Marta Montenegro: The Most Common Gym Injuries

(Andrew Meade Photography)

If you avoid working out at the gym because of fear of injury, don’t. By not going to the gym, you are at worse risk of developing anything from a coronary artery disease to osteoporosis, especially if you sit in front of the computer for eight hours or so.

Gym injuries happen. An injury can be emotionally, physically and financially costly. Sometimes, it can even take you away from the gym for much longer than what you thought.

This doesn’t have to happen if you understand the risks and how to avoid them.

Men’s trunk vs. Women’s foot

“By far, the most common acute, non-urgent injuries are muscular strains and ligamentous sprains, accounting for 46 percent to 60 percent of all acute injuries in strength training,” according to “The Overview of Strength Training Injuries: Acute and Chronic,” Current Sports Medicine Reports (2010).

Moshe Lewis, MD, MPH, Volunteer Clinical Faculty, UCSF Chief, Physical Medicine and Rehabilitation, explains that the lower back, knees, shoulders and ankles are the most frequent injury spots.

“Anywhere there is a joint, there is a possible lurking as you grind these joints during exercise,” he says. “This can bring together a perfect storm of advancing age, gravitational forces and wear and tear resulting in an injury.”

The strength training overview report shows that males had a larger proportion of upper trunk injuries (26.8 percent) when compared to women (18.4 percent). Females had a larger proportion of foot injuries (22.9 percent) than males (11 percent).

Lewis, who was not involved in the study, points out that women are more likely to be injured in fitness classes, whereas men are more likely to cause injuries to themselves by lifting weights. Few men cross gender lines to join the females in these exercise classes that traditionally involve a rapid succession of twisting movements, a common root of injuries.

Weights Warning

Richard Lopez, Ph.D., exercise physiologist, professor at Florida International University, examines the most sensible injury spots when lifting weights:

1. Shoulder risks when doing shoulder press, dips and chest press

How to avoid it: Avoid excessive external rotation of the upper arm when doing shoulder press. If you are using machines, select a machine that provides a hand position that does not require excessive external rotation. Similarly, if using free weights do not perform the overhead press from behind the neck. Avoid using a heavy weight that requires the use of momentum and induces poor form.

Instead, perform the exercise using a controlled motion and concentrate on good form.

In regards the chest press and dips moves, avoid overextending the shoulder joint. Keep the arms close to the bench when doing dips. Likewise, when performing chest presses, keep the arms at the same level of the shoulders. If you suffer from shoulder impingement, do shoulder press with a neutral grip (palms facing each other) to avoid excessive pressure in this area.

2. Lower back risk with squats, deadlifts, leg press, lunges standing exercises, rotations:

The back is a staple in the body stabilization; therefore, it has a role in all moves.

How to avoid it? First, check your form. One way to reduce the risk of injury is to maintain good form and with many exercises. This means maintaining the “neutral spine” position. Don’t tilt your pelvic back or forward; keep it in the neutral position.

Likewise, strengthen the abdominals by doing a combination of static and dynamic moves such as:

a) Planks. Start with the basic, holding the position for up to 60s, repeat 3 times, to move gradually to planks raising one feet at a time to then one arm at a time without twisting your hips and while keeping the back flat.

b) high and low cable wood chops (2-3 sets of 10-12 reps).

3. Knee risk when doing leg exercises and/or high impact moves such as plyometrics

How to avoid it? When performing free weight exercises such as squats and lunges, flex the hips and knees slowly. Keep you bodyweight over the middle and heel area of the feet. Very importantly, keep the knees aligned over the feet and do not let the knees go beyond the toes when descending. To avoid excessive stress on the ligaments, don’t let the thighs to go beyond the parallel position. Also stop the descent if the lower back begins to round or the heels rise off the floor. When performing the leg press or hip sled exercises avoid using too much weight. Performing the exercises with too much weight places excessive strain on the tendons. As we age, tendons are the weak link the muscle-tendon chain. You know you are using too much weight when your form begins to deteriorate. If you find yourself slipping down in the seat and rounding your back it’s too much weight.

Foot risks: The most common type of ankle sprains, lateral or inversion sprains, occurs when the foot is turned inward on the leg. Frequently, the cause of injury can be stepping on an uneven surface, or landing with the bottom of the foot turned inward.

How to avoid it? In-step classes the exercisers are required to step up and down at various angles. As the class progresses, in trying to keep with the cadence (or instructor), the participants can fatigue and lose their coordination. When this happens they don’t step unto or off of the platform correctly and they roll their ankle. Maintain good technique even if it means falling behind the cadence. Also remember that it is OK to stop for a while and catch your breath. Also, when lifting weights, perform the exercises in standing position and once you feel strong, mix up some moves with one leg lifted off the floor. It’s important to work on balance moves since we tend to spend so much time sitting.

Watch where you drop the weights off

Those free weights injuries don’t happen just because of the neuromuscular challenge that they impose to the body. Actually, the most common mechanism of injury – in general, regardless of the age – was weights dropping on the person (65.5 percent). Make sure that when lifting weights you leave the proper room from the other trainees to perform their exercises and try to not walk up in front of a person when doing challenging moves such as squat, lunges and shoulder press where concentration is a must to avoid injuries.

Cardio Warning

For Ken Baldwin, assistant professor, Department of Sport and Wellness SUNY-Plattsburg, everything starts with a good posture. Baldwin notes he is concerned when people are running, spinning or using the elliptical machine.

“When people hunch over and lean their head forward, they are not in good alignment, their back’s rounded out. Every time your heel hits the ground, you’re putting major stress on the back—from the lower back to cervical spine. If you do it for 20 to 30 minutes in the wrong alignment, there’s no wonder why your knees, hips and back are bothering you,” says Baldwin.

Another threat is the rowing machine. Moshe Lewis, MD, MPH, Volunteer Clinical Faculty, UCSF Chief, Physical Medicine and Rehabilitation, explains that “too many middle-aged men think they can walk into the gym and climb on the rowing machine like they were still in their 20s, only to wind up flat on their backs, the result of a sprained back.”

How to fix it?

Baldwin recommends looking at the entire posture alignment when hitting any cardio machine.

“Make sure both shoulders are level, the head is leveled,” he says. “When I look at them from the side with the ear, shoulder, hip joint going linear in a straight line, the better posture alignment allows more muscles to develop better in balance with the body.”

Four points of posture

1) Sit/stand as tall as you can—think about lengthening your vertebrae in your spine from your waist to your head.

2) Shoulders at 90 degrees, chest is held up high. When the lungs are realigned in proper position—they perform better.

3) Retraction: Keep your shoulder blades back/retracted. This works two major muscle structures, medial trapeziums and your rhomboids, and can help maintain posture.

4) Pull your abdominal muscles in, making them tight. Contract. Pull your belly button into spine.

Don’t get trapped in a chronic injury

While these are the most common acute injuries, tendinopathies, inflammation of a tendon, is the most chronic issue when it comes to the knees and shoulders. Experts explain that typically these conditions develop due to repetitive motions and overuse. Poor technique, lack of the appropriate recovery, muscle imbalances and lack of cross-training activities are leading causes.

Marta Montenegro inspires people to live healthy lives by giving them the tools and strength to find one’s inner athlete through her personal website MartaMontenegro.com. She created SOBeFiT, a national fitness magazine for men and women, and the Montenegro Method DVD workout series – a program she designed for getting results in just 21 days by exercising 21 minutes a day . Marta is a strength and conditioning coach and serves as an adjunct professor of exercise physiology at Florida International University.

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