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Sunday, January 3, 2016

Injury Prevention In the Gym without Giving Up Gains or Intensity



Introduction
It's time for my annual fitness post. This year's topic will be injury prevention in the gym (without diluting the intensity of your training). This was a particularly bad year for me in terms of injuries so I had to find ways to do the best I could. Hopefully some of my experience will help you get through any injuries that you have or will have. And if you're over 30, you will get injuries whether you exercise or not! 

Caveats
First of all, for liability reasons I should make clear that I am not a registered homeopath or energy healer. I don't have a psychic connection with the Truth and so you should be skeptical of my evidence-based approach to health fitness. I get a lot of my information from pubmed, professional trainers/athletes, and medical professionals rather than from the universe whispering the Truth to heart.  

To be fair, my starting point is always personal experience. I've had many many injuries and tried all the wrong ways to avoid and rehabilitate them.  

The Most Important Fitness Goal After Age 30 (Not an Exaggeration)
After age 30, the single most important fitness goal--the central organizing principle of all your physical activities--must be to avoid getting injured. I'm not kidding. If you do this one weird trick (that they don't want you to know about) you stand a significantly greater chance of staying in shape and healthy.

Why? Because when you're injured you can't train. When you can't train you lose momentum, enthusiasm, and whatever gains you're holding on to.  I like to think of it this way: It's better to train at 85% 100% of the year than to train at 100% 75% of the year.

A common scenario: You're doing relatively well with your fitness and diet. You've established your routine. That is, you've finally developed your exercise habit to the point where the inertia that used to suck you back into the couch when it was time to work out is no longer as powerful. In short, after many a battle with yourself, exercise and a (relatively) healthy diet are now habits!

Alas! Out of nowhere you somehow injure yourself exercising. Maybe you didn't warm up enough. Maybe your body wasn't feeling right but you pushed yourself anyway. Maybe you tried to lift too much. Whatever. The point is, now you're injured.  

Whereas a youngster heals fairly quickly from all but severe injuries, each year past 30 equals an almost logarithmic rise in recovery time. Conclusion, even for a minor sprain it's gonna take a few weeks (at best) to heal. 

Depending on how bad the injury was you may or may not have a legitimate excuse not to exercise. Your routine stops. Instead of going to the gym, you are sedentary. Your eating habits start to slip. The momentum is gone. Worst of all, your healthy habits are being undone. They are becoming unhealthy habits. 

You survive psychologically and eventually get back to the gym. But it's different now. You've taken at least 2 steps back. All that work that you put in before is undone. Psychologically you ask yourself "what's the point if I'm just going to get injured again and I'll lose all the work I put in this time." Not to mention all the hard work getting back to where you were. 

To summarize, after age 30, injuries are your worst enemy. They break your good habits. They make you depressed while you can't train and while you watch your hard work wilt away. They're psychologically difficult to come back from. 

So, 
THE FIRST RULE OF EXERCISE CLUB IS DON'T GET INJURED AT EXERCISE CLUB. 

What does this entail?
(a) Warm up 1: If you're lifting weights, don't even touch them until you've spent 10-15 min on a cardio machine to get your heart rate up and blood in your muscles. Never lift cold.

(b) Warm up 2: For your first and second exercises do as many warm up sets as you need until you feel warmed up. I usually do at least 3 before I go to my working weight. 

(c) Listen to your body: If either during your warm up or at any point your body "doesn't feel right"--that is, the weight feels heavier than normal or there's pain or irritation where there usually isn't--either stop or reduce the weight. Usually what I'll do when this happens is I'll drop the weight by about 20% and finish the rest of my sets there. I finish the workout uninjured and return the next day. 

(d) Leave one in the chamber: Don't push for that last rep. I know, back in the day it was all about squeezing out the last rep--going to exhaustion. However, as I've learned more times than I care to remember, this is the most common reason for injuries in the weight room. In fact, I'd say 80% of my injuries occurred when I pushed myself past exhaustion (it's an anecdote, therefore counts as science). This doesn't mean you need to lift like an over-cautious nervous nelly. It just means that you don't go past failure in individual sets. Throw in an extra set or two into your workout if you still have energy but don't push individual sets to failure. If you do, understand that it comes with risk.

(e) Lift technical not heavy: There are two important aspects of technical lifting (that are relevant here). First, is use correct biomechanics. In plain language, to avoid injury always use correct form. If you can't complete your repetitions with perfect form, you're lifting too heavy and are putting yourself at risk of injury. Second, focus on the contraction rather than moving the weight. This is often referred to as mind-muscle connection. If you don't feel the contraction in the muscle you're supposed to be working, stop and reassess how you're doing it. For bodybuilding and fitness the goal is to work particular muscles in particular ways. Moving a weight up and down is merely a means of doing that. Don't mistake the means for the end. Consciously meditate on the muscles you're engaging throughout each repetition. 

(f) Use negatives and TUL: 'Negatives' are the non-lifting portion of the exercise. I.e.., it's the downward part of the movement. Most recreational lifters don't give this portion of the movement much thought. They just lower the weight into position for the lifting phase. However, the trend in the current and best literature is that negatives are where major gains can be made. To do negatives, slowly lower the bar to the lifting portion of whatever movement you're doing. That is, fight gravity. Then lift. 

Here's an excellent example and explanation of why it works: Video
Here's another version for shoulders emphasizing the negative even more. You can use this technique for any exercise: Video (5 count for the negative)

Why does this reduce likelihood of injury and increase gains? TUL: Time Under Load. Apart from weight, the most important variable for determining whether a muscle will grow is the time it's under a load. We can use this principle to reduce injuries because if I lift more slowly, I'm not going to be able to lift as much weight. The higher the working weight, the greater the chance of injury.  So, when I work out, I actually don't lift very much (relative to other lifters my size) but I move the bar slowly in the negative portion of the movement. When you calculate TUL, it's at least equivalent to what it would have been had I used heavier weights but allowed gravity to do the negative for me. In short, my muscles are doing just as much work as if I'd lifted heaver weights but because I'm using about ~20% less weight, my risk of injury goes way down.

(g) Use pauses at the top and bottom of each movement: Using pauses as both the top and bottom of a movement also exploits the TUL principle.  The length of the pause is just enough to stop any 'bounce'--this means about a two count. By pausing at the peak and bottom of each movement my muscles' TUL is at least equivalent to what it would have been had I used a weight about ~20% heavier. I get the same stress on the muscles but with a lower risk of injury. Also, I find that pausing at the bottom of each movement really helps me to mentally focus on which muscles I'm engaging in the movement. It's important to note that when I pause at the bottom of the movement, I'm not relaxing the muscles. In fact it's quite the opposite. I'm loading the tension in my muscles like a spring. When I feel everything's aligned, I release the 'spring' and explode out of the pause. Try pausing at the bottom of your squat or straight-legged dead lifts. You'll love me in the morning when you can't get out of bed (TWSS).

Regarding pausing at the top, the idea is the similar to the bottom pause. My muscles are not disengaged. They are at their point of maximum contraction and I hold it for a count. 

Here's a video of lifters using a pause at the bottom of a front squat (You can use the technique for any lift): Video
Here's 4X Mr. Olympia Jay Cutler using a pause at the top: Video

Conclusion:
Although this was a particularly bad year for me regarding injuries, I'm sure it would have been worse if I hadn't employed these techniques in the gym. (My neck injury was from the one time in a few years I didn't warm up properly). To recap everything: 

1. After 30, your number one goal going into the gym is to walk out of the gym without any injuries. 

2. You can do this in a way that doesn't compromise your workout's intensity.