By Kirk R. Davis, D.O.
Americans are becoming increasing interested in health and fitness. As part of their exercise program, many of them are participating in weight training. It is estimated that more than 50,000 emergency department visits a year are related to weight training injuries. Following proper weight training techniques may prevent a portion of these injuries.
Training injuries requiring emergency department visits are often a result of “accidents” with use of weight training equipment. Many of these may be prevented with proper weight lifting techniques. The first technique is utilization of a “spotter” which is a training partner or a gym staff member that assists you in “lifting off” the weights at the beginning of the exercise and assists you (spots) during the exercise period. This is quite important as this individual can prevent injury from initial fall of weights, assist during lifting, and help “rack” the bar at the end of the exercise. The utilization of a spotter can prevent injuries to muscles and joints. The use of collars which secure weights to weightlifting bars can prevent slipping and falling of weights during the lift. One should be reminded also to be quite cautious when removing weights from a bar as they can fall from a bar causing severe foot injuries. If the weights are removed in an uneven fashion, this can also cause the bar to propel through the weight room causing serious injury. Replacing the weights on the weight rack is also a common source of hand and finger injuries by crushing them between. Using and replacing dumbbells can produce similar injuries.
In many cases, weight training injuries have been associated with anabolic steroid use. These controlled substances are illegal to be used to obtain gains in strength and muscle. Steroids cause changes in the muscles, tendons, and ligaments making them more susceptible to injury. Their significant side effects include acne, baldness, testicular shrinkage, liver abnormalities, heart problems, breast growth in men, aggressive behavior, and death.
Children that have not yet reached skeletal maturity are at a particular risk for growth plate injuries from weight training. Therefore, the American Academy of Pediatrics has issued guidelines for weight training in children. These guidelines include close supervision by knowledgeable trainers. Adolescents should refrain from vigorous weight training until they are passed puberty.
General principles to follow during weightlifting include a short period of cardiovascular warm-up should be performed to increase blood flow to muscles. Specific stretching exercises directed at the body part to be exercised should be undertaken. The weight being used should allow six to 15 repetitions to be performed with good form in order to prevent injury. Bouncing, jerking, or throwing the weights should be avoided.
Several specific exercises commonly produce injuries. The bench press places tremendous stress on the shoulders. You should avoid single repetition maximum lifts which could contribute significantly to shoulder injury. A “hand-off” from a spotter needs to be mandatory for all bench press activities. General training techniques include hand spacing no wider than one and a half times the width of the shoulders. The bar should be lowered in a controlled manner, maintaining the shoulders less than 45 degrees away from the body, touching the chest just above the highest point. Buttocks should remain on the bench without excessive arching of the back. Another common exercise that is very stressful on the shoulders includes the behind-the-neck shoulder press. This exercise should be avoided as it puts excessive stress on the neck and shoulders. A good substitute may be on the shoulder press or many of the new shoulder press machines that place the shoulder in a much safer position. The “lat” pull-down machine is a common fixture in many of the health clubs. This machine can be quite useful, but doing pull-downs behind the neck can also place excessive stress on the neck and shoulders similar to the behind-the-neck shoulder press. This should be avoided and front/lat pull-downs should be used as a substitute. Excessive extending of the back to complete the exercise should be avoided throughout the maneuver. The squat is an exercise where the bar is supported on the back while the exerciser performs a squatting motion. This exercise has gotten a bad reputation over the years as injuring the back and knees. This can be an excellent exercise, if done properly with spotters and proper supervised form. One should avoid excessive bouncing in the lower positions and maintain good spinal alignment throughout the motion. A lifting belt may remind one to maintain proper form as well as special bars, racks and many machines exist to stimulate this activity and may provide a safer alternative.
Observing these simple training principles and instruction from properly trained gym personnel should allow weight training to be an enjoyable and healthy portion of an exercise program.