Summary of 17 most common injuries related to training in the gym

This series of blogs has been designed to give you information about the 17 most common issues related to training in a gym. Each blog discusses what is commonly seen by trainers and physiotherapists when people train in the gym – and also the importance of having a trainer and physiotherapist working closely together to create a training plan to prevent injury and maximise results.

The synergy of a physiotherapist and trainer working together has huge benefits in terms of continuity of care, injury prevention, and communication between all clinicians and you – the person trying to achieve the goal.

When a physiotherapist and trainer work together injuries can be prevented by early assessment to identify problems which may occur in the training process. The key principle here is prevention of injury rather than healing of injury once it has occurred. The physiotherapist is valuable in his / her knowledge of medicine and musculoskeletal injury, and the trainer is valuable in setting training goals and making sure you are motivated and carry through with your plan.

If you are interested in working with a physiotherapist and a trainer who have spent years refining the process of injury prevention contact us as at mail@physical-edge.com now.

Making common sense training goals

Many of us like to set goals which will push us to our limits.  If we want to learn something well, we usually have a teacher or a coach, and this applies to physical training as well.

If you set a goal and along the way you get injured, or you can see that your sport is unsafe because your body cannot cope with the loads exerted on it, then have the common sense to change. The ability to listen to your body can prevent acute and long -term injuries. It is not worth training for weeks or months, to get injured and see your goals slip away.

A physiotherapist and trainer can help you make common sense decisions about your training goals. Both clinicians will listen to what you want to achieve, and assess your body, to decide whether or not your goals are realistic. Choosing the appropriate training goals will make training safe and achievable.

The body is not a machine, it responds to physical stimulus and will adapt over time. Setting goals which are small, on which you can build towards a much bigger goal, is the best way to train. A physiotherapist has knowledge in the areas of pathology, physiology and neurophysiology. A trainer knows how to train to achieve physical goals. Working with a Physiotherapist and Trainer gives you the professional support to choose the training program to best suit your needs.

Make a common sense decision now, before you waste time and money, and suffer injuries. Consult your physiotherapist and trainer as they work with you as you achieve your training goals.

Get your Biomechanics assessed early to avoid injuries

There is a difference between osteopaths, chiropractors and physiotherapists. Physiotherapists’ background is often based upon rehabilitation and, in this sense, physiotherapists learn to assess the biomechanics of the joints of the body and then how that movement is coordinated in function. For this reason you see physiotherapists associated with professional sports teams.

Understanding the biomechanics of the body helps to identify the cause of an injury or, if an injury has already occurred, how to rehabilitate a person back to sport. A trainer’s role is to strengthen the body and, in this sense, they will look at how to control movements with specific strengthening exercises. The physiotherapist can complement the trainer by looking at the finer points of joint movement and by integrating other systems of the body, such as neurophysiology, pathology, and the cardiovascular system.

When training for the first time in the gym, or looking to achieve a goal, it helps to have your biomechanics assessed to aid in avoiding injury. An experienced physiotherapist and trainer can work together to protect from potential injuries which can occur if the body already has poor biomechanics. No two people are built the same, and therefore an assessment should be very bespoke. An example of poor biomechanics would be: a person who has a restriction in the ankle joint such that when they do squats, lunges or step-ups this causes a secondary movement in the knee, hip or back – and somewhere pain will start to occur. This is a very simplistic example of how to assess biomechanics, but it illustrates the importance of identifying these problem areas.

Biomechanical issues may not be a problem in the initial stages of training, where the number of repetitions or length of training is low. However, when training distances and intensities increase, these biomechanical issues will start to cause injuries. It is advised that you do not try to work through these injuries, but rather have them assessed, to allow your training to progress smoothly and with minimal chance of injury. The synergy of a physiotherapist and trainer working together is a formidable team in helping to prevent injury –and exists in many professional sporting environments.

