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Exercise Without Injury

by Allegra Tiver

You can reach your goals injury-free by listening to your body and tailoring a workout routine to fit your abilities.

You know the drill. It happens every year. Spring arrives, and something inside tells you it’s high time to peel yourself out of the imprint you’ve made in your couch and get into motion.

While deciding to start a workout regimen is an excellent first step on a path to personal health, before lacing up your sneaks and rushing to your favorite gym, it’s important to know your risks for injuries—and even what you can do to prevent and treat them.

“What we see regularly is overuse injuries or underrecovery injuries,” says Brian Kane, co-owner of Evolution Fitness in Cherry Hill. Also the director of program design and a fitness coach at the facility, Kane says workout injuries are less likely to result from a specific traumatic incident than the body just being out of balance from repetitive misuse.

“When you look at the muscular system as a suspensory system for your skeleton, over time the system gains too much length or too much tension,” explains Kane. There are a number of everyday things that foster such imbalances, he says, from sleeping posture to driving patterns, including steering and pressing the pedals. “This accumulation of tension presents itself as pain,” Kane says.

Common issues
There are some key areas in which these patterns show up as injuries when you get on the workout wagon.

Shoulder impingements, for example, are tendons that are either pinched or entrapped and may manifest in exercises that require pushing or pressing out front or overhead. Spending significant time hunched over computers can actually shift the shoulder blades, inviting injury in that area of the body.

“Instead of being nice and tucked away on your back, they drift around the side of the body, compressing the muscles in the front,” Kane says. “Over time, the pectorals and anterior deltoids get extra strong and create too much tension, overcoming the scapular stabilizers.”

During press exercises, the area is inflamed, there is no room for muscles to slide smoothly, and there is a risk for tendons to snap, Kane explains.

The iliotibial band (IT) band, a secondary extensor tendon that runs laterally from the top of the hip down to the knee, has a tendency toward “friction syndrome” if the quadricep is overworked or the hamstring is weak. It is common since much of the population sits in chairs at desks, where hips, gluteal muscles and hamstrings do no work, but quads and hip flexors do.

“Body weight combined with the pressure of a chair compresses the gluteus muscles, causing them to continually relax,” Kane explains. “Atrophy occurs and compensatory patterns begin.”

IT band syndrome is frequently found in runners and cyclists due to overuse of the small muscle at the top of the hip, Kane says. But desk-sitters experience it too, since knees get overused to compensate for muscle imbalances in the hips, butt and legs.

“Think of it like a rubber band. When one end is tight, it puts tension on the opposite end,” Kane says, adding it’s important to recognize everything in the body—muscles and bones, ligaments and tendons—are interrelated in a powerful way, and so it’s necessary to approach a workout regimen wholistically.

“It’s important to identify symmetry and asymmetry, and tailor your program,” he says. “Corrective patterning gets the joints and muscles working together, and once you are back in balance, you start to get real results from workout programs.”

The importance of technique
Body awareness and experience level are other crucial areas to explore as you embark on a new exercise routine. Moving slowly enough to listen and understanding what you can expect to feel will keep you on track.

“People have one body, and they have to treat it like they have one body,” says Garnell Peters, personal fitness trainer and founder of Athletic Solutions in West Berlin.

Core strength is the basis for most exercises, Peters says, including the power movements and squats. Executing them incorrectly and without stability could pose risks for injury to the lower back and knees.

“Strengthening the lower back by engaging the core is key to dead lifts or anything over the head—push presses, snatches, or clean and jerks,” Peters says. “There is really a progression to do these types of movement.”

Observing what exercises others do can certainly provide a glimpse into what’s possible with time. However, Peters cautions those just starting out against trying them without some kind of training.

“If you’re not engaging your core and hips when you’re doing squats, too much pressure is being put on your low back and knees,” Peters says. ”Squats should be based on the glutes, and you should do a hip series to warm up.”

Incorrect repetition of exercises will especially stress your body—and in the most vulnerable and complex areas such as the rotator cuff, the small group of muscles and tendons that surround the shoulder joint.

“My philosophy is you train to gain. Mentally, physically, emotionally. Mind, body and soul,” says Peters, who offers the Training For Warriors program. “Your body is your temple.”

By approaching your workouts with patience, dedication and this kind of wholistic commitment to conditioning, you set yourself on track for true success. “What drives me is not what happens in here,” Peters says of the gym. “It’s seeing people fired up, feeling passionate to get to their goals on the outside.”

Give your body a break
If your workout is about you—your well-being and your goals—approaching it with anything but compassion for your physical and mental health would seem counter-intuitive. But pushing beyond personal limits is actually how many injuries occur. “It’s common to see people coming in shortly after starting one of the high-intensity workout programs like P90X, Insanity or CrossFit,” says Brad Bernardini, a double board-certified orthopedic surgeon and sports medicine specialist at Reconstructive Orthopedics, with multiple locations across South Jersey.

The popular workouts often demand participants exercise to the point of fatigue, Bernardini explains, which could be a recipe for injury if coupled with an unconditioned body and group mentality.

“People new to a high-intensity exercise program don’t have high levels of fatigue resistance, or a strong foundation for fitness, so their muscles and tendons aren’t ready for the stress and are prone to break down. Oftentimes in a group setting, they push on because of peer pressure.”

The muscle-tendon junctions are hotbeds for injury, says Bernardini, who sees tendon strains, partial tears and sometimes full tears. Common tendonitis sites are the rotator cuff, bicep, patella (low edge of knee cap) and quadricep (top edge of knee cap).

A triathlete himself, Bernardini explains how workouts really work and why taking heed can keep injuries at bay.

“Workouts are breaking your body down. You’re not making gains during the workout—you’re stressing muscles. During recovery, the body responds and gets stronger, so allowing time between workouts is super important.”

Bernardini recommends a mini-cycle for safe progress: two to three weeks of workout intensification, then one week of easing off.

Should you become injured, Bernardini doesn’t recommend complete rest since deconditioning can be more detrimental than the injury.

“You want an active recovery, where you’re still stimulating muscles, tendons and joints. That way, you shift the scales in favor of healing instead of breaking it down.”


Athletic Solutions by GP Fitness
420 Commerce Lane, Suite 4
West Berlin
(609) 605-3047

Evolution Fitness
1990 Route 70 E.
Cherry Hill
(856) 751-1300

Reconstructive Orthopedics
Locations in Cherry Hill, Lumberton, Marlton, Moorestown, Sewell, Somerdale, Vineland and Voorhees
(800) 896-RECON (7326)

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 5, Issue 12 (February, 2015).
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