More or less everyone who has ever lifted weights for a considerable amount of time is bound to run into an injury of some kind. Weightlifting is a sport like any other where every athlete wants to be the best they can be – mediocrity is not in their vocabulary. As a result, lifters often push themselves beyond their means – often with success – but other times resulting in minor, or in some cases, major injuries (read: epic fuck-ups). Just like in any other sport – a lifting injury can set you back in achieving your goals.
You’ve heard it all before: don’t overtrain, incorporate a deload, take a break from training. All of these topics have been beaten to shit. If you don’t already know: don’t train 7 days week, periodize your routine, and take a week off now and then. Done.
But forget about the standard bro topics.
Educated lifters (a.k.a. readers of this blog!) will always do their best to pay attention to correct form and generally know their limits quite well. Some injuries, however, are not simply form related and can be caused by structural imbalances, repetitive stress, or an acute traumatic event.
This article will discuss the most common injuries to the most injury prone structures in the body and what steps can be taken to remedy or prevent these injuries.
|Muscles of the rotator cuff.|
Signs that you may have a shoulder impingement would be: reduced or painful mobility in the shoulder, pain during internal or external rotation of the arm, sharp or nagging pain during or after pressing exercises, or painful clicking/snapping/grinding in the shoulder. Some of these symptoms are a clear indication of a tear – some are indications of an impending tear or tendonitis. If you suspect a complete or partial tear of a shoulder tendon or muscle, visit a doctor immediately for a thorough diagnosis before attempting any further weightlifting or rehabilitation on your own.
Shoulder imbalances are preventable and generally reversible by balancing the use of all muscles in the shoulder. The major muscle groups connected to the shoulder are: the deltoids, rotator cuff and trapezius. Since the bench press tends to be the favourite of many lifters, they often neglect the rear-deltoids, traps and the rotator cuff muscles. It is in your best interest to compliment every “push” exercise with a “pull” exercise. As well, it is important to compliment any exercises that require internal rotation with exercises that require external rotation. You’ll find combining “push” exercises with external rotation don’t mix well – an example would be reverse-grip bench press which becomes pretty dangerous; instead focus on “pull” exercises for external rotation.
Push Only: Press
Pull Only: Barbell row
Pull with Internal Rotation: Barbell row with prone-grip
Pull with External Rotation: Chin-up
Traps: Barbell Shrugs / Cleans
Traps with Internal and External Rotation: Barbell Snatches
The VMO, or vastus medialis obliquus, is the tear-drop shaped muscle found on the inside of the leg running along the femur and ending at the knee. Its primary function is to aid in stability during knee extension. Imbalances associated with this muscle can manifest themselves in several ways. Diagnosing a VMO imbalance can be tricky and can be mistaken for tendonitis, ligament laxity / tears, or even cartilage damage.
A VMO imbalance can result in several peripheral issues in the lower body including lower back pain, iliotibial band syndrome, patellofemoral pain syndrome, sacroiliac joint dysfunction, piriformis syndrome, etc. A VMO imbalance is generalized as an imbalance between the muscles on the inside of the knee and the muscles on the outside of the knee – i.e. weak vastus medialis and strong vastus lateralis in most cases. This causes the knee to improperly track over the tibia when performing knee flexion/extension exercises like squats – this can result in a host of more severe issues if left uncorrected.
It is in our best interest to balance the muscles of the quadriceps evenly. The number one sign of a weak VMO that I see on a daily basis is when I see people performing quarter squats with their knees wobbling and toes pointed straight ahead. Squats should be performed just below parallel with a slight external rotation of the leg using a manageable weight. Mark Rippetoe of Starting Strength often emphasizes the importance of consciously “shoving the knees out” during a squat – not only to engage the glutes but to keep the knees from tracking incorrectly during the movement. I would focus more on not having the knees wobble at all during the movement – this is talked about in detail here. If the VMO is very weak, some strengthening of the muscle should be done in isolation – i.e. using leg-extensions.
