As many of you will know one of my special areas of interest as it relates to my coaching practice with Triage is that of helping people through pain, and helping to teach people how to prevent injuries with smart programming. So whether that be a new injury or a recurring injury, particularly in the context of resistance training. So people who lift weights but especially those who lift weights and do some other physical activities. For example, people who lift weights and do Jiu Jitsu, or lift weights and run, or lift weights and box, or whatever it happens to be. I like working with those types of people because there are some unique challenges there. Unfortunately, there isn’t much high-quality information out there on this sort of stuff, and there are many lessons to be learned that relate to anyone who is dealing with pain or has a recurring injury or niggle that keeps bothering them when they’re lifting in the gym.
So what I want to answer in this is the question of “why do we get injured in weight training?”
How To Prevent Injuries With Smart Programming
There are a number of different reasons why you may get injured during weight training, and there are a number of different contributing factors. To be honest, most of them can be put under the umbrella of inappropriate load management, or inappropriate loading. And that can be broken down into multiple different subcategories. Understanding these will allow you to make smarter training programs that will hopefully allow you to reduce your injury risk.
For example, one of those would be training volume. And if we think of training volume as being a very gross measure of the overall load exposure, that could be quantified as the total number of sets performed, and the total number of reps performed. The total number of sets is probably the most useful, particularly those sets that are taken close to failure. And that’s where volume begins to intersect with training intensity. Because if you’re doing a high amount of volume, let’s say you’re doing 30 sets for shoulders per week, and you’re also taking those to a high intensity, both absolute intensity, in terms of how heavy the weight that you’re lifting is as a percentage of your one-rep max, and then relative intensity in terms of how close that is to failure (this can be measured in terms of reps in reserve (RIR) and/or rating of perceived exertion (RPE).
Okay, so relative intensity can be thought of purely in terms of percentage of one-rep max, but what I mean there is, how heavy the weight is in absolute terms, and how heavy that weight is for you specifically, and how far you’re taking it in terms of proximity to failure. And one of the worst things you can do from a prevention of pain and injury perspective is doing loads and loads of sets (a high volume), and take them all to failure or close to failure. That’s just not great practice. So fundamentally, when we discuss how to prevent injuries, we need to address how much volume you are doing and how intense that training volume is.
Other things that come into it then would be things such as repetition tempo, and how in control of your movements you are. These are things that are also important, but again, they fall under that bracket of overall load management. Because, for example, if you’re using a really fast tempo, like dropping really fast in your squat, and you’re not controlling it at all. You’re dealing with far greater forces when you come to the bottom of that rep than you would be if you were to decelerate the weight and control the movement all the way down. Dive bombing a squat is a much different exercise than if you were to come down nice and slowly, and control the transition. This can be illustrated very simply by taking an object, for example, let’s say I’ve got a glass in my hand. If I bring it down slowly and rest it on the arm of my chair, that’s fine. It’s not going to damage the arm of the chair or the glass. No problem. It’s not going to be a big noise, no catastrophe. But if I was to drop this glass onto the arm of that chair? Then that would be a much different experience. Similarly, if you put a 10-kilo weight plate down on your foot nice and slowly, then that’s likely fine. You can handle that. But try dropping that 10-kilo weight onto your toe from head height. Trust me, as someone who has done this before, this is a much different experience. And I have the broken bones to prove it. You don’t want to do that. Okay, so the velocity at which you move matters, the technique and joint angles, etc., that you achieve, the range of motion, that again, all factors into that because it modifies the actual loading that you’re experiencing.
So performing, let’s say, a 50-kilo dumbbell press, which is your six-rep max and you are going as low as you possibly can and finding any way to get lower despite the fact that your shoulders are already hurting. When you get towards the bottom and you don’t consider yourself to be a very flexible person, that again is one of those things that could contribute to a higher risk of injury because the loading is more novel, it’s more progressive relative to your current ability, and as a result, the overall load that you’re dealing with is actually increasing. Because holding a 50-kilo dumbbell with arms straight up is very different from them being forced all the way back into maximum shoulder extension. You may simply not have the strength to stabilise the shoulder in that deep position, and as a result, even though your chest muscles may be able to handle that loading, the other structures involved, may not be able to handle that loading.
Okay, so there are some of the variables you want to be thinking about. Now, generally, people probably overemphasize the importance of the technique component and underemphasize everything else. That’s one of the biggest mistakes I see. People worry far too much about the specific joint angles they’re achieving, like always thinking about stuff like “is my back rounding?”, and not enough about the fact that they’re doing 10 sets of deadlifts to failure. It doesn’t matter how straight you keep your back in a deadlift if you’re doing far too much volume, and far too much intensity. You’re working far too hard, and your risk of injury is increasing as a result.
