By Dr. Mercola
Exercise is a key component of a healthy lifestyle, but exercising incorrectly can lead to injury—a fate many have experienced. Being sidelined for days, weeks, or longer can set you back a great deal, not to mention result in costly rehab.
To avoid this, it's worth being aware of which exercises are well-known for causing injury when done incorrectly, and to avoid them unless or until you've found a qualified fitness expert who can teach you how to do them properly.
CNN1 recently highlighted 10 exercises known by physical therapists as being high-risk. Done properly, these exercises are actually really beneficial. You just need to be careful, and learn them under the supervision of a knowledgeable coach.
One exception is the seated leg extension, which I recommend avoiding altogether as it's just not a valuable exercise. The two best exercises for you are the Kettlebell swing and the deadlift—provided they're done correctly, with proper form supervised by a trained professional.
One important factor that places you at an increased risk of athletic injury is your joint mobility. As physical therapist Alison McGinnis tells CNN:
"If you don't have enough mobility at each joint to perform an exercise safely, then really any part of the body is at risk for injury."
So what are some of the exercises that, when done incorrectly, are most likely to reward with injury rather than fitness?
The following are among the riskiest moves, according to six physical therapists who work with sports injuries, along with some additional ones I recommend you either avoid or take precautions with.
Crunches: Bicycle-Style and Regular
When doing a bicycle crunch, maintaining a solid core is key for avoiding lower back problems. High speed twisting motions like this can easily lead not only to muscle spasm, but also disc herniation.
Cervical spine injuries are also common among those who crane their necks back and forth at high speeds. To avoid injury, slow down the movement, and keep your abdominals flexed.
Regular crunches can also lead to lower back and spine injuries, including herniation, as it places excessive pressure on the anterior portion of your spine, which pulls on your lumbar vertebrae.
To do a crunch properly:
- Lie on your back with your feet against a wall (so your knees and hips are bent at a 90-degree angle)
- Tighten your abdominal muscles and raise your head and shoulders off the floor
- Try crossing your arms on your chest instead of behind your head (to avoid straining your neck)
- Hold for about three deep breaths, lower to the ground, and repeat
Behind the Head Exercises: Lat Pull-Downs, and Shoulder Presses
Note that the key here is pulling the bar behind your head. The bar should be pulled to your upper chest, not behind your neck, to avoid injury.
As noted by physical therapist Jessica Malpelli: "The lat pull-down places a lot of stress on the anterior joint capsule of the shoulder and can eventually lead to impingement or even rotator cuff tears."
Anytime you raise or pull a weight down behind your neck or head, you're forcing your shoulders into an abnormal plane of motion with regards to the movement of your shoulder joints, thereby dramatically raising your risk for injury.
Behind the neck shoulder presses is therefore another high-risk exercise that can overload your shoulders. "No pain, no gain" does NOT apply when it comes to forcing your joints into unnatural positions, or positions that exceed your mobility.
A safer approach is doing the lat pull-down in front of your face. As for behind the neck shoulder presses, you're better off doing seated rows, or exercises designed to improve shoulder mobility and stability, such as working with elastic resistance bands or a medicine ball.
The Kettlebell Swing
The kettlebell swing is a phenomenal strength-building exercise. It's one of my favorites and one I regularly do. However, proper form and technique is essential for avoiding injury. One key consideration to remember is that you're not using your arms to lift or swing the kettlebell.
The power of the movement comes from your lower body, specifically your glutes and hamstrings. Using your arms to move the kettlebell can damage your rotator cuff, and raises your risk for other shoulder injuries.
Kettlebell routines throw off your center of gravity, forcing you to use multiple muscle groups, including your core, to maintain your balance. This is part of why it's such an effective whole-body exercise.
However, I recommend spending some time with a personal trainer (ideally kettlebell certified) for coaching, or by enrolling in a beginner group class to learn the proper techniques.
Some key points to remember when doing the kettlebell swing is to focus on the motion of your lower body. As you swing the kettlebell forward, engage your hips. Thrusting your hips forward allows your arms to naturally move away from your body without using your arms to "lift" the weight. The power to swing the kettlebell comes from thrusting your hips forward.
