By Dr. Mercola
Exercise is an important component of optimal health, but a sports injury can easily sideline you for days, weeks, or even longer. Many are those who quit exercising after an injury altogether, so avoiding injuries from happening in the first place is an important consideration.
Injury typically occurs when your muscle is overloaded beyond its ability to handle the stress placed upon it, either due to lack of conditioning or trauma. At the point of overload, you may either tear the tissue, and/or your nervous system will deactivate the muscle through a series of reflexes called proprioceptors.
When other tissues and muscles take over to protect the injured site, this adaptation can "lock" into your neurology, leading to altered or adapted movement patterns. Essentially, it alters how you move and use your body.
While this takes stress off the injured muscle, allowing it to heal, the adapted muscle is at a mechanical disadvantage, making it more prone to injury in the future.
This can set into motion a vicious cycle of progressive injuries, cascading out from the original source. Just about any exercise can lead to injury if you fail to take body mechanics into account, and/or push harder than your current level of fitness will allow, but some are clearly more hazardous than others.
Five risky strength training moves are discussed in the video above. These include:
- Chest flys
- Behind the neck shoulder presses
- Upright Rows
- Good Mornings
- Leg Extensions
The featured article1 reviews another eight exercises best left undone, unless you’ve been trained on proper execution. Here, I’ll review some of the exercises notorious for causing injury when done incorrectly.
High-intensity interval training (HIIT), which is a core component of my Peak Fitness program, is key for reaping optimal fitness results. There are many HIIT variations, but the technique I use involves doing eight 30-second sprints, each followed by 90 seconds of recovery.
HIIT is far more effective and time efficient than conventional cardio. All you need is about 20 minutes two or three times a week, compared to an hour or so on the treadmill, several times a week.
While you can turn virtually any exercise into a high-intensity exercise, the highest intensity training is sprinting. On the upside, you can do them anywhere, either indoors or out, and barefoot sprints on the beach or any grassy area will also give you the added boon of grounding.
That said, sprints are also among the riskiest, so if you’re just starting out, HIIT sprints are best avoided. Several people I know became injured using sprinting as their first foray into HIIT. I too got injured by ignoring the recommendation to stretch properly before sprinting and it took me three years to recover.
The stretching exercises I demonstrate in the video below finally helped me recover from my torn hamstring, but I suggest you avoid making the same mistake and just do the stretches before you start sprinting.
It's probably best to start out on a recumbent bike and then progress to an elliptical before you try sprinting. I recommend avoiding doing sprints on a treadmill due to the risks involved. It takes time to get the treadmill up to speed, and if you get exhausted there's the risk you might fall (or get flung) off the machine.
Treadmills are associated with more than 24,000 injuries each year—usually muscle strains and the like— and even a few deaths.2 This danger was recently highlighted by the death of David Goldberg, CEO of SurveyMonkey and husband of Sheryl Sandberg (Facebook CFO), who died as a result of falling off a treadmill and hitting his head.3
That said, if you’re fit enough to do sprints and properly stretch beforehand, it can be a phenomenal and inexpensive exercise.
Sit-Ups and Crunches
Sit-ups and crunches are among the most popular core exercises, yet few do them correctly. According to exercise physiologist Heather Milton,4 crunches are completely unnecessary, being both ineffective and tending to strain areas that are already prone to injury, such as your spine and lower back. Herniation is another risk associated with crunches, due to the forces produced. As noted in the featured article:
“Sit-ups, in particular, put undue pressure on the anterior portion of the spine, which pulls on the lumbar vertebrae. What’s more, your basic sit-up only engages the rectus abdominis muscle — just one abdominal group in the entire group of core muscles.
‘The rectus abdominis is supposed to control against extensive extension of your spine, so it shouldn’t be shortened as you contract with a sit-up,’ says Milton. ‘It should be able to maintain a good length all the time.’
Instead of sit-ups and crunches, Milton recommends the plank. The key to the movement is to keep the core engaged with the back and legs in a straight alignment. Arms can either be fully outstretched or bent at the elbows.”
Planks are indeed a phenomenal exercise for core strengthening, as they engage multiple muscle groups simultaneously. Planks can give you a tighter tummy, improved posture, flexibility and balance, and less back pain—basically the benefits you seek from the sit-up, without the associated risks. If you still want to do crunches, pay careful attention to your form.
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
In the video below, Darin Steen demonstrates a slightly more advanced form of crunch using an exercise ball.
Chin-Ups, Pull-Ups, and Kipping Pull-Ups
Unless you’re strong enough, attempting chin-ups or pull-ups may do your shoulders more harm than good. The so-called kipping pull-up is a version popularized by CrossFit, and involves doing a pull-up using a pronated hand grip and snapping your hips, allowing you to perform your reps more rapidly. A demonstration of this move can be found in the featured article,5 which has the following to say about it:
“[Athletic therapist Jen] Mark described the kipping pull-up to me as ‘ridiculous.’ [Exercise physiologist Heather] Milton echoed her sentiment, pointing out that these movements put a considerable amount of stress on the shoulders and joints. These are areas that are already prone to injury during a standard pull-up movement, due to the pronated grip with which it is performed.
‘When you’re in a kipping pull-up position, your hands are turned away, which decreases the space in your shoulder joint, so when you’re hanging from that position it puts a lot of stress on the tendons and the structures within your shoulder joint,’ says Mark. ‘So anyone with shoulder issues is at risk of experiencing a lot of pain when they raise their arms overhead.' Milton says that by turning hands inward for a more neutral grip, athletes can decrease some of the pressure.”
