Monday, 10 June 2019

The Truth About “Dangerous” Exercises

You want to get strong, lean and jacked. You train hard and read everything you can to help you reach your goals. Along your journey, you find varying opinions on the safety of certain exercises. Some tell you to just shut up and train. Others claim that there are certain exercises you should never do. Then there are those who have a problem with every productive exercise ever invented. So who is right? Who cares! Here is what YOU need to know so you can reach your goals without destroying your body. 

Photo by Edgar Chaparro on Unsplash

1. Put things in perspective 
When you compare all weight-training sports to team sports, your risk of injury is pretty low (1). Your training risk will vary depending on your style of lifting. For example, when comparing different strength sports, research shows bodybuilding has the lowest injury rates (0.24-1 per 1000 hours) while strongman and highland games and have the highest rates of injuries (4.5-6.1 per 1000 hours and 7.5 injuries per 1000 hours respectively) (1). Even competitive weightlifting has only 2.4-3.3 injuries per 1000 hours and powerlifting has 1-4.4 injuries per 1000 hours (2). The reality is that there is always risks. The ironic thing is that we expect them to happen in competitive sport and yet are shocked when they happen in lifting. 

2. Choose YOUR path
Some lifters put it all on the line to achieve their goal. They will do whatever it takes, inject whatever takes and live with whatever the consequences it takes to reach the goal of a world record or to win a prestigious title. Others just want to build muscle, get stronger and feel great for a lifetime. These are two very different paths that each have pros and cons. Make the choice, own it and train on YOUR terms. 

3. Know where the expert or “expert” is coming from
Don’t just blindly listen to experts when they tell you that a certain exercise is bad or dangerous. Instead, consider where the expert is coming from and how that might influence his/her opinion. Here are some examples:

Great Lifters:
Great lifters can offer a ton of valuable training information. However, you have to remember that a lifter’s opinions on good and bad exercises are based on his/her personal experience. If a lifter has done a “dangerous” exercise for the last 20 years without a problem, he/she will dismiss warnings not to do that exercise. It is also unlikely that someone became a good lifter without having better than average resiliency. 

Bad Lifters: 
Bad lifters love to make excuses. If they can’t do a popular lift well, they will demonize the lift and try to convince as many other people as they can not to do the lift. Don’t listen to bad lifters. 

Various Health Practitioners:
Most doctors, chiropractors, and physical therapists are not training experts. Those are, have educated themselves, gained experience and spent considerable time under a barbell. Many practitioners base their opinions on exercise safety from the opinion of colleagues and clinical observation. For example, if a practitioner sees a lot of patients who injured their low back injuries from deadlifts, he/she may start telling people that deadlifts are bad for your back. However, if you have spent some time in a weight room, you know that a good-looking deadlift is a rarity. The problem is not the exercise, but rather that most people do ugly deadlifts. 

Note: if a qualified health practitioner tells you not to do an exercise right now because of an injury – please listen. 

Athlete Strength Coaches:
Strength coaches have huge pressure to deliver results fast. However, the fastest way for a strength coach to get fired is to get elite athletes hurt in the weight room or to see a spike in team injury stats. In addition, sports already place a ton of stress on an athlete’s body. As a result, strength coaches favor highly effective, but lower-risk exercises.

Lifting Coaches: 
For coaches and trainers that work with powerlifters, bodybuilders, CrossFit, strongmen, and Olympic-style weightlifters, training in the sport. These coaches and athletes are often willing to push the risk level further. In addition, they tend to work with people who are naturally more resilient than your average Joe.

Everyone:
We are all naturally biased against exercises that have caused problems for us.

4. Find Your Spot on the Genetic Resiliency Continuum 
Some people are built like tanks. They can do rounded back deadlifts, behind-the-neck presses, upright rows, bench press to the neck, sloppy bent-over rows and bounce their butt off the floor on every squat rep without getting hurt. Others can’t touch a barbell without getting hurt. Between these two extremes is a continuum and you have to find where you are on the continuum. Here are some considerations to help you:

Skeletal thickness: 
If you have big, thick joints, they will likely be able to take more of a pounding than if you have smaller joints.