Bent Over Rows
There's plenty of room for error with this exercise. As noted by Malpelli: "[O]ften patients perform them bent over at the waist. Being in that much lumbar spine flexion can cause a disc to displace posteriorly, potentially hitting a nerve." A safer way to do them is to lie face down on a large exercise ball or bench, rather than just lurching forward, bending at the waist. You also want to avoid rolling your shoulders forward.
When done right, deadlifts are a great full-body exercise. When done incorrectly, they're a recipe for lumbar injuries and muscle spasms. Since you're lifting heavy weights, typically far more than your body weight, proper form and warm up are critical for avoiding injury. One of the most severe risks is herniating a disc in your spine, which can have painful and costly long-term ramifications.
Key considerations include maintaining good posture and a neutral spine, and avoiding using your back to lift the weight. Snapping your arms to lift the bar, lifting with a rounded back, and/or failing to engage your core are other common mistakes.
A strong core is also important. If your core is weak, you have little chance of performing a deadlift correctly, so you're better off doing other, safer core exercises before attempting deadlifts.That said, it's one of my favorite strength exercises and at 61, I'm able to deadlift 325 pounds for six reps, which you can see in the video above that I recorded with my trainer earlier this week.
To perform the deadlift correctly, be sure to engage your lats and abdominals. The movement requires you to hinge at the hips, contracting your glutes and extending your hips. To practice the movement before getting started, follow exercise physiologist Heather Milton's2 suggestion: Do the following hip-hinge exercise, without weights:
- Stand about six inches from a wall, back toward the wall
- With your spine straight, hinge your hips backward, as if you're about to sit down in a chair
- Lightly tap your behind against the wall, and then hinge your hips back to upright position. Be sure to engage your glutes and extend your hips
Like the deadlift, the overhead squat is a challenging whole-body exercise that has many benefits, provided it's done right. Lifting a significant amount of weight is often challenging enough; adding a squat can really throw off your form. Lack of mobility in your hips, knees and ankles can make matters even worse. Besides straining those areas, the overhead press also strains your shoulders and back.
McGinnis offers the following suggestion: "Stop when your low back starts to arch excessively, your knees drive forward past your toes or your arms move forward. Whatever depth that is, that is the bottom of your squat." Going past this point will compromise your form, and heighten your risk of shoulder, cervical, thoracic, and/or lumbar injury.
A safer exercise, and one that requires less mobility to perform correctly is the behind the neck squat. In the above video I shot last week, I'm squatting with 145 pounds, which isn't really heavy but I am able to squat deeply and keep my chest out. This type of exercise is one of the best and, like the deadlift, among the most effective exercises for increasing overall body strength. It serves to increase growth factors that also stimulate muscles in your entire body that you did not work out.
Backward Medicine Ball Rotation Tosses
A weighted ball, aka medicine ball, is an inexpensive addition to any home gym, and is great for adding resistance to your abdominal workout. They can also add variety to a number of other exercises. Some caution is warranted however, and as noted in the featured article, forcefully rotating your spine backward—especially with a weight—is a recipe for a herniated disc, or two. Anytime you're bending or rotating backward, the movement should be done slowly, and with great control. A far safer option is to do lateral, forward-moving medicine ball throws, to boost power.
Seated Leg Extensions
The seated leg extension is done on a leg extension machine, which places the focus on the four muscles on your upper leg and thigh -- your quadriceps. Strong quadriceps are important for maintaining good leg, hip, and knee strength, but the leg extension machine has all of the resistance near your ankles, which puts a lot of torque on your knees. As a result, you may wear down cartilage and potentially damage your knee joints over time. If you do use the leg extension machine, make sure to keep your muscles engaged the entire time, with only a quick pause at the top and no rest at the bottom. Keep the motion smooth and regular, and avoid jerking your leg upwards.
You'll notice that your stomach muscles work with your legs on this exercise, but be careful not to allow your back to do the work -- not only will it NOT build up the muscles you're targeting, but it could strain your back, causing problems that may need medical attention. Flexing your toes, which many do when performing this exercise, will strain your hip flexors, which may already be overly tight.
Personally, I recommend skipping this exercise altogether, as the risk of injury is high, and the benefits so minor. There are far more effective ways to train your quads. Squats for example are phenomenal for increasing leg strength (including your quadriceps, hamstrings, and calves) without the risks posed by the leg extension machine. Just make sure you have a knowledgeable trainer review your technique to make sure it is ok and your hip is getting back and your chest is straight.