Personal Training Series: Pitfalls of leaving injuries too long

In physiotherapy I see many sports injuries. Often I will see injuries which have been present for several weeks, months or even years. Clients tell me they were never told by their doctors or specialists to see a physiotherapist and that they decided to leave time for the injury to heal by itself. By the time they come to physiotherapy the injuries have set in to the body; the central nervous system has adapted to the pain and now can prolong pain. The musculoskeletal system  has weakened or become tight, or moves incorrectly.

If you get injured call your physiotherapist to get advice straight away. Why wait? If you can’t see the physiotherapist, the physiotherapist can advise you over the phone what to do for your acute injury. It is in the phase just after inflammation that training can be very effective. Training in this time allows the body to adapt to load in a positive manner. The body becomes stronger, stiffer and moves correctly.

Starting treatment when an injury has been present for weeks, months or years will take longer. The amount of input the client has to put in outside of the physiotherapy clinic is also increased. What you are trying to do is to tell the body a new way of moving and being, and it takes time for the body to adapt to this new stimulus. The stimulus has to be applied frequently and regularly. Sometimes 100% resolution of the injury is unrealistic; in some cases it is more realistic to teach a person how to manage their pain rather than cure the pain completely.

It is obvious that it is important to treat acute injuries immediately and to seek medical care. Being proactive at the start avoids a tedious recovery time, which is likely to be the case if treatment is sought much later.

Once the physiotherapist has seen you through the acute phase of your injury, he can work with a personal trainer to design a training programme which is appropriate for your goals. The exercises given to you may have to be adapted for the injury, and these can be changed as the injury heals. Having a personal trainer watch you during the training process ensures that you do not do anything wrong, and risk reinjuring the body part.

The physiotherapist will know when your body is ready to train at full intensity again. The close relationship between the trainer and the physiotherapist is beneficial because the professionals know each other, talk the same language and can progress you through your training at the appropriate times. If you have physiotherapy questions, do contact us as http://www.physical-edge.com.

Personal Training series: Setting goals too high

The danger of training can often be setting goals too high. It is very easy to decide that training with a trainer is the start of a whole new change of life. In some ways it is, but in other ways the goals that are set with the trainer need to be realistic for your body type and athletic ability. Of course, you can gradually build up to bigger and bigger goals, but at the start it helps to set achievable goals and test how your body adapts.

I have noticed that when clients come in with an injury they may suddenly decide to compete or race, where before the injury they had no desire to train. There is something about getting treatment or starting training which triggers within people a desire immediately to take part in races. I have had clients who injure their knees and yet suddenly want to do a marathon; this is a great example of setting goals which at the time are unrealistic. A more appropriate strategy may be to recover from the injury, build up strength, start looking at running technique, and slowly build the distance you run eg 10km, 15km, 21km and then a marathon.

I had another client who wanted to run a half marathon 3 months after giving birth; she reported pain in her body and required treatment which stopped her from training. 9 months down the track she completed the half marathon, and retrospectively acknowledged that she initially started training too early; she now knows  that her body needed the time to heal from the birth of her child before it was ready to withstand the impact of running and training. Her half marathon was a great success; she enjoyed the day and did not get injured. If you are going to do a half marathon for the first time, you want it to be an enjoyable experience. If she had done the race 3 months after giving birth, it would have been a painful experience and probably put her off running forever.

Having a physiotherapist and trainer work together can help you assess the current state of your body, and then help you set a plan to develop your strength, endurance and power. They can also look at your technique before helping you to set an appropriate goal. Having a trainer is hugely beneficial in overseeing your progression, and the physiotherapist can see how your body is improving and give you guidance as to how quickly training can progress. The physiotherapist also has the advantage of understanding medical conditions and the impact this will have on training.

Working progressively towards a goal often requires a change in a client’s mind-set. Patience is not everyone’s natural tendency; however if someone wants to achieve a goal there will be an element of patience required. If the goal is inappropriate – since the client does not want to wait to go through the training process – then a new goal needs to be set. At the end of the day the client will fail if the goal is set too high, and this reduces motivation for training in the future.