Programming To Prevent Injuries Key Takeaways
So, the thing that I would like you to take away from this is that you should be more concerned about your overall training programming, rather than your specific technique. Bodies are generally quite robust and resilient, but you can do too much. You should probably worry a little bit less about being a perfectionist with technique and worry a little bit more about the programming element. Technique is still important because it fits into that domain of load management, because different techniques, different joint angles, and the manner in which you perform the exercise does alter the loading on the body.
For example, is it a wide-grip bench press with elbows out wide, or is it a close-grip bench press? You’re dealing with different loading there. If you were to break down the biomechanics or the physics of that exercise, it is actually different. The joint structures involved are dealing with different forces. So technique 100% matters, you can’t say it doesn’t matter because it modifies the distribution of load. Thus, unless you’re going to say that the load doesn’t matter for injury risk, obviously technique matters. But the overall load management is what I’d really like you to pay attention to. This is particularly important for those of you who perform multiple different activities, for example, people who are running and doing weight training. It’s very common for people to adopt a weight training program that someone might be able to tolerate as a bodybuilder, and to then add in a load of running on top of that.
This is further compounded by the fact that most people don’t think about load management at all when it comes to running. They do 5K and they go as fast as they can, 10K as fast as they can, again increasing their risk of injury because we’re pushing that loading far too quickly. This is one of the things I come across most often with new clients who are taking up running. I have to slow them down, often slow them way down, and stop chasing the times. They have to learn to detach the ego.
And clearly, that’s relevant to weight training as well. You’ll see this with people who, let’s say, they finally start bench pressing over 100 kilos, they finally break that milestone, and they don’t want to train under 100 kilos at all anymore because they’ve attached themselves to that level. They’ve attached themselves to that, and they’re like, even if they’re supposed to be doing sets of 12, they probably will just avoid doing sets of 12 because they don’t want to do less than 100 kilos.
One final thing that I’d like to mention is the role that novelty or staleness can play in increasing the risk of injury. Now, we don’t have much granular evidence on this, particularly in weight training, but as a whole, what you tend to see is that training that is novel every now and then, so there’s variety in the stimuli at a given point in time and also across time, that tends to be better from an injury prevention or injury risk reduction perspective. What tends to not work so well is doing the same thing all the time, particularly if that same thing is in accordance with all those things that we already discussed, such as high volume, high intensity, poor control of your reps, etc.
And this is most evident, when you look at early sports specialisation, when you look at children in sports. If they specialize really early, they’re at higher risk of injuries, burnout, and other complications down the line versus those who play multiple different sports. That same thing applies to the adult athlete who needs to be a generalist before they specialize. So if you can lay a solid base of fitness and strength capability, so you train through lots of different joint ranges of motion, different exercises, different resistance profiles, etc., that’s going to be superior than just doing, like, three exercises for 60 sets a week. Because what you have to realize is that even if you’re doing, let’s say, multiple different squatting variants, for example, you’re doing a split squat, you’re doing a back squat, and you’re doing a leg press. They’re all squat-type exercises. They’re slightly different muscle recruitment patterns and slightly different distribution of joint forces between those different exercises. As a result, you’re going to have more training longevity versus simply applying those forces in the exact same way every single time. And that’s pretty intuitive, I think. You know, if you’re going to file something like your nail down, and you file it from just one side, let’s say I’m doing it for 60 seconds, if I do that all from one side, I’m going to get to that the skin much sooner. As a result, I’m going to start bleeding out that finger, and it’s going to be a pretty horrible feeling. Whereas if I do that 60 seconds and it’s like 10 seconds here, 10 seconds there, 10 seconds over there, etc. now I’ve got a well-rounded nail. It’s nice and short, and I haven’t dug so deep into any one area of the nail that I’ve now got a bleeding finger. So if we are trying to prevent injury, it is important to have variety and not let your programming become too stale.
So hopefully, that gives you guys some things to think about, and hopefully, some things that you can apply within your own training. People are often very resistant to doing the things that actually do help them reduce their risk of injury and overcome pain. And that’s one of the reasons why I end up working with these people. So hopefully this article has helped you better understand the variables that go into designing a resistance training program that will help you prevent injuries. We produce a lot of content on our YouTube channel, we also produce a lot of written content for the website (a good place to start would be this article on nutrition, then this article on sleep, and finally this article on stress management) and we also certify people to become a nutrition coach, if any of those interest you.
Gary McGowan
Hey, I am Dr Gary McGowan, co-founder of Triage, qualified Doctor, Physiotherapist, and Coach.
Having graduated with first class honours in Physiotherapy (BSc) and Medicine (MB BCh BAO), I aim to blend medical science with a decade of coaching experience to help you maximise your performance, transform your body, and optimise your health.
I enjoy grappling, hiking, lifting, and other modes of physical training. When I’m not training, I like to read broadly, particularly philosophy, religion, and history. I love the natural world, particularly the mountains & lakes of my hometown Killarney, County Kerry.