Limb length: 
If you have longer limbs, your joints will move through a greater range of motion and in an attempt to get what we often refer to as “full range of motion” actually exceed their natural range. In addition, longer limbs mean longer levers. Combine long limbs with small joints and you have more stress concentrated into a smaller area. 

Joint structure:
You joint structure can have a significant impact on your ability to do certain exercises. This can include things like acromion types which affect your ability to press overhead. It could also include your pelvic structure and the femoral angle of the neck of your femur which impacts how deep you can squat. 

Does this mean I need to go get X-rays? No. (However, if you have ever had an X-ray to either of these areas, you could ask your doctor if you could have a peak). What it means is that you should stop looking at what others are capable of doing and focus on what you can do. This is not an excuse to be lazy or to neglect proper mobility work and corrective exercises. Instead, you need to honestly reflect on what is and isn’t working for you. 

If you have a fluid lockout, love pressing big weights overhead and can do so without pain during or after, you may be very structurally suited to this movement. In this case, enjoy. If on the other hand, this is causing pain and feels unnatural, consider pressing with an angled barbell or on a high incline. The same applies to squats. If deep squats feel great and you are doing them well, enjoy. If not, modify your stance and depth to what suits your structure and allows you to squat without pain. 

Nervous system efficiency and fiber type dominance: 
If you have a really efficient nervous system and are a fast-twitch freak, you may also find yourself getting injured more easily. I first learned about this from Mike Boyle and have seen it in my own athletes. It is as if some people just have too much horse-power to safely handle. If this is you, be extra careful.

5. Consider past and current health issues
If you have beat up areas of your body in the past, you may want to play it safe in these areas. You also want to rule out current health issues. If you have (or had) an orthopedic health problem, even great exercises done with great form can still cause problems. 

6. Consider out-of-gym stress   
Like mileage on a car, stress accumulates in your body. Look back on your life up until this point. What jobs have you had? What sports have you played? What joints have taken a beating? What about now? The more you stress certain joints outside the gym, you more you will want to play it safe with those joints inside the gym. 

For example, compare a bodybuilder to a basketball player. The bodybuilder places virtually no stress on his knees outside the gym. As a result, he can handle exercises that are more stressful on the knees such as hack squats and leg extensions to isolate his quads. The knees of a basketball player have already taken a beating from lot of jumping and pounding up and down the court. As a result, he may need to stay with more knee-friendly exercises such as box squats and reverse lunges. 



7. Truly learn proper technique
All great exercises have some element of risk. Your form will literally make or break you on these exercises. Take Olympic-style weightlifting for example. With the high-speed reps and extreme joint positions, many would view it as high risk. However, research shows the opposite. Injuries per 100 participation hours in Olympic-style weightlifting are 0.0017. That is lower regular weight training (0.0035) and over 3600x lower than child soccer (6.2 per 100 hours). (3). 

If you are serious about reaching your goals, invest the time to get your form right. Film yourself and have a look at your form. If it looks ugly, clean it up. Check your ego at the door. Earn the right to lift the big weights by first learning proper form with the lighter weights. If you need help, get some coaching.  

8. Factor in your foundation
Think back to your childhood and teen years. Did you grow up playing outside, building forts, climbing trees, playing a variety of sports for fun and wrestling with your friends? Have you lived on your feet and done manual labor? If so, you have a great foundation for enjoying the benefits of hardcore training with less risk. Note: this is the foundation that most of the old-time lifters had.

