Monday 1 October 2018

If You Want To Stay Fit And Painfree Don't Ever Do This Exercise!!!!

       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. 

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