Barbell Squat / Leg Press
The imbalance - or more specifically - the inhibition of the gluteus muscle groups has reached epidemic proportions amongst the general population. The majority of the population will never really notice a gluteal imbalance because they will never use their glutes to their full potential. Lifters, however, will notice gluteal imbalances (often catastrophically) when attempting heavy lower-body lifts that approach their 1RM.
|Gluteus medius and minimus (left side, back view).|
Strengthening the glutes should come secondary to activation of the glutes. A daily task for all people (lifters or not) should be to stretch their hip flexors. For lifters, it is imperative to not only stretch your hip flexors but to also activate the glutes prior to, during and after any exercise session. If you attempt a heavy, deep squat with weak or inhibited glutes you are almost guaranteed to injure yourself sooner or later. The same goes for a heavy set of deadlifts or rows and explosive exercises like cleans, snatches, swings or even sprints. Activation should be done with max-effort isometric holds and strength should be built with heavy compound movements.
Hip flexor stretch
Isometric glute bridge
I hate using the word "core" – I feel people will think of those stupid night-time infomercials for utterly useless ab-building gizmos. Core in its true sense refers to the lower part of the trunk and the hips. More specifically, the abdominal muscle groups, the lower back, lower latissimus dorsi, the gluteal muscles and hip flexors. No, it doesn't mean just abs – sorry to disappoint.
Imbalances occur when muscle groups become weaker or stronger than their antagonizing muscle group. This overlaps with the gluteal imbalance we discussed. But the same can happen with the muscles of the lower back and their antagonists – the abdominal muscles. I always recommend doing exercises that work both at the same time – i.e. deadlifts or other compound movements. Don’t go home and start crunching or doing hyper-extensions.
The primary function of the erector muscles of the back is to prevent spinal flexion as is the function of the abdominal muscles! So guess what?? You’re not supposed to be crunching away at those abs, that’s not what they were made for. They were made to stabilize the trunk. A similar analogy would be the forearms – we can curl away at our forearms but the greatest strength gains will be from grip-intensive exercises… same goes for abs.
A shock – I know. Don’t believe me? Sit down and try flexing your trunk (bending your upper body down towards your legs)… no so bad! But did you use your abs much?? A little, maybe. Now flex your abs consciously and try to do the same thing… bet you didn’t get as far down did you?? That’s right – because your abdominal muscles were working to prevent flexion of the trunk and hence, prevent the bending of the lower back. This comes in very handy during squats and deadlifts.
An imbalance in either of these muscle groups can cause excessive flexion of the trunk while a load is being applied (lifting something). This means trouble for our precious spinal discs. This is, also why you will hear people say “lift with the legs”. And why the deadlift is such a great core exercise because it exercises resisting trunk flexion by both the abs and lower back (erectors) isometrically. You will find that most people who use lifting belts are doing so due to a weak core. I say ‘most people’ because at excessive weights a belt may be a good idea regardless. Build the core by lifting within your means – a solid squat or deadlift session can leave your abs and lower back pretty sore.
Sample Deadlift-Day Routine
Isometric glute bridge using a 3-5-1 cadence complete 5 reps
Single-leg isometric glute bridge using a 3-5-1 cadence complete 5 reps for each leg
Deep hip flexor stretch
Bar-only warm-up for 10 reps
Hip flexor stretch
40%-1RM warm-up for 5 reps squeezing the glutes at the top of the movement
Hip flexor stretch
70%-1RM warm-up for 3 reps squeezing the glutes at the top of the movement
*(Hamstrings and glutes are fully activated at this point)*
Hip flexor stretch
2RM set for 2 reps squeezing the glutes at the top of the movement
Hip flexor stretch
*(Pyramid down as required)*
So now you know how to prevent injuries and prevent the most common imbalances that exist for lifters and non-lifters alike. As a rule of thumb, I always recommend the use of compound exercises before isolation is required. However, if you are already experiencing symptoms of an injury you can always perform isolation exercises as well. Keep in mind stretching and activation are two very different techniques. Stretching should be employed when you are not planning to use the muscle – i.e. best used on rest-days. Activation should be done prior to attempting any lifts that require the muscle being activated.
Use these tips to injury-proof your body and keep your training humming along without hiccups. If you are currently injured or become injured – don’t fuck-up it even more… seek the advice of a competent medical professional before attempting to self-diagnose or correct the issue. If you are not familiar with how to perform certain exercises, seek the advice of a trainer or a physical therapist.
The exercises recommended in this article will cover every major muscle group and joint in the body from head to toe and should be, in some variation, part of your strength routine. In a future article, I will discuss the form for deadlifts and bench press in depth.
For answers to more specific questions or something I have not covered that is of interest to you, comment on this post, tweet or email me.