Living the WELL Life


Just Don't Do It! - by Kenneth Dill, PT

Friday, August 05, 2011

Over the past 30 years, I have had the pleasure of helping tens of thousands of people successfully rehabilitate from a variety of injuries. A large percentage of these people were injured because of things they had done to themselves!


 Many of my clients were actually trying to do something good for their health when it backfired and hurt them. They either read an article, mimicked what a celebrity was doing on T.V., or, worst of all, got bad advice from someone they trusted (i.e. a doctor, physical therapist, athletic trainer, coach or workout buddy.).  Excluding professional athletes who are willing to take high risks for potentially higher rewards, the rest of us really need to understand the risk/benefit ratio of an exercise (see my earlier blog for details.).

We also need to stop and think what our long term goals really are when we add or increase our exercise routine. This is especially true when you are just beginning. Here is a partial list of exercises that have helped keep me in business over the years when people got hurt from misguided advice:

1. “Sit-up” machines. Resisted ab machines are NEVER worth the risk. They are hard to adjust to your specific body type/height. They create the false sense that a ballistic movement will work the abs harder/better. For many people with injuries or congenital anomalies, their spines can’t handle that much forced flexion. More importantly, you don’t need the risk of heavy resistance. Abdominal muscles are designed to stabilize your spine. They need to be strong over many hours of the day (or athletic event).  With no equipment at all, you can do an ab routine safely that will meet all your stabilization needs for sports or cleaning out the basement while at the same time keeping you out of my office with a back injury.

  2. Deep push-ups. Using blocks, handles, chairs, etc. to do deep push-ups (where your chest goes below your hands) is just asking for a rotator cuff injury. Turn on your back, and add to this category bench press where hands go below your chest. This is the same problem, just facing up instead of down. When your arm goes that far back with added resistance or multiple reps, the rotator cuff WILL break down. Take a stroll around any heavy weight lifting gym and check out how many scars you see on shoulders from rotator cuff repairs. Do push–ups flat on the floor so you can’t go too deep. Likewise, do dumbell chest presses lying on the floor so your elbows can’t go too far back.

3. Side lying sit-ups/crunches. Back to the abdominals, a constant source of misuse and disuse. When you lie on your side and raise up, you are jamming the facet joints of your spine, risking yet another back injury. Worse yet is the fact that it is not doing anything that you really want/think it is. This motion works the quadratus lumborum muscle, NOT the oblique abs. Oblique abs are very important, but they are worked in a rotational pattern, not side-bending. This should be done on your back or standing. Also, all functional movement in sports or those done on the job are done in rotational patterns, not straight side-bending.

4.  Squats and calf raises with weights. I put these together because the same logic applies to both for not doing them; they result in excessive compression through the spine. Our spines need to be able to support us against gravity for 60-100 years. If we help, it can do it. If we abuse it, it will become an ongoing source of chronic pain. Putting heavy weights on your shoulders puts a direct linear force down through all your discs and facet joints. And they don’t need any more accumulation of strain if you want it to hold up 90-100 years. Squats and calf raises done without weights (for high level some light plyometrics) will strengthen your calves and thighs sufficiently unless you’re an NFL lineman.  Cut the weight and do more reps.

5. Military press. This exercise is a double whammy and will put both your spine and your rotator cuff at risk. By pressing straight up with heavy weights the rotator cuff is compromised and all the force goes directly down through the spine. Strengthening the shoulders/upper back can safely be accomplished with front and lateral arm raises, rowing, and full body work such as pilates plank, etc. This is another non-functional movement that is not worth the risk!

This list features some of the exercises that I see most commonly causing more harm than good, but there are many others.  Always stop and think of the long term goal, then the risk/benefit ratio. As also noted, many of these don’t even accomplish what you really want them to. So if exercise is the ‘gift you give yourself’, make sure it is a gift you want to keep. There are no returns on the one body we are given. We must take care of it like our lives depend on it…because they do! The next time someone shows you a ‘fad’ exercise, or a ‘cool new move’, or any of the above listed moves, just DON’T do it!

 



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