Injury Prevention

Regardless of what your fitness training level or experience is, it’s safe to say that you’ve probably been sidelined by some type of injury at least once in your life.  Injuries are almost certainly imminent, and they are the cause of a great deal of frustration among active populations, as injuries not only compromise performance, but they also often prevent people from doing certain activities.  However, despite all of the bad things that come with injuries, the fact is that most injuries could have actually been prevented had the appropriate precautionary measures been taken either before, or after the first onset of symptoms.

There are many types of injuries, but most fall within one of the following categories:

  1. Hernia – a bulge or protrusion of an organ through the structure or muscle that usually contains it.
  2. Strain – overstretching and/or overuse of a muscle.
  3. Sprain – overstretching a ligament connecting two bones.
  4. Tendonitis – inflammation of the tendon connecting muscle to bone.
  5. Bursitis – inflammation of the bursa sack, which serves as padding between a muscle and a bony prominence.
  6. Contusion – bruising caused by impact.
  7. Fracture – breaking of a bone.  Fractures can be either hairline, simple, or compound.
  8. Herniated disc – a rupture of the fibrocartilage of the disc between spinal vertebrae.

Here are some of the most common injuries:

  1. Pectoral tear: This injury results from avulsion/tearing of the tendon connecting the pectoralis major to the humerus (upper arm bone).  A minor tear will be painful and may demonstrate minimal bruising.  A major tear will result in a balling of the muscle towards the sternum with a significant amount of bruising.
  2. Neck strain: Injury resulting from excessive stress placed on the muscles of the neck.  This injury most commonly happens during exercises such as squats and shrugs.
  3. Elbow tendonitis:

-triceps tendonitis: pain along the tendon of the triceps connecting into the pointed part of the elbow.  Resulting from overuse.

-lateral epicondylitis/tennis elbow: pain along the lateral epicondyle (outer bone on the upper portion of the forearm).  Results from strain placed along the origin of the extensor muscles of the forearm.  Can ultimately result in tearing of these muscles.

-medial epicondylitis/golfer’s elbow: pain at the medial epicondyle (inner bone on the upper portion of the forearm).  Due to overuse of the flexor muscles of the wrist usually indicated by pain with gripping weights.

4. Back strain/sprain: indicated by pain at the center of the lower back, along the top of the gluteal muscles, or along the paraspinal muscles.  This usually results from lifting too much weight or using poor form during squats or deadlifts.

5. Knee strain/sprain: various injuries include meniscal tears, patellar tendonitis, ACL tears, and bursitis.  These are generally indicated by pain along the joint line of the knee, behind the knee joint, and/or just below the knee cap along the patellar tendon.

6. Bulging/herniated disc: a rupture of the fibrocartilage of the disc between spinal vertebrae .  This most commonly occurs in the lumbar region of the spine.  The most common symptom of a bulging or herniated disc is sciatica, which is pain induced by pressure on the sciatic nerve.  This can result in pain ranging from the hip all the way down to the toes.

7. Jumper’s knee: also known as patellar tendonitis, it is characterized by pain in the interior patellar region of the knee.  Jumper’s knee is common among athletes who partake in frequent jumping as well as individuals who have pre-existing stiff ankles and/or ankle sprains.

8. Shin splints: a fairly common injury among athletes and trainees who frequently engage in activities that are centered around running, such as cross country, hiking, soccer, and football.  Shin splints are caused by repeated trauma to the connective muscle tissue that surrounds the tibia.  Left untreated, shin splints can manifest themselves into stress fractures of bones in the shin.

9. Achilles tendonitis: inflammation of the Achilles tendon, often caused by heavy exertion and repeated calf flexion during physical activity.

I don’t know about you, but when I read those injuries and their descriptions, it makes me want to do everything I can to avoid enduring the pain that many of those can bring.  I’ve personally dealt with a herniated disc as well as elbow tendonitis, and both of these injuries are highly irritable as well as frustrating.  Luckily, with proper care, patience, and rest, injuries do eventually go away.  What’s more, there are also a number of things you can do to put yourself in a place where getting injured.  Check out the following tips!  If done properly, these will drastically reduce your chance of injury, regardless of what type of physical activity you’re engaging in:

