Admit it... you aren't as young and healthy as you used to be. Hell, I'm only 26 and I'm considered a corrective exercise guy and even I get banged up from time to time while lifting heavy stuff.
Lifting weights spans a tremendously broad continuum. On one hand, resistance training is largely the basis for modern physical therapy. Plenty of tension and plenty of reps can really help to iron out muscular imbalances and strengthen previously injured tissues.
On the other hand, putting hundreds of pounds on your back and in your hands on a regular basis can take its toll, no matter how structurally balanced you are. It's why deloading periods are so important for long-term training success.
A deload week doesn't just mean more reverse band work.
In "The Injury Prevention Roundtable," I alluded to a deloading strategy I call the "prehab week." In a nutshell, I take a lifter's injury history into account and program accordingly during the deload week rather than just considering volume and intensity. We still drop volume and/or intensity, but we do so with a more critical eye to exercise selection.
Featured below are my top five prehab week deloading strategies. For most of you, this will be week 4 of every four-week cycle. You don't have to adhere to this strategy year-round, but rather once every two to three deloads you take.
Injury History: Primary External Impingement
Layman's Description: Your shoulder used to hurt with overhead activity, bench pressing, lateral raises, and maybe pull-ups. It was a diffuse pain more than it was a sharp pain and you couldn't reproduce it just by digging your finger into your shoulder.
By "you," I mean all you geeks who are hunched over your computer screen right now, demonstrating the exact posture that increased your likelihood of this problem.
Deloading Strategy: First, you'll want to drop straight bar benching, overhead pressing, and vertical pulling. Instead, you can go to push-up variations, dumbbell bench pressing, and a ton of horizontal pulling (rows).
You'll also want to extend your warm-up so that it focuses on more thoracic extension and rotation range of motion, along with serratus anterior and lower trap activations. You can find video examples of each in Shoulder Savers Part I and Part II. I also love the Inside-Out DVD from Mike Robertson and Bill Hartman for this very reason.
Additionally, you should foam roll your pecs, lats, and posterior shoulder girdle (back of your armpit). When you're done, toss in some stretching for all three as well.
To be honest, these are things that you should already be doing all the time, but they still warrant mention, since very few people do them enough.
Injury History: AC Joint Problems
Layman's Description: You may have had a traumatic shoulder injury like an AC separation, or maybe it's just something that gradually appeared over time.
Either way, it was a sharp pain that you could elicit by reaching across your chest, going into the bottom position of a dip or bench press, or simply by digging your finger in to the front of your shoulder. You might also have it starred on the calendar as the day of your first and last judo class.
Deloading Strategy: First off, if you've had AC joint problems, you should never do another dip again. If you are, take a permanent deload from them.
It's best to drop benching variations every 12 weeks or so, and instead replace it with – believe it or not – overhead pressing. Yes, Cressey really said it! AC joint issues traditionally handle overhead pressing variations much better than benching.
All of the warm-up strategies still apply, though, with the possible exception of stretching the pecs. If you have any sort of shoulder problems, chances are that you have weak lower traps and serratus anterior, so adding in some extra attention there won't hurt the cause.
Injury History: Anterior Knee Pain
Layman's Description: You had pain in the front of the knees, usually accompanied by some lateral knee pain as well. There are a lot of problems at the ankles and hips (and, less commonly, the knees themselves) that can lead to these issues.
In most cases, it's worse with going up and down stairs, quad-dominant squatting, and prolonged holds in awkward sexual positions.
If you went to a typical physical therapist for it, they probably talked about "vastus medialis" this and "inner quad" that, and then they gave you a few quad stretches and a recommendation to do leg extensions while those of us in the know wept silently thousands of miles away.
Deloading Strategy: You're likely going to have the most problems with quad-dominant squatting and forward lunge variations. Forward lunging is more decelerative and stressful to the knee.
In place of these movements, you can easily maintain a solid training effect by substituting deadlift and good morning variations, reverse lunges (stepping back takes away much of the deceleration problems), and possibly wider stance squatting. Box squats tend to be a good option because they promote sitting back with very limited knee breaking.
Basically, your goal is to train more posterior chain and less quads, although you'll still be getting a sufficient quad stimulus to maintain a training effect.
As with our shoulder issues, we have a series of mobility and soft tissue items to address. You'll want to take the foam roller or lacrosse ball to the glutes, IT band, tensor fascia latae, quads, adductors, calves, and peroneals.
In your warm-ups, focus on movements that increase hip internal and external rotation, as well as extension. Some people may need to improve hip flexion range of motion (via psoas strengthening), too. Be sure to also work on optimizing dorsiflexion range of motion with ankle mobilizations.
Interestingly, a lot of these recommendations parallel the tips Mike Robertson and Geoff Neupert provided in Olympic vs. Powerlifting Squats when they were helping you to improve squatting depth. Isn't it interesting how efficiency, health, and performance all go hand-in-hand?
Mel Gibson is Mike Robertson. Julia Roberts is Geoff Neupert.
Injury History: Lower Back Tightness
Layman's Description: Admittedly, this isn't usually as much an "injury" as it is a problem that comes about because lifters have crappy form that has led to overuse of the lumbar erectors because they A) lack hip extension range of motion, B) just aren't strong enough in the glutes and hamstrings, or more likely C) a combination A and B.
Believe it or not, relatively speaking, this might actually be more common in female lifters, who are generally more anterior-weight-bearing than male lifters. Especially when you have a female who is rocking the muffin top.
Muffin tops. Hard on the