As a physiotherapist who also works and lives in the
fitness industry I’ve seen many people who have hurt themselves performing
various exercises or activities. Over time – a few common exercises stand out
in my head as problematic for many of the people I work with. In this article I
tell you what exercises you must absolutely avoid to stay fit and painfree.
…..Alright, but seriously, now that the clickbait is out
of the way it’s time to get to the true purpose of this article. A
recent
couple of stories have been making rounds over the past few weeks as they
recommend modifying or eliminating specific exercises for people over 50.
Although
my involvement with the middle aged & elderly has decreased as a result of
my recent change of jobs I still spend a fair amount of time with those
populations through my current job and through my involvement with the
University of Waterloo. While the above pieces are a bit overboard and can
border on fear-mongering – it’s important to understand that some exercises may
not be good fits for certain people. Instead of saying an exercise is bad or
good a better way to do things is to look at an exercise through the questions
I pose below
Question 1: What
is the goal of the individual?
This will vary based on the setting you work with (rehab
vs fitness) and the specific population you work with. The goals determine the
acceptable risk/reward ratio of the exercise.
For instance – a heavy deadlift with chains on each end
of the bar may be an appropriate exercise for someone competing in strength
sports but can be overkill for someone who’s interested in other goals such as
pain relief, fat loss, hypertrophy or improved athleticism. Another exercise
that has less joint load may be a better choice for them.
Running is a big example of this as it does have a higher
injury rate compared to other activities,
even
strength sports. If you enjoy running; are healthy; and manage
training load, recovery, nutrition, sleep, psychosocial factors etc well it’s
probably a fine activity for you. But if you’re 100 lbs overweight and have a
variety of medical & orthopedic issues there are better options to improve
your fitness.
Basically, to make a long story short, does the exercise
fit within the goals of the individual and work towards those goals.
Question 2: Can
the exercise be done properly?
Research and anecdotes have shown that there are lots of
different ways to perform an exercise properly. But there does, in my opinion,
need to be standards for technique when it comes to higher load movements such
as the powerlifts & the Olympic lifts. I’m not gonna lose sleep if someone
forgets to “grip the floor” with their toes in a front squat but if they’re
excessively falling forward and their legs look like that of a baby giraffe
then it may not be an appropriate choice for them.
Side note: before saying an exercise can’t be done
properly and making your client do a million corrective exercises – try showing
them what you’re looking for in terms of technique, coaching & cueing them,
and also experimenting with different grips & stances & bar positions.
If they still can’t do it properly despite all that then, in an SFMAish sort of
fashion, break things down to look at mobility and control of individual joints
to see what is lacking and modify training as deemed appropriate by giving your
client exercises that can be done properly.
Bottom line: if an exercise, despite proper coaching and
cueing, can’t be done to an acceptable standard find another option to achieve
the goal.
Question 3: Does
the exercise aggravate any medical issues?
In general, for fitness training, exercise should be
painfree. If an exercise causes issues modifications should be given to make
training painfree.
Some exercises just don’t sit well with certain people.
Tricep extensions/skullcrushers/JM presses etc; regardless of technique, order
in the workout, rotation of exercises, or volume progression; just irritate my
elbows so as such I stick to pushdowns and tricep dominant pressing movements
(i.e. dips, close grip bench press).
The only exception I make in training, as I
talked about
with Travis Mash, is when an athlete is peaking for a major competition that
means a lot to them. In that case “the juice may be worth the squeeze” to quote
Brian Carroll.
In rehab, for the most part, exercises should be painfree
where possible – but I also believe some people (i.e. chronic pain,
post-surgical, central sensitization) may not be able to do anything painfree. Exercising
patients into pain is a complex and difficult topic which I plan to write about
in more detail in a future article. I
would say if you’re not someone who’s well versed (from a research knowledge,
professional training & licensing, and experience perspective) in exercise
for those populations you need to refer out to someone who is. If you need help
contact me via Facebook.
If an exercise doesn’t have an appropriate risk/benefit
ratio based on the goals of the person don’t force it if it’s painful.
Question 4: Is the
exercise being programmed & progressed appropriately?
Sometimes an exercise is good but can be programmed
inappropriately. Take for instance people that go from squatting 1x/week to
doing a “Squat Everyday.” Neither of those are bad programs but there needs to
be a proper progression that allows for recovery & building work capacity.
In a
previous
article I discussed Tim Gabbett’s research provided some general
ideas on progressing activity volume that I find useful for competitive
athletes, weekend warriors, and even people with persistent pain.
I hope this article provides some useful algorithms for
you to determine whether or not an exercise is good for you or your clients. As
always – thanks for reading.
