Don't Let an Injury Sideline Your Workout

According to the Consumer Products Safety Commission, over 50,000 people across the US visited the ER in 2011 as a result of injuries they sustained in the gym.  These are injuries that are sustained from wide range of factors including; falling off a treadmill, exercise ball, dropping weights on their foot or tripping over jump rope.  Although the majority of these are the result of accidents and required an ER visit, the majority of injuries we see in the clinic are not as dramatic and do not require an ER visit.  However, figure 1 shows the rise in workout related injuries from 2009 to 2011 and although they may not be as dramatic, they are very common and in most cases avoidable. 

Figure 1 - Shows rise of injuries by Sport from 2009-2011 - Amongst 20-40 year olds

So how do you avoid a workout related injury and what do you do about if you suspect you have one?  This is often a very difficult question to answer as exercise itself does cause some musculoskeletal pain or discomfort.  So, how do you know if it is an injury or simply a result of your last workout?  In this 2 part series, we will attempt to help you determine that.  First, we will indentify some of most common workout related injuries and common mechanisms that cause.  In the second series, we can talk about what early intervention you can do to prevent from becoming something that puts your workout on temporary or permanent hold. 

Most of the workout injuries we see would fall into the following general categories:

·        Low back pain.  This is definitely one of the most common we see and easily avoidable.  This type of pain or injury is commonly associated with:

o   Squats, leg press, bent over rows and dead lifts

§  Usually result of poor technique or using a weight that that is beyond person’s capability.

§  Ensure you are using proper form and when form is compromised, decrease intensity.

o   Running on the treadmill

§  Usually result of poor running technique, poor shoe wear, some underlying movement dysfunction or tightness in the lower quarter or core.

§  If you are having back pain with, try running on incline.  Doing this decreases spinal extension and can aid in reduction of pain.

§  If continues or progresses, have someone do a running assessment on you.  A qualified PT, DC or ATC can often aid in assuring proper foot wear and addressing underlying issues.

·        Shoulder pain.  This is definitely one that we see more and more in males and can be prevented.  The underlying pathology is numerous but commonly associated with:

o   Bench Press, shoulder press, bicep curls, lat pulls, push-ups

§  Usually result from underdevelopment of the rotator cuff, serratus anterior, poor posture during and range of motion beyond what is “shoulder healthy”

§  Ensure you are using proper form and if you feel like you have a “nagging” shoulder problem, you should have it assessed.  It can mean the difference between ice and a labral surgery.

o   TRX

§  A lot of the band work places the shoulder in extremely compromising positions.  Need to be cautious with as we have seen a lot of labral tears as a result of.

§  Ensure you are doing proper form, under proper instruction and if you have pain in the shoulder with, discontinue.

·        Knee pain.  We see this a lot in men and women but more commonly in women.  The underlying pathology is numerous but commonly associated with:

o   Step-ups, squats, box jumps, lunges, etc.

§  Last month’s blog was on a research project we are doing on these movements and the association with knee pathology.  If your knee moves in those predicatable patterns during the above exercises, you should talk to your personal trainer or see our onsite PT.

§  These movement result in a lot of stress to the knee/hip and low back.  If you do them while you train, you are training to do them with everything else you do.

Please keep in mind these are not all the injuries we see are listed nor all the mechanisms that cause these injuries.  This is simply a list of some of the most common and some simple things you can do to prevent.  A little bit of knowledge can prevent a whole lot of pain.

About the author:  Trent Nessler, P.T., D.P.T., M.P.T., is a physical therapist, and CEO of Accelerated Conditioning and Learning.  He is the researcher and developer the Dynamic Movement Assessment™, author of the textbook Dynamic Movement Assessment and Correction: Enhance Performance and Prevent Injury, and associate editor for International Journal of Athletic Therapy & Training.

References:

1. Consumer Products and Safety Commission.  www.cpsc.gov
2. Jones, B; Knapik, J.  Physical Training and Exercise Related Injuries.  Sports Med.  1999; 111-25.
3. Baby Boomer Sports Injuries, U.S. Consumer Product Safety Commission, April 2000
4. Fiatarone M et al.  High intensity strength training in nonagenarians.  JAMA 1990, 263 (22):3029-3034.
5. Withrow, T; Huston, L; Wojtys, E; Miller, J.  “ The relationship between quadriceps muscle force, knee flexion, and anterior cruciate ligament strain in an in vitro simulated jump landing”.  Am j sports med.  34:269-274, 2006.