Article By: Dale J. Buchberger, PT, DC, CSCS, ACBSP
The warm and sunny weather thaws the muscles and joints from the winter stiffness. It also brings renewal of exercise habits and the willingness to “get back in shape”. If you are venturing into the gym after a long hiatus here are a few simple tips to help your return to activity be a safe and injury free one. First, have a goal and a plan. Remember to start slow and expect soreness, not pain. In the first two weeks back to the gym, walk away from the table hungry. That means to leave the workout knowing you could have done more, but don’t. Drink plenty of water throughout the day and give yourself a few minutes a day to perform some light stretching. Initially, your muscles and tendons will stiffen in the early weeks of exercise.
Remember you can make all of the changes in the world, but if you continue to lift beyond your weak link and you continue to lift incorrectly, it won’t be a matter of if you get hurt, but when. Technique is everything. Do it right or don’t do it. Last but not least always weigh risk versus benefit. If the risk of injury is greater than the benefit, it is an injury waiting to happen.
Lets start with a staple of many weight training programs, the straight bar bench press. The straight bar essentially makes it easier to lift more weight. Therefore you are exercising outside your weakest link (shoulder) when using the straight bar to bench press. The straight bar bench press weakens the rotator cuff and damages the shoulder and acromio-clavicular joint (ACJ). The straight bar bench press motion places unusually high stress to the ACJ. Straight bar bench pressing with excessive weight causes the gleno-humeral joint (shoulder) to become a weight bearing joint. This results in premature degeneration, since the shoulder joint is not designed to be a weight bearing joint.
The simple fix here is to replace the straight bar with dumbbells. Remember just replacing the straight bar bench press with dumbbells does not guarantee prevention of a shoulder problem or resolution of your existing shoulder problem. Performing the dumbbell bench press correctly with good technique increases the chance of success in resolving or preventing a shoulder problem.
The “lat pull” machine is another common exercise used in the gym and another exercise that commonly causes shoulder and neck injuries when performed incorrectly. The “lat pull down” should not be performed by pulling the bar behind the head. This compromises the rotator cuff and the neck. Instead the bar should be pulled down to the front and toward the chest. This will accomplish the goal of improved strength while reducing risk of injury.
Another problematic exercise from the past is known as the upright row. It is performed with the hands close together on a bar and the bar is lifted straight up towards the chin. This places the rotator cuff in a position of impingement and increases the load on the AC joint. The increased load and impingement results in gradual tearing of the rotator cuff and premature degeneration of the AC joint. A combination of exercises will be needed to replace the upright row. Exercises such as shoulder shrugs, seated rows and one arm bent over rows can successfully replace the upright row and the reduce risk of shoulder injury.
The last culprit in the gym is the seated behind the neck press. This exercise places the shoulder at risk of instability and shoulder impingement syndromes. It also places excessive load on the shoulder joint and the AC joint resulting in premature degeneration. It places the neck in a compromising position of forward flexion and may result in neck strain, cervical spine disc herniation and premature degeneration.
The nuts and bolts of premature degeneration in the shoulder is that total shoulder replacement surgeries are not as perfected as the knee or hip replacement. This means that if you become a total shoulder replacement candidate due to years of excessive and incorrect lifting practices, you are all but guaranteed to lose some degree of function and quality of life as a result of the surgery. Unfortunately, I have seen patients in their mid-forties that were total shoulder replacement candidates because of a life time of not only heavy lifting, but heavy lifting incorrectly. If you make the changes listed above to your weight training program, you can reduce your risk of premature shoulder injury significantly. If you need advice on a strength training program speak to a trusted healthcare provider of your choice.