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.

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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.

Personal Training Series: “Don’t care, get over the finish line”, can lead to injury

Some athletes are bloody minded and will do anything to win. Some clients only see the goal at the end but don’t think about the process of getting there. In physiotherapy I see many people who have trained incorrectly because they focus only on the event they are racing and not on how to train to get there.

Having a personal trainer and a physiotherapist work with you can vastly improve your chances of reaching your goal, with minimal to no injuries. The training process can be designed specifically for the goal and the exercises required to achieve the goal can be taught correctly.

When designing a training programme there are many variables to consider such as: exercise technique, timing of training, intensity of training, the environment of training, progressions of training, and even what is happening in an individual’s life. Having a team to work with you takes away the need to think. The professionals also have the experience and the knowledge to give you the best training advice.

When working with a physiotherapist and trainer you can contact them at any time. They can talk to you when you get injured, when you have questions about your training, and when you want to know what to do if you get injured. Having this team is like being a professional athlete, and provides the greatest chance of success.

I have seen amateur athletes start training, and progress doing extremely well without any help; then they reach a certain mileage in training and their body starts to break down.  At this point it is too late to change technique and training regime because the race is within a few weeks. Treatment is then about first aid care – doing everything possible to keep that person training despite the risk of increased injury, and the fact that the race is now in jeopardy. There are many emotions which accompany being in a position of unknown at race time. A person with injuries does not know how the body will react during the race; the target or goals in that race no longer apply; and all those weeks / months of training have been put at risk. To cross the finish line is often the goal after an injury has occurred. A plan then needs to be made to race the following year with correct training principles, guided by the personal trainer and physiotherapist.

It helps to get the right advice to train. Speak to your physiotherapist – who works closely with a personal trainer – to create a winning team.

Personal Training Series: Putting the patient at risk

A patient came to me from training one on one with a trainer. She’d achieved many of her training goals in the gym, and therefore decided she wanted a new challenge. She asked the trainer to set a new challenge; and so the trainer decided to make her an Olympic weight lifter. This client was 5 foot tall, of medium build, and had never done heavy weight training before. The trainer gave her a deadlift to do, and in the process she felt a sudden sharp pain in her lower back and dropped the weights. She was in agony, could not sleep and noticed the pain whenever she was sitting for prolonged periods of time. On assessment she had significantly damaged ligaments around her sacro-iliac joint and it was now hypermobile. The treatment for this condition required regular physiotherapy, Pilates, and a modification of her training.

The above story is an example of an inexperienced trainer pushing the client beyond what should be expected of him / her (in this case a 5 foot tall medium built woman). The client has stopped going to that trainer and now requires more low level exercise training, rather than high level training such as running and weight training – which is what she originally desired.

When a physiotherapist and a trainer work closely together this situation can be avoided. The physiotherapist and trainer will assess whether an exercise programme is appropriate to give to the client, then find an alternative training method or set a different and more realistic goal if necessary. The client benefits from avoiding injury, continuing training, and having constant surveillance of how his / her progress is going. This is an example of why a physiotherapist and a personal trainer working together with a client makes a great team.

Give yourself realistic timeframes to train

Having a goal is great because it drives you when times get tough during training, and it keeps you focussed through the training period. The time it takes for you to achieve your goal will vary depending on what that goal is. Sometimes I have seen people set goals with time frames which are too short.

When I completed my Ironman in Switzerland, I gave myself 1 year to prepare for the race. I worked with several coaches. Having 12 months gave me to time to learn and to get it right. I needed the time – because I was working – to fit in skill sessions, such as learning how to swim correctly, and to find the equipment I needed to race. I did get injured in the early stages of my training because my body was adapting to 6 days a week training. Having 12 months to train for the race allowed time for my body to recover from its injuries and to get back to full fitness to train again.

When the time to train before a race is too short there is greater risk of failure. I have had a client wanted to race the ‘Marathon de Sables’ in 2 years’ time, and to do an Ironman in 1 year’s time – and she had no background in endurance training; she also had an existing ankle injury. Setting goals like these is unrealistic; if you talk to a coach he will put a true time frame in for each event you want to complete. Personally I think it is better to leave more rather than less time to complete endurance events.

Remember, talk to your physiotherapist, coach or personal trainer when you want to set a new goal – to make your time frames realistic and to avoid injury at the same time.

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.