, these types of stress fractures occur in people who have just started running or who have decided to rapidly increase their training. A good rule of thumb is to limit your mileage gains to less than 10 percent per week.
Care must be taken in dynamic exercises
Many meniscus tears can occur during dynamic movements, like this box jump. They seem simple, but dynamic movements like the one below must be done carefully and with a clear understanding of good form.
One of the most common serious sports-related injuries is a meniscus tear, which at least 10 percent of people will sustain in their lifetime. The menisci are cartilage discs that act as shock absorbers, they are located at the ends of the femur and tibia. Most tears are caused by cartilage degeneration, which makes it more susceptible to injury, and can occur during squat or twisting movements, such as box jumps or weighted squats, or when playing tennis, soccer or basketball.
Meniscus tears usually occur during dynamic movements. The risk of injury increases when these movements are performed too quickly, carrying too much weight, or not having practiced enough. For example, in squats, if a person has “too much weight and goes down too much, the meniscus can tear,” explains Matava.
As with other injuries, the risk increases toward the end of training, when fatigue sets in. Shroyer learned this lesson the hard way when he overexerted himself lifting weights. “I was getting tired, but I said to myself, ‘You can do one more series,’” she said. Instead, she tore the cartilage at the end of her femur, an injury that required surgery and six weeks of immobilization.
When it comes to progress in the gym, there is a tension between pushing yourself to improve and ending up injured. Shroyer’s advice is to focus on the idea that “next week I can do more, because I’ve given myself time to recover,” he said. When it comes to a training routine, he recommends combining consistency with gradual progression.
“I always encourage people to do something they trust,” says Shroyer. “Take it easy, but do it anyway. Exercise can put someone at risk for injury, but not exercising puts someone at risk for poor health.”