MAX FITNESS

Exercise
for Injury
Prevention

Te last thing you want when

you get back into working out (or
anytime for that matter) is an
injury. Here's how to avoid injury
and some great exercises to try!

BY STEPHANIE DORWORTH, PT, DPT, MTC, CPT

WITH SUMMER upon us, I am sure

you have a few health and ftness
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
fexibility all of which are preventable
with proper education and practice! So
lets 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 mindmuscle 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.
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MAY 2015

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HAVE GOOD POSTURE: In todays

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 frst: 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 benefcial. 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 (090 degrees of knee fexion) versus
a short ROM (0-50 degrees of knee
fexion). One of the fndings was
that the group that trained the full
ROM developed signifcantly 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: Lets 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!

MS&F

Four most common injuries

in people ages 50+ and how to prevent them:
Rotator
Cuff Injury

Chest Injury

Sciatica

Patellofemoral
Knee Pain

What is it?

The rotator cuff (RTC)

is made up of four
muscles/tendons
in the shoulder:
-Supraspinatus
-Infraspinatus
-Subscapularis
-Teres Minor

The chest is made

up primarily of two
muscles: pectoralis
major and minor.

Sciatica is shooting
nerve pain into one
or both legs that may
be associated with leg
weakness, numbness
or tingling.

The knee is comprised

of many ligaments,
menisci, muscles and
tendons. If those are
not injured, one other
possible source is poor
tracking of the patella
(knee cap). This can
cause infammation
and therefore pain.

Causes

-Repetitive overhead
activity
-Bone spurs
-Falls
-Lifting injury
-Muscle imbalance
-Poor posture

-Traumatic injury
-Chronic overuse
-Improper weightlifting
technique
-Muscle imbalance
-Poor posture

-Disc herniation
-Spinal stenosis
-Spondylolisthesis
-Tight piriformis
muscle
-Sitting long periods

-Hip internal rotation

posture
-Hip external rotation
posture
-Flat foot
-High arches in the
foot
-Common in long-term
runners

Exercises to
prevent it

-Strengthen the RTC,

traps and serratus
anterior muscles
-Stretch the pectoralis
muscles

-Strengthen the
scapular stabilizers so
scapular depression/
retraction can be
maintained during
chest strengthening
exercises like the
Bench Press
-Stretch the pectoralis
muscles

-Strengthen the
abdominals/core
and the lower back
muscles
-Stretch the legs,
especially the
piriformis muscle

-Address the cause of

the problem frst
-This may require an
orthotic if the cause is
fat foot
-This may require
strengthening/
stretching to fx a
muscle imbalance

Turn the page for 12 exercises for injury prevention.

MAY 2015

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