However, what if the above description doesn’t fit you at all? What if you grew up playing video games? What if your only physical activity consisted of specializing in one organized sport from a very young age? What if your work has you sitting at a desk slumped over a computer and smartphone? If what I just described is your past, don’t start demonizing exercises, instead, deal with the real problem. Here are some practical solutions: 
  • Get a standing desk
  • Use your breaks at work to do some corrective exercises
  • Look for active things to do during your leisure time 
  • Spend a few blocks of training emphasizing the muscles you can’t see in the mirror
  • Stretch your chest between sets of back work and your hip flexors between sets of glute & hamstring work
  • Use your warm-ups to work on corrective exercises
  • Don’t do movements you can’t do. For example, if you are a dysfunctional mess and can’t squat, use other exercises such as lunges to train your legs while you fix your squatting mechanics.
  • Replace some screen time on your off-days with functional movements such as rolling, crawling and climbing
  • Consider taking a basic gymnastics class
  • Use various loaded carries and sled work as workout finishers to build work capacity
  • At least for now, start with lower-risk exercises…


9. Replace higher-risk exercises with moderate or lower-risk exercises as needed 
Now, based on all the factors we have just gone over, it is time to choose. Exercises will come in moderate, higher and lower risk variations. 

Moderate risk exercises
Remember that every effective exercise comes with some risk. If you want to completely eliminate your chance of injury in the weight room stay on the couch (but then you pretty much guarantee you will die of a heart attack). With proper technique, an appropriate structure, good joint health, no excessive work/sports stress or movement dysfunctions, you will likely enjoy a lot of benefits with a low risk of injury. Examples of moderate-risk exercises include: 

Squat: Back Squats
Hinge: Deadlift
Vertical Push: Press (i.e. standing barbell press)
Vertical Pull: Pull-Up/chin-up/pulldown
Horizontal Push: Bench press
Horizontal Pull: Bent over-rows  


Higher-risk exercises
Higher risk does not mean that they are evil and should be outlawed from every gym. Talk to enough lifters and you find compelling evidence that many people have done them without injury. These exercises have been used successfully to target specific areas. While they have caused injury for some, they have helped bodybuilders become champions and lifters set world records. They may help you, or they may hurt you. Some examples of higher-risk exercises include: 

Squat: Hack squats, rock-bottom squats, low bar squats
Hinge: Deficit, stiff-legged, and rounded back deadlifts
Vertical Push: Behind the Neck Press
Vertical Pull: Behind the neck pull-ups/downs, kipping pull-ups
Horizontal Push: Bench Press to Neck, cambered bar bench press
Horizontal Pull: Bent-over rows with lots of body “English”


Lower risk exercises
Because of all the variables we discussed above, there can be times when want to replace high and even moderate risk exercises with lower-risk variations. These often take stress off your spine, shoulders and knees, which research shows are the most common sites for lifting injuries (2). However, done correctly they can still provide a power muscle stimulus. 

Squat: Front, Zercher, safety squat bar, lunges/split squats
Hinge: Trap bar, rack/block, and Romanian deadlift, hip thrust
Vertical Push: High incline, angled barbell, and dumbbell presses
Vertical Pull: Neutral grip pull-ups/downs, ring pull-ups/chin-ups
Horizontal Push: Moderate-grip, floor, low-incline, and dumbbell bench press, push-ups
Horizontal Pull: Seated cable, inverted, and chest-supported rows

Note: if you are unfamiliar with any of these exercises or want to learn more about how to do them, you can find them on my YouTube channel.

Many of these lower-risk exercises have research-supported benefits as well. Here are some examples: 
  • Front Squats have been shown to hit your quads (Vastus Medialis in this study) harder than back squats (4). They also reduce spine compression and may even be easier on your knees (5). 
  • Safety Squat Bar Squat was a favorite of Dr. Squat (i.e. Dr. Fred Hatfield) who squatted 1014 pounds at age 45. This bar allows you to squat with a more upright angle, which placed less stress on your low back (6). It also places your shoulders in a more comfortable position. A nine-week training study comparing safety squat bar squats to back squats found similar improvements vertical jump and sprinting speed and greater strength gains with the safety squat bar group (7).  
  • Biomechanical analysis of the trap bar/hex bar deadlift shows less stress on the lower back than regular barbell deadlifts (8). 
  • Research on recreational lifters has shown a significant association between performing exercises in the high-five position (i.e. behind the neck presses and pulldowns) and anterior shoulder instability and hyperlaxity (9). EMG research on lat pulldowns shows that pulling to the front is more effective for hitting your lats (10). Likewise, dumbbell shoulder presses have been shown to be very effective for hammering the deltoids (11). 
  • Bringing your grip in narrower on the bench press to 1.5x biachrominal (i.e. shoulders at the bones on top) width may reduce your risk of injury (12). 
  • Bench pressing with dumbbells allows your joints to move more naturally. EMG research has also shown that they use the pecs significantly more than pressing with a barbell (13). 


