This is a guest post by my good friend Patrick McGrann, a Physiotherapist in Belfast, Ireland. Paddy says…

I am delighted to be asked to write a guest blog for MuscleHack. As a Physiotherapist I have a great interest in all things exercise and lifting. And as a lifter myself, I have been a big fan of Mark’s message for years. When he asked me to write a piece on weight lifting injuries, I jumped at the chance.

Good Pain vs Bad Pain

As a bodybuilder it is essential that you are in tune with your body. To help prevent or avoid injuries you need to know the difference between pain caused through exertion during a lifting session and the pain caused by an injury.

By understanding what the difference is, you will be able to stop pushing the bad pain, preventing a full blown injury, and allowing you get back to the gym sooner.

1. Lower Back Pain

90% of the population will experience lower back pain (LBP) at some point in their lives. There are varying degrees of back pain, the most common being mechanical LBP, which can be treated conservatively (not needing surgery).

Our lower back is involved in most things you do in weight lifting. It is involved during standing bicep curls as well as when you are dead lifting. When you experience LBP it can affect most of the exercises you do in the gym preventing you from training, not good!

What are the causes of Lower Back Pain

• Not warming up:
  • It’s crazy the amount of times I see people walk into the gym (after a day of sitting on their bums), go straight over to the squat rack, fire out 10 reps and then load the bar up and go for it. Then they wonder why they have back pain. A good warm up is essential to preventing back pain. Your glutes are the foundation your back sits on and they should be primed and ready for action. If your on legs day you should carry out this Glute Warm Up
• Poor technique: There are 2 ways to hurt your back through poor technique.
  • The first one is the most obvious, if your lifting technique is poor your going to hurt your back. It doesn’t have to be a rubbish deadlift technique with 200kg on the bar! It can be as simple as swinging your back during bicep curls. You do this over a few sets and your back will give out.
  • The second way is through poor manual handling technique. Your lower back is at its most vulnerable when you are bent over and twisting to the side. This is exactly the same position I see lifters picking up dumbbells or plates and moving them from rack to bench or floor to rack. You need to slow down and essentially dead lift each weight to where you want it to go. Nothing worse than having to tell someone you hurt you back lifting a 45lb plate.
• Lifting too heavy:
  • Trying to lift a weight, which is too heavy, will load forces on your lower back that it’s not ready to take. It will also cause you to adapt your technique (most likely for the worst), which will increase the stress on the back and cause you pain.

Treating Lower Back Pain

• When you have acute back pain you should:
  • Rest from aggravating activities
  • Take pain medication as needed
  • Walk – try to go for a walk every day. Start with 10 minutes and increase as able
  • Do not stay in the same position for more than 20 minutes
  • Use a lumber support for your lower back. You can make one by rolling up a towel and taping it in place
  • Use heat to reduce muscle spasm
  • Go and see you local Chartered Physiotherapist
• Learn to Hip Hinge
• Work on your core to prevent recurrence of pain and aid recovery after injury.
• Modify your training and slowly re-introduce your body to lifting again
• If you have pins and needles, numbness or weakness in your leg(s) go and see your doctor

 

2. Muscle Tear

For bodybuilders and lifters muscle growth is the reason that you push the boundaries of discomfort, tiredness and pain (remember good pain). When you injury or tear a muscle, scar tissue will develop, which can reduce the effectiveness of the muscle and increase the chances of recurrence in the future.

What  are the causes of a Muscle Tear

Potential causes of muscle tears in the gym include:

• Lifting too heavy:
  • When a muscle is overloaded it reaches breaking point and the excessive force causes the muscle fibres to tear.
• Overuse:
  • This can occur when you exercise the muscle too much with out proper recovery time. The muscle becomes fatigued, resulting in a tear
• Misuse:
  • This comes back to poor technique. Lifting weights the wrong way will cause the muscle to tear, doing a job it’s not designed to carry out.
• Not warming up sufficiently:
  • Muscle is like an elastic band. The warmer it is, the more efficient the contractile fibres become. A cold muscle is a quick way to increase the risk of a tear.

Treating a Muscle Tear

When it is an acute tear follow the M.C.E. Protocol.

There are 3 grades of muscle tear, which need to be consider when treating it.

• Grade I:
  • Minor damage to the muscle fibres. There maybe mild pain (bad pain) with little to no swelling and no bruising present. Your muscle will still have full strength. Follow the M.C.E Protocol.
• Grade II:
  • There is a partial tear in the muscle. There will be moderate pain, bruising and swelling present. There will be a reduction in strength output of the muscle. It is essential to go and see a chartered Physiotherapist to reduce scare tissue formation and improve your rehabilitation.
• Grade III:
  • This is a full tear/rupture. There will be extreme pain, swelling and bruising. You will need to seek medical advice immediately with surgery a likely outcome.

 

3. Tendinosis

This is a degenerative condition affecting tendons. It is a chronic condition caused by overuse or repetitive movements (similar to a repetitive strain injury). Microinjuries to the tendon accumulate faster than it takes to heal, resulting in the breakdown exceeding the repair. Common areas affected in bodybuilding include:

• Tennis Elbow:
  • This involves the extensor muscle group in the forearms
  • Pain is located on the outside of the elbow
  • It is caused by heavy lifting, forceful forearm pronation and supination or lack of internal rotation at the shoulder joint
  • Pain occurs when gripping a weight
  • Bodybuilders complain of a lose of grip strength or difficulty carrying weights
• Supraspinatus tendinosis:
  • This involves one of the Rotator Cuff muscles, which is involved in abduction and stability
  • Pain is located at the front of the shoulder
  • It can be caused by increased loading during weight lifting (too much too soon) and muscle imbalance at the shoulder blade-rotator cuff area
  • Pain will be experienced during over head movements for example a military press and sleeping on the side of injury

Treating Tendinosis

• Rest
  • This is rest from the aggravating factors/movement. By the time you are experiencing pain from this injury it may have been building for a few weeks. Tendon injuries take time to heal and when you carry out the painful movement you only set the healing time back. So if it’s sore doing military/dumbbell press, then stop this movement.
• Eccentric loading
  • Eccentric loading has been shown to be very effective for healing tendinosis injuries. Loading the tendon this way allows for the collagen fibres of the tendon to grow in a more parallel alignment, speeding up the recovery process.
• Soft tissue work:
  • Going to your local chartered Physiotherapist to get some deep tissue frictions or soft tissue mobilisation can improve your recovery from injury
• Braces:
  • These can be used if you really want to perform an exercise/lift without pain. They provide support and stability while off loading the tendon
• Weight Lifting technique:
  • Make sure that your technique is correct during the aggravating lift. Tennis elbow can be caused by lack of internal rotation of the shoulder. An example of this is developing tennis elbow from face pulls due to lack of internal rotation at the shoulder. Possibly think of changing the type of equipment you use for example switching from Barbell to dumbbells for overhead press. The dumbbells allow your shoulders to move in the path most suitable for your pattern of movement therefore protecting your tendons and muscles.

I hope you guys found this useful. Please leave any comments or questions you may have, we would love to hear from you.

Thanks again to Mark for asking me to do this. It was an honour and a pleasure.

 

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