  1. Warm up: Perform 15-20 repetitions of the exercise you are preparing to do using very light weight.  You can also aid the warm-up process by walking on the treadmill for 5-10 minutes before your workout.
  2. Stretch: after warming up, stretch the muscles you are preparing to work.  Take the joint to the end of its range of motion and hold for 30 to 60 seconds.  It’s important that you hold the stretch, refraining from bouncing (moving back and forth very quickly).  Bouncing a non-warm, non-stretched muscle can result in injury.
  3. Focus: be sure to keep your mind on what you are doing.  The easiest way to hurt yourself or another person in the gym is to fail to pay attention to what you are doing.  It can be extremely easy to accidentally drop a plate or dumbbell on your foot if you are checking out other people in the gym or if you’re chatting with a friend.  Maintaining a strong focus in the gym will also help you to keep proper form and also spot your partner in a safe manner.
  4. Diet: a diet high in protein will help to maintain muscle fiber strength and help to promote a quicker recovery.  If you’re struggling to eat enough protein through your diet, then supplement with protein powders and isolated amino acids such as glutamine, which will help to make sure that your body is getting enough supplies to properly rebuild muscle tissue.
  5. Shoes: Whatever you do, do not wear sandals in the gym!  Open-toed shoes offer no protection whatsoever against falling plates, other people stepping on your foot, or catching a toenail on the edge of a machine.  Wear stiff-soled, comfortable shoes.  If you do much running or walking, you should replace your shoes every 3-4 months.
  6. Wrapping: using knee wraps during heavy squats to protect your knee joints.  They do this by helping to increase external pressure and distribute strain across a larger area.  Wrist wraps are also useful during heavy lifts such as deadlifts or shrugs.  They not only prevent you from dropping the weight, but will also allow you to lift heavier due to the fact that you don’t have to worry about your grip.    However, keep in mind that these tools should be used in moderation when lifting. If you constantly rely on knee wraps and straps to lift, then you’re compromising the strength of your supporting muscle groups, and over time this can lead to an increased risk for injury.  Save the wraps and straps for sets with extremely heavy weight.  If the weight is moderate, you shouldn’t have an issue going without them.
  7. Use proper form: Failing to perform exercises with perfect form puts you at a tremendously increased likelihood for injuring yourself.  When you’re working out, be sure to leave your ego at the door before stepping into the gym.  Not only will strict form help to stave off suffering injuries, it will also allow you to fully exhaust the muscles you’re trying to work out.   Remember, form > weight.
  8. Be sure to have shoes that have solid support: One of the best ways to prevent suffering lower-extremity injuries such as jumper’s knee, shin splints, and Achilles tendonitis is to always be sure that you’re wearing shoes that are at least fairly new.  Using shoes for too long is a bad idea because over time, the structure of a pair of shoes will wear down, leaving less support for your legs, which puts you at a higher risk of injury.  If you’re extremely physically active and doing lots of cardio, try to get a new pair of shoes to work out in at least every three months.

When you’re working out, if you experience any sort of discomfort that is out-of-the-norm, you should stop what you’re doing to assess the cause of the pain.  It’s pretty easy to differentiate between “good” and “bad” pain.  “Good pain” is the pain you feel when you’re working really hard, and it usually comes from increased blood flow and lactic acid buildup in your muscles.  “Bad pain” is the sharp pain that you experience when something isn’t right – it’s your body’s way of telling you to STOP doing whatever it is you’re doing because it’s only exacerbating the problem.  And while it might be tempting to fight through this pain, just realize that in the long run, it’s always better to take a little time off than it is to worsen the injury and have to take a prolonged period of time off.  If you do end up feeling pain and are resting your injury, you should seek medical attention if the pain lasts for several days (with you resting completely and not engaging in any form of physical activity).

With many injuries, some simple self-treatment can go quite far in helping you get better. The “R.I.C.E.” method of treatment works very well for many sprains and strains.  The “R.I.C.E.” acronym stands for rest, ice, compression, and elevation, and the protocol is quite simple.  After the injury occurs, your activity should be reduced, (if needed) the injury should be splinted, and you should be sure to refrain from bearing any weight on the injured location.  Then, use ice packs to help minimize the swelling.  Use ice for no longer than twenty minutes at a time, as putting ice packs on for too long can lead to frostbite.  You should continue to reapply ice for subsequent twenty-minute periods to continue to reduce swelling.  A good rule of thumb is to take as much time off from applying ice as you iced the injury.  So, if you initially iced your injury for twenty minutes, you should spend at least twenty minutes with no ice on the injured spot before icing again.  When applying compression, be sure to do so lightly using an elastic wrap so that it can accommodate increases in swelling.  Also, be sure to elevate the injured body part above the heart, which will reduce blood-flow (thereby reducing swelling) to the injured area.

If you’re suffering from chronic, nagging injuries, heat can really help with pain relief.  Use heat before engaging in activities that aggravate your chronic injuries, such as prolonged muscle strains.  The heat will help to stimulate blood flow to the area, loosening and relaxing the tissue of the injured area.

Practice these tips, and you should see a reduction in the number of injuries you incur.  Also, if you do happen to suffer the misfortune of getting injured, practicing the aforementioned methods of treatment can help get you back to 100% in the shortest amount of time possible!

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4 Responses to Injury Prevention

  1. Melanie Bowen says:

    Hello,

    I have a question about your blog, could you please email me? Thanks!!

    Melanie

  2. Alex McPhee says:

    Curious on your opinion on stretching before lifting. Most of the information I have read shoes no connection to injury prevention by static stretching before a workout. Stretching statically may also decrease the strength you then have to use the muscle later. A metaphor I’ve found useful is stretching out a rubber band (the muscle) before using it to hold something up will then not be able to hold up as much (lift as much) due to it being stretched out and not as strong. Dynamic warm ups, however, are more often reccomended to aid in injury prevention, get the blood flowing, and prepare the body for an intense workout.
    I have found personally that static stretching is indeed detrimental to lifting more weight but was curious to hear what your thoughts were.

    • I totally agree with your sentiments on dynamic vs. static stretching before a workout, with the caveat of if a person has a pre-existing/former injury. While static stretching certainly decreases maximal power output – thereby decreasing lifting capacity during the workout – I think there are some cases where it may be advantageous for someone to perform certain static stretches before working out. Take me, for example. I’ve herniated a disc in my lower back before (2009), so now before and after every workout (regardless of whether or not I’m training legs that day) I statically stretch my hamstrings (in addition to performing certain dynamic stretching movements before the workout). On days I train my legs, I also perform static hip flexor stretches to help make sure my hip mobility is good-to-go before I begin adding lots of poundage. While I think this may have an effect on slightly lowering my lifting capacity, I’ve found it to be incredibly effective in keeping my lower back feeling great. I also tend to focus more on the mind-muscle connection while lifting, and most sets I do are pretty high volume with moderately heavy weight, and I haven’t really messed with weights that flirt with what my theoretical 1RMs would be/are in quite some time.

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