When a client sets goals or has ambitions which are too high we call these fantasies. Physiotherapist and trainer can put goals into perspective, set realistic targets, and make the process enjoyable

Personal Training series: The Shoulder injury in training

Shoulder pain is a common complaint when training in the gym. I have often seen shoulder pain occur when someone is doing a deep bench press or a very low shoulder press. This pain could be associated with a clicking noise or a sharp pain at the point of deepest position. Often the person tries to train harder to resolve the problem, because they believe that strengthening the shoulder will be the solution to the problem.

The other time shoulder problems can occur is when someone is given a new exercise which is very functional in many degrees of motion, using small weights quickly or pushing very heavy weights. Today exercises are often more functional which means that they do not function in single planes of motion. These movements can be very complex and require coordination and skill. When a person does this for the first time, and then they try to do this too fast with a heavy weight, they lose control of their shoulder joint and the shoulder joint is put under unnecessary stress. This stresses the shoulder over time and breaks down the tissues leading to injury.

When the total movement of an exercise is videoed it can be seen that the shoulder can also be put under stress because other parts of the body are not moving as well. When someone rotates their body and pulls weight up and out above their head, if their hips, pelvis or knee are not moving in a coordinated fashion the shoulder gets unnecessary stress and this can also lead to tissue breakdown and injury. An injury can occur from one explosive movement or from repetitive movements done badly over time. Sudden movements are often associated with a one off severe pain; however the repetitive movements done badly over time tend to creep up on a person. Pain develops insidiously and starts at a low level, gradually building to a point at which they must seek physiotherapy.

Rehabilitation protocol for shoulder pain can be very complex as the shoulder is the most mobile joint in the body. The shoulder can be prone to increased movement in some areas but stiffness in others. The spine, hips and knees – even the big toe – joints can all be causes leading to shoulder pain. The assessment protocol for assessing the shoulder will be a global one and treatment may involve working on areas other than the shoulder.

To prevent shoulder problems it is very important for a physiotherapist to work closely with a personal trainer. The trainer communicates clearly with the physiotherapist what they intend to do with their client, and then the physiotherapist can guide the trainer as to what potential risks there are. If this close relationship functions correctly between the physiotherapist and trainer than injuries can be prevented, goals can be achieved and long term damage to the body can be avoided.

Personal Training series: Heavy weight training and injury prevention

Many people like to look their best and this requires a toned shaped body. Some people want to lose weight and this will also involve weight training. It has been found that a combination of cardiovascular exercise and weight training can get faster results because increased muscle mass will burn more calories and hence improve reduction in weight, as well as a shaped body.

If someone starts weight training from scratch injuries are often common because the correct movement patterns are unknown. Most people know that they can hire a one-on-one trainer to assist them in this process.

Weight training has many forms; if the weight training is kept at a light to moderate weight, and the movement patterns are correct, injuries can be prevented. Problems start to occur when weight training becomes very heavy. In order for muscles to grow they require a stimulus harder than the time before; training can start gradually and increasing in weight is a simple process. When a person starts to reach the maximum weight that they can push then challenges will occur.

The challenges of pushing weights higher than a person’s current maximum lifting weight will be controlling the weight when putting it into a starting position; lowering the weight in a controlled fashion; avoiding excessive joint position; and finally pushing the weight back to the start position. Sometimes lifting heavy weights will require standing, a lunge position or a position other than on a stable bench. When a person has to control a heavy weight, as well as the position of their entire body, the movement becomes very complex.

Commonly the injuries I see when someone lifts heavy weights are at the very start of the movement and in the middle of the movement. The weight is very heavy and at the start of the movement the person has to lift from a standing still position. To generate extra power a person will compensate by swinging their body to help; it is at this point that an injury may occur to the lower back, the sacroiliac joint, the knee or any other joint that is the weakest joint in the link. The time pain occurs is in the middle of the movement because the middle of the movement is the most awkward; controlling the body puts the body in its weakest position, and tissues get injured.