Unless your lats are strong enough, attempting chin-ups or pull-ups may do your shoulders more harm than good. Your lats are among the most underused muscles, and to do a proper pull-up, you must engage these underworked muscles. As noted in the featured article:
"'You need to have your chest up with your abs engaged, and lead the pull with your elbows,' says Sulyn Silbar, orthopedic massage therapist and owner of Body + Mind NYC. 'Most people cannot do them properly, as their lats aren't working or aren't strong enough, and therefore the body compensates by using the upper traps and chest to do the movement.' This can lead to short, tight pecs, or worse, shoulder issues. Learn the pull-up using a band and checking your form in the mirror or with a certified trainer before you start knocking them out."
Pull-ups or chin-ups can still be a good exercise—but you need to be strong enough to pull them off. For a demonstration, please see my previous article on proper pull-ups or watch the video I previously did on pull-ups below.
Total Video Length: 18:39
The last exercise physical therapists recommend doing with caution is the preacher curl, which is known to cause injury for the simple fact that you're trying to strengthen a muscle while seated with poor posture. As explained by David Reavy, PT, OCT, a physical therapist in Chicago: "It puts the muscle in an active insufficiency, which means the muscle is already shortened, and puts your shoulders in an anterior tilted position and in abduction, which means they are farther apart. There is no stabilization of your core or lats because your shoulder blades are out of place and you are in a forward posture." A safer and more effective exercise is half-kneeling bicep curls.
Effective Treatment Strategies for Athletic Injuries
Even when you're cautious, simple mistakes can lead to painful injuries. Should that occur, keep in mind that athletic injuries often do not require treatment per say as much as they require rehabilitation, or a chance for your body to heal. All of the following methods offer non-invasive and safe ways to recover from athletic injuries. Just be sure to take your recovery seriously, as staying physically active and athletic is one of the best things you can do for your health, and you may not be able to continue if you're struggling with chronic pain from an improperly healed sports injury.
If you suffer pain from an injury, arthritis, or other inflammation-based pain, I'd strongly encourage you to try out K-Laser therapy. It can be an excellent choice for many painful conditions, including acute injuries. K-Laser is a class 4 infrared laser therapy treatment that helps reduce pain, reduce inflammation, and enhance tissue healing—both in hard and soft tissues, including muscles, ligaments, or even bones. These benefits are believed to be the result of enhanced microcirculation, as the treatment stimulates red blood cell flow in the treatment area. Venous and lymphatic return is also enhanced, as is oxygenation of those tissues. Ultrasound Treatment Research3 suggests ultrasound treatment may be a quick and minimally invasive treatment for plantar fasciitis—a painful condition caused by inflammation of the tissue (plantar fascia) running along the bottom of your foot, connecting your heel bone to your toes. The novel ultrasound therapy uses ultrasonic energy to cut and remove damaged tissue while sparing healthy tissue. In this study, patients reported a 90 percent improvement or more after two weeks. Whole Body Vibration Whole body vibration (WBV) involves standing on a platform that sends mild vibratory impulses, which activate muscle fibers, through your feet and into the rest of your body. Your muscle spindles fire secondary to the mechanical stimulation produced by the vibrating plate, and this rapid firing of the muscle spindle causes a neuromuscular response that leads to physiological changes in your brain as well as your entire body.
Since injuries can leave cellular memories behind, using WBV stimulation allows your body and brain to rapidly de-imprint these old cell traumas, re-imprinting with positive, healthy information. This allows for better and more efficient rehabilitation of injuries from sports than traditional methods of therapy.
Chiropractic One of your first considerations should be a well-trained chiropractor who has special interest in sports medicine. One particularly useful technique is Applied Kinesiology, which is a form of muscle testing. It is important to do your homework though and ask around for some good recommendations. If you don't get great results don't give up, you just may need to try another chiropractor. Acupuncture Meridian-based energy therapies like acupuncture are quite useful for treating a number of health problems; pain in particular. Other therapies such as guacha, cupping, and moxibustion—the burning of herbs on or over the skin—can be used to support tissue healing. Emotional Freedom Technique (EFT) Traumas and injuries can leave cellular memories in your brain or body tissue that impede normal body movement or function, even after they're healed. EFT, which is a type of emotional acupressure, helps you to release these "memories," clearing your body of negative energy and facilitating healing.