References:
  1. Keogh, JW, & Winwood, PW. The epidemiology of injuries across the weight-training sports. Sports Medicine (Auckland New Zealand), 2017, 47(3):479-501. doi: 10.1007/s40279-016-0575-0.
  2. Aasa, U, Svartholm, I, Andersson, F, Berglund L. Injuries among weightlifters and powerlifters: a systematic review. British Journal of Sports Medicine, 2017, 51(4):211-219. doi: 10.1136/bjsports-2016-096037.
  3. Hamill, BP. Relative safety of weightlifting and weight training. Journal of Strength and Conditioning, 1994, 8(1): 53-57.
  4. Yavuz, HU, Erdağ, D, Amca, AM, & Aritan S. Kinematic and EMG activities during front and back squat variations in maximum loads. Journal of Sports Sciences, 2015, 33(10):1058-66. doi: 10.1080/02640414.2014.984240. 
  5. Gullett, JC, Tillman, MD, Gutierrez, GM, & Chow JW. A biomechanical comparison of back and front squats in healthy trained individuals. Journal of Strength and Conditioning Research, 2009, 23(1):284-92. doi: 10.1519/JSC.0b013e31818546bb.
  6. Hecker, KA, Carlson LA, & Lawrence, MA. Effects of the safety squat bar on trunk and lower-body mechanics during a back squat. Journal of Strength and Conditioning Research, 2018, Oct 22. doi: 10.1519/JSC.0000000000002912. [Epub ahead of print].
  7. Meldrum, R, & DeBeliso, M. A comparison of back squat & safety squat bar on measures of strength, speed, and power in NCAA division I baseball players. International Journal of Sports Science. 2018, 8(5): 137-144. p-ISSN: 2169-8759, e-ISSN: 2169-8791. doi:10.5923/j.sports.20180805.01. 
  8. Swinton, PA, et al. A biomechanical analysis of straight and hexagonal barbell deadlifts using submaximal loads. Journal of Strength and Conditioning Research. 2011, 25(7): 2000-2009. doi: 
  9. Kolber, MJ, Corrao M, & Hanney, WJ. Characteristics of anterior shoulder instability and hyperlaxity in the weight-training population. Journal of Strength and Conditioning Research. 2013, 27(5): 1333-1339. doi: 10.1519/JSC.0b013e318269f776.
  10. Sperandei, S, Barros, MA, Silveira-Júnior, PC,  & Oliveira, CG. Electromyographic analysis of three different types of lat pull-down. Journal of Strength & Conditioning Research, 2009, 23(7):2033-2038. doi: 10.1519/JSC.0b013e3181b8d30a.
  11. Saeterbakken, AH., & Fimland, MS. Effects of body position and loading modality on muscle activity and strength in shoulder presses. Journal of Strength & Conditioning Research, 2013, 27(7):1824-1831. doi: 10.1519/JSC.0b013e318276b873.
  12. Green, CM, & Comfort, P. The effect of grip width on bench press performance and risk of injury. Strength and Conditioning Journal. 2007, 29(5): 10–14. 
  13. Farias, DdA, et al. Maximal strength performance and muscle activation for the bench press and triceps extension exercises adopting dumbbell, barbell, and machine modalities over multiple sets. Journal of Strength and Conditioning Research. 2017, 31(7): 1879–1887. doi: 10.1519/JSC.0000000000001651.




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