A client was training and wanted to be pushed more, and therefore was told to start Olympic deadlifts. She was 5 foot, of petite build, and when she explosively lifted this weight her sacroiliac joint popped. Treatment for this joint has taken several months and she now requires pilates and controlled movement training to keep her pain at a satisfactory level.

At some point in a person’s training lifting heavy weights may become necessary. If a physiotherapist can identify weak areas within the body – and the trainer is aware of these areas – then when lifting  a heavy weight in a complex movement pattern, the trainer can help a client control and prevent injury.

My advice is always to have your entire body assessed before you start lifting weights to give the trainer the information they need to prevent an injury from heavy weight training.

Personal Training series: Predicting Injuries

No two people have the same body; and even if two people look the same their ability to withstand load can be vastly different. Commonly in the clinic my clients complain about holding good posture. They report how other colleagues in their places of work can sit with bad posture but never develop pain. Why is this?

There are some people who have a musculoskeletal system which is able to withstand the abnormal loads on their bodies in poor sitting postures: there are others who have a very low tolerance to the stress of sitting with poor posture. There may be many reasons for this but I think a major factor is simply genetics. Genetics cannot be changed. Therefore, two people should avoid comparing themselves when it comes to posture, movement and pain.

Another example of this is athletes – who play sport regularly – and get more injuries than others who may sit at home with an unhealthy lifestyle and watch TV. If you play sport you are generally going to be healthier on the inside but maybe more prone to injuries on the outside. Unfortunately this cannot be avoided as sport does put abnormal loads on the body. If the body cannot adapt to these loads then injuries will occur.Those people who sit on a sofa and eat unhealthy foods do not expose their body to the stresses of sport and in the long run may have fewer injuries and actually better joint condition.

When a physiotherapist assesses a person a bespoke testing protocol is followed; this protocol will take into consideration the movement patterns this person puts themselves through in normal daily life as well as in their sports or hobbies. This assessment is a very functionally based assessment whereby the client can see where their issues are in daily function or sport – and then has a goal to achieve in the rehabilitation process.

The physio will do a thorough examination of the musculoskeletal system and identify individual variances within each person. Physiotherapists can then report to the trainer what the potential consequences of training that person will be. This method will also identify what limitations this person may have when setting goals. When a physiotherapist and personal trainer work closely together you get a synergy like no other. The client gets fully assessed at the start and the constant feedback throughout the training process will provide a bespoke feedforward system for goal attainment and injury prevention.

When a physio and trainer work closely together injuries due to movement can be predicted. Sometimes a client can do an awkward movement once, twice, ten times but if they decided to run a marathon with the biomechanics that they have they will develop an injury. The training process must be adapted to provide help to prevent this injury increasing strengthen and flexibility in various parts of the body to enable that person still to run a marathon.

It is my intention that a client is able to train with very few major injuries; continue to train if they have minor injuries; and attain their goals on time. The client also has the benefit of knowing the physiotherapist, and of knowing that the trainer and physiotherapist are working together as a team.

Personal Training series: Physical Edge Physiotherapy team working specifically with Personal Trainers for superior results

I believe being healthy is important, as it affects every area of life – if you are healthy you can do more and feel better doing it. Often people find it difficult to motivate themselves to go to the gym or to do sport; they need someone to direct them in their training, give them focussed goals, and keep them motivated along the way. Personal trainers play a significant role in this regard – helping people achieve their physical goals. Today personal trainers often work in one-on-one training facilities, to offer functional gym training in a smaller more intimate environment;the gym generally has better equipment, is cleaner and the trainers can offer state of the art functional training.

Having spoken with several high profile trainers in London, we have identified the need for physiotherapists to work with trainers.People find it frustrating when they get injuries and the trainer sends them to a physiotherapist they do not know; the physiotherapist may not clearly communicate back to the trainer what the client’s injury is, and how to help heal that injury during training. Sometimes training is stopped for no reason and the client is taken away from his / her training goals.

