I am excited to share my most recent article with you all…
EXERCISE FOR INJURY PREVENTION
By: Stephanie Dorworth, PT, DPT, MTC, CPT
With summer upon us, I am sure you have a few health and fitness related goals written. I am also positive getting injured is not one of them. None of us go to the gym with the intent of getting hurt. Yet that happens more often than you would think. As a physical therapist, I see this every day and the majority of the time it is to people 50+. Why is that? It is not solely because of age. Other likely causes include a lack of warm-up, poor posture, not strengthening through a full range of motion, lifting too quickly, progressing too quickly and/or poor flexibility – all of which are preventable with proper education and practice! So let’s look at those in detail:
Warm-up: An active warm-up is crucial for you to begin your workout with warm muscles and a strong mind-muscle connection. Static stretches should not be performed pre-workout. Instead, perform 3-4 sets of 7-12 reps of a compound exercise that targets the muscle group you are working out that day. Be sure to fully shorten the muscle group in 2 seconds, hold that contraction for 3 seconds, and then slowly return in 2 seconds. This step becomes increasingly important as you age.
Have good posture: In today’s society, many of us are computer magnets, which results in muscle imbalances. Commonly, the head is forward, the shoulders round, the front chest muscles shorten and the back muscles weaken. So we therefore have an imbalance where the anterior muscles are short and the posterior muscles are elongated and weak.
Before you begin any exercise, make sure your posture is perfect first: head aligned, shoulder blades squeezing together and abdominals bracing. Lifting weights with bad posture and form is the main cause of gym-related injuries I see in my clinic.
Strengthen through a full range of motion: A huge mistake many people make is they strengthen through only 50 percent of the range of motion (ROM), so they are doing their muscles a disservice! Many recent research studies show strengthening through a full range is more beneficial. For example, in 2013, McMahon published a study comparing strength gains in participants who performed their squat, leg press and leg extensions with a full ROM (0-90 degrees of knee flexion) versus a short ROM (0-50 degrees of knee flexion). One of the findings was that the group that trained the full ROM developed significantly more knee extension strength (18 lbs. on average) compared to the group that trained through a short ROM (4 lbs. on average). The group that trained a full ROM were also able to maintain their strength gains longer during a 4-week period of detraining than the other group.
Practice time under tension: The time-under-tension method is a way to lift while focusing on timing, control and effectiveness. When it comes to lifting, fast is not always the best option when avoiding injury. Slow and steady wins the race. Much research shows that slower muscle contractions actually require more muscle force and therefore lead to more muscle growth. So with this method, a very slow eccentric (negative) contraction is the key. The optimal time for a muscle to be working under tension (not at rest) during a set is 40-70 seconds. So here is an example of timing to use for your weightlifting workout sets: 1 second concentric/positive contraction +4 second eccentric/negative contraction. This is done without a pause at the beginning or end of the rep. So 8-14 reps with that exact timing will get you 40-70 seconds of total time-under-tension.
Progress slowly: Let’s say you have not lifted weights in awhile. Walking into the gym and lifting the same amount you used to would not be safe. After two weeks off, you begin to atrophy. So allow yourself time to build back up slowly.
Stretch post workout. I recommend you stretch out every major muscle group, not just the group you worked out that day. A 2012 meta-analysis concluded that pre-workout static stretching should be avoided. After your workout is the only time to perform static stretches for 30 seconds at a time.
And of course, do not forget the basics like hydrate well, eat well and allow for enough rest and recovery!
Top 12 Exercises for Injury Prevention:
This program can be done every day. Perform each strengthening exercise for 3 sets of 15 reps. Perform each stretch 2x for 30 seconds.
1. Band Shoulder External Rotation At Side: Place a towel inside your elbow, pull the band outward while keeping your elbow bent at 90 degrees. Purpose: Strengthens the RTC muscles
2. Band Reverse Flys: Stand and hold the two ends of the band with your palms down and elbows slightly bent, protract (round) your shoulders, and then draw your elbows backward slightly (do not bring the arms behind the body though). Purpose: Strengthens the posterior (rear) deltoids
3. Bench W’s with Dumbbells: Lie on your stomach on an incline bench holding dumbbells, squeeze your scapula back and lift your arms into a “W.” Purpose: Strengthens the scapular stabilizers and trapezius muscles
4. Forearm Planks with Scapular Protraction/Retraction: Start in a traditional plank position, then go from protracting (rounding) your scapula to retracting (squeezing) them together. Purpose: Strengthens the scapular stabilizers, trapezius muscles and abs
5. Bird Dogs: On your hands and knees, slowly raise one arm with the opposite leg while keeping your back in a neutral position. Purpose: Strengthens the abs, back extensors, glutes
6. Side Plank with Hip Abduction: In a side plank with your top arm on your hips, your top foot should be dorsiflexed with your toes pointing down to the floor (to internally rotate the hip), and then raise your top leg up while maintaining the plank. Purpose: Strengthens the abs, scapular stabilizers, lower back muscles and gluteus medius
7. Stability Ball Bridges: Lie on your back with your legs straight and calves on the ball, arms reaching up to the ceiling, then lift your hips up while staying balanced and level. Purpose: Strengthens the abs and glutes
8. Chops with Medicine Ball: Start in a sumo squat position holding the ball near one foot, then straighten your legs as you lift the ball to the opposite side and overhead, keeping the belly button pulled in toward the spine to support your spine. Purpose: Strengthens the abs, obliques, legs and is functional lifting practice
9. Lateral Neck Stretch: Pull your head to one side while holding onto a seat/bench and leaning toward the opposite side being stretched.
10. Foam Roller Chest Stretch: Lie on top of a long foam roller with feet on the ground, arms in a “T” outstretched on the ground.
11. Piriformis Stretch: Lie on your back and pull one leg’s knee and ankle towards the opposite shoulder.
12. Hamstring Stretch: Lie on your back with both legs straight, then pull one leg towards you while keeping the knee straight and the foot flexed.