We think we are doing what is healthy for our bodies – going to the gym and lifting weights. Strong muscles perform better, have better endurance, and are less prone to fatigue and injury. Weight lifters, however, can be at high risk for developing tendonitis, rotator cuff injuries and peripheral nerve compressions. They may commonly experience elbow, shoulder, back and knee pain.
Last week I had two clients walk into the clinic. Both had valid work-related elbow pain and finger numbness caused by repetitive use of the arms. One is a graphic artist, the other a manual laborer. Both also have that solid, heavy-set, weight-lifter physique. If I had not already guessed that these were body-builders, the look in one’s eyes when I told him he had a grip strength that was functionally weak would have given him away. How could that be? This guy could probably not remember the last time anyone told him he was weak in anything. However, his grip test gave a good indication of how pain is limiting his ability to perform work, leisure and self-care tasks.
In addition to providing standard, work-related ergonomic information to my clients, I find myself providing instruction in exercise programs and ergonomic lifting techniques to prevent further injury and enhance recovery of injuries.
Here are some ergonomic tips to keep you pain-free at the gym.
GENERAL TIPS
- When starting or changing a program, train with a fitness expert who knows proper technique.Don’t push through pain. Pain is our body’s warning signal that something is wrong. If you are having pain, train with a health care professional who has experience with injury recovery.
- Warm-up muscles prior to working out.
- Stretch the muscles after working out. Stretching will lengthen the muscles that have tightened during the training and help to eliminate post-exercise soreness.
- When lifting, use proper form. Lift slowly and don’t use momentum to swing a weight. Although you may be able to lift heavier weights when using momentum, you are not isolating the muscle to work it efficiently. You also place yourself at higher risk for strains, sprains and muscle tears.
- Choose a weight that is appropriate for lifting without your form breaking down. Gradually increase the amount of weight you lift (Gradual Progressive Overload or GPO).
- Use your breathing. As you exhale strongly and contract your abs just prior to performing a strength move, you stabilize your core muscles and can lift more safely and efficiently.
- Release tension from any muscles that are not performing the exercise, especially the neck and shoulders.
- Don’t lock your elbows or knees.
- Take a 1-2 minute break between to allow muscles to recover. Or alternate muscle groups being worked (for example, alternate between an arm and a leg set).
- Balance the muscle groups being worked.
- Don’t overwork the “mirror muscles” – the ones you see in the mirror such as the chest (pectorals) and upper shoulders (trapezius). If too bulky and tight, these muscles can compromise nerve function.
- Make sure to work the lower back and mid-back (for example, the mid and lower trapezius, posterior deltoids, latissimus dorsi and serratus anterior).
- Don’t overwork the “mirror muscles” – the ones you see in the mirror such as the chest (pectorals) and upper shoulders (trapezius). If too bulky and tight, these muscles can compromise nerve function.
- Don’t work out every day. Let the body recuperate and heal after a heavy workout.
- Avoid the use of steroids. In addition to a host of other serious side-effects, steroids increase the risk of tendon and ligament injuries. Growth Hormones can also cause hypertrophy of subcutaneous tissues leading to compression of the nerves.
- When at the gym, concentrate on your program so that you are using proper form. Don’t train if you are overly tired.
- Be safety conscious and aware of your workout environment. Watch for objects or spills on the floor that can be safety hazards.
- Eat healthy and stay hydrated. Dehydration can adversely impact muscle performance and endurance.
EXERCISE TIPS
- Don’t overwork the upper traps, biceps, triceps or pecs. Hypertrophy of these muscles can cause nerves to become pinched.
- Strengthen the postural muscles of the mid and low back (rows, lat pulls and reverse flys).
- If you have elbow pain, avoid extreme elbow bends when performing rows and pulls. For example, pull down to mid-chest rather than to shoulders. Never perform a behind the neck pull-down or press.
- If you have numbness or pain in the hands or wrist, use push-up bars or weights to position the wrist in neutral when performing push-ups.
- You may need to take a break from push-ups, presses and elbow curls until symptoms resolve.
- Strengthen the rotator cuff.
- Strengthen the core.
- Stretch the pecs (these chest muscles can become very tight during weight-training routines), neck (scalenes, levators, sternocleidomastoid, posterior neck) and forearms (flexors, extensors and rotators).
FROM THE EXPERTS
- Greg Gagliardi, D.C., a chiropractic physician writing for BodyBuilding.com, recommends that weight lifters avoid upright rows, close grip bench presses, wrist curls off the end of a bench and power cleans because of the excessive loading and shearing forces that they place on the muscles, tendons and ligaments of the wrist while they are held in unstable positions.
- Curtis Schultz, another writer for BodyBuilding.com, attributes shoulder impingement and rotator cuff injuries to improper lifting form, changing a routine too often, and overloading and pushing too much weight. He recommends that weight lifters perform the military press (both with the weight held behind or in front of the neck) and dumbbell presses in a seated position (to avoid cheating) with motions smooth and controlled. The arms should not lift over the level of the shoulders when performing side lateral raises. Avoid a grip too far outside shoulder width when performing a bench press. Avoid the back squat. The heavy weight held on the neck or upper back can cause impingement. In addition, improper placement of the squat bar has caused subluxation of vertebrae in the neck.
- Dr. Pete Gratali from ESPN’s Body Shaper recommends performing a high repetition, low-weight warm-up of the internal and external rotators of the shoulder (30-50 repetitions of 5-10#) before beginning any shoulder routine to prepare the muscles for heavier work.
Having an injury does not mean you need to stop a weight-lifting program all-together. In fact, strengthening can aid in the prevention and recovery of repetitive strain injuries. However, you may need to work out smarter and not harder. Respect pain, play it safe, and incorporate ergonomic principles into your routine.
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For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.