The way to improve the training process is to have a physiotherapist work with the trainer from the very start. By getting assessed by a physiotherapist before training starts, a person can discuss their injuries and how their body operates with a medical professional. The physiotherapist will identify the injuries, past and present, which may present during training sessions; even if there are no current injuries, the physiotherapist can identify potential pitfalls a person may encounter as they go through their training regime towards their goals. Once the person is assessed by the physiotherapist the physio can feed back to the personal trainer what to look out for during the training process, what limitations there are for that person in training, and whether the training goal is appropriate. The trainer can then confidently train a client knowing that he/she is supported by a medical professional who understands injuries and how the body functions in response to them.

The personal trainer will continue to communicate closely with the physiotherapist during the training process; the physiotherapist will continue in their assessment of a client throughout their training regime in order to maintain correct movement of the body and further direct the trainer towards more advanced training goals. By working well together in this way the physiotherapist and trainer help to provide a better service to their clients. If an injury does occur during training the physiotherapist will already know the client, and the trainer will be able to communicate immediately with the physio on how to proceed. The synergy of this relationship far exceeds any personal training system by itself.

The benefits to the client are:

  • Prevention of injuries during training
  • Faster goal attainment
  • Faster return to training if an injury does occur.

If you are interested in working with a physiotherapist and personal trainer contact us at http://www.physical –edge.com

Decision to race the L’Etape du Tour

It has been 5 weeks since I finished the Ironman in Switzerland. I have been eating whatever I wanted and I noticed my metabolism initially was very high. After eating a meal I would get hungry within 2 hours and I could feel my body getting thinner, especially my face.

My body wanted to continue training but I resisted and in 5 weeks I have completed only one,  45 min run. I got straight back into work as a physiotherapist and had very little sleep over the first 2 -3 weeks. This exhausted me to the point of feeling sick. I had not felt this way so often before and I think my body tired much faster after the ironman. I could rest and felt great for 2 days but if I had another late night the tiredness returned. The Ironman does take all your reserves of energy and I am still recovering today. Maybe without late nights and work I could recover faster? I am feeling better this week than last week and with a more sleep I know I will recover fully.

I wanted another challenge after the ironman. The time it takes to train for an Ironman is too much to continue doing these events. I know my strongest discipline is the cycling and I have decided to learn more about this sport whilst continuing to compete in shorter distance triathlons.

The decision I have made is to complete  a stage of the Tour de France which is called the LE’tape du Tour. I want to learn how to fix bikes, the biomechanics of cycling, training correctly and the etiquette of the sport. I plan to use this experience to help my knowledge of endurance events and improve performance in Triathlons.

I got my bike out of its bike box, after the ironman, and reassembled it. I had taken the front fork out of the body of the bike and it took some guess-work how to reassemble it correctly. If  you are taking it apart make a mental note of how the bearings and smaller spacers fit together.

I bought new Zipp 303 wheels as I was impressed with the Zipp wheel set I used for the ironman. I got advice from my bike mechanic, Dave, on which wheelset is suitable for road cycling. The 303’s have been designed for aerodynamics both up and down hills. They are strong enough to train on and will be less affected by cross winds when cycling.

I took the new Zipp 303’s into my cycle shop in Putney and had Patrick, cycle mechanic, show me how to put on new tires, change the rear cassette, and alter the brakes when I switch from training wheels to the Zipps. I have these lessons videoed on my youtube site on http://www.physical-edge.com.

We decided to put Latex inner tubes on the wheels to keep them extremely light. If I am spending £1550 on wheels it is worth maximising their performance. I now have both training wheels and Zipps to race on and I can put them on my bike when I choose.

I will now talk to Fran, my coach for the Ironman, and we are putting together a training program in the gym to prepare me for training on the bike. The idea is to build up Strength, Endurance and Power and then start training in a structured way from January. The date for the 2011 L’Etape du Tour has not been decided yet. The organisers must wait for the official Tour de France  race dates to be set, last year the race was in mid July.

This week I start in the gym and will see my coach on Friday for a training plan.