While kipping pull-ups are best avoided unless you’ve been taught proper body mechanics by a knowledgeable CrossFit trainer, standard pull-ups or chin-ups can still be a good exercise—but you still need to be strong enough to perform them correctly. For a demonstration, please see my previous article on proper pull-ups. If you’re just starting out, consider doing a supine pull-up instead, demonstrated in the following video.
When performing a deadlift, proper form is critical to avoid injury. One of the most severe risks is herniating a disc in your spine, which can have painful and costly long-term ramifications. Performed correctly, it’s an excellent full-body exercise, but many fail to keep a neutral spine, courtesy of poor posture in general. You also do not want to use your back to lift the weight, which is typically significant. Snapping your arms to lift the bar, and/or failing to engage your core are other common mistakes.
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 60, I’m able to deadlift 335 pounds for multiple reps. Milton explains how to perform it properly in the featured article, noting:
“You should have your lats engaged, you should have your abdominal supporting structure engaged, you should be creating a hinge at the hips, contracting the glutes, and extending the hips.”
To practice your form, Milton suggests doing 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
Bulgarian Split Squats and Lunges
A Bulgarian split squat is performed by placing one leg on a bench behind, and then doing a one-legged squat holding a pair of dumbbells. There’s little reason to perform this exercise, and unless you have the strength, balance, and flexibility to pull it off, the risk of injury is unnecessarily high.
A safer exercise is the regular lunge, but even that exercise needs to be done correctly. If you use hand weights, back strain is a possibility. Also avoid extending your front knee beyond your toe, as this redistributes the weight too far forward. Be sure to keep the weight on your heel, not your toes. When done correctly, you should feel “the burn” in your front leg glute, and your hips. Keep in mind that poor hip and/or lower back flexibility will make it difficult for you to execute this move using proper form.
Overhead Presses and Behind the Neck Shoulder Presses
Shoulder injuries can result from performing either of these exercises. The overhead press is done by lifting a weighted bar from the rack to a fully extended position directly overhead. In contrast, the behind the neck shoulder press is done by getting beneath the bar so it’s behind your neck, and then raising and lowering the weight to and from this behind-the-neck position. As explained in the video at the top, overhead presses tend to overload the shoulders in general, but the plane at which it’s done can make a big difference.
When you go behind the neck, 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.
A better choice here is to do exercises designed to improve shoulder mobility and stability, such as working with elastic resistance bands or a medicine ball. Seated rows are also a better option, according to the featured article. Upright rows, however, is another high-risk move best avoided—especially if you have shoulder problems or weak shoulders.
The upright row is performed standing, pulling a weighted bar upward toward your chin which—as explained and demonstrated in the video above—places your shoulders in an impingement position. So, if you don’t have a shoulder impingement already, you could easily develop one with this move.
One example of a back extension exercise is “Good Mornings,” which has a high chance of injury. As explained in the featured video, most people simply do not have the thoracic extension necessary to pull it off. The thoracic spine6 refers to your upper- and middle-back, and inflexibility in this area will prevent you from properly straightening your spine and/or maintaining that neutral position throughout the exercise.
On the other hand, you do not want to over-arch your back, as hyperextending your back is another route for injury. The Superman exercise is another example of a back extension exercise that can be problematic.
As noted in the featured article:
“The back-extension machine lends itself to this kind of abuse, which is known to aggravate the lower back owing to the exaggerated range of motion. This movement is also meant to be performed slowly. Some people do them so quickly they’re unable to properly hold their body structure, which imposes undue strain on the spine and lower back.
The spine isn’t really meant to bear this kind of pressure... [T]his sets people up for fractures and slipped discs. Some experts, such as kinesiologist Stuart McGill... contend that back extensions shouldn’t be attempted at all due to the strain they place on the spine. Instead, McGill recommends the birddog position... to strengthen back extensors.”
The article includes a photo of the birddog position, which is performed as follows: the starting position is on your hands and knees, on the floor. Engage your core, extending your right arm forward and up, and your left leg backward and up, until both are parallel to the floor. Hold for a few seconds, then lower both extremities back to starting position and repeat with the opposite arm and leg.
Effective Treatment Strategies for Athletic Injuries
Last but not least, as an all-around injury prevention strategy I highly recommend Foundation Training, which is based on exercises that teach you to optimize your posture and decrease all sorts of bodily pain. Foundation exercises can significantly decrease your risk of any number of exercise injuries. Many professional and Olympic athletes use this technique. But, should your prevention attempts fail and you do end up with an injury, what then?
Athletic injuries often require no treatment per say, so 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.
K-Laser Class 4 Laser Therapy 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 Research7 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.
Advanced Muscle Integration Technique A novel therapy used by many professional and elite athletes that is useful for many common injuries focuses on interrelationships between muscle function, range of motion, and restriction that contribute to pain. This technique, which incorporates multiple muscular skeletal techniques, acupuncture points, trigger points, and other alternative modalities, can oftentimes resolve injury-related pain in minutes, accelerate rehabilitation, and can dramatically help improve athletic performance.
Using this technique on the foot and ankle, recovery time for grade 1 and 2 type ankle sprains can potentially be reduced to minutes, compared to the 4-6 weeks required when following conventional treatment for a sprained ankle.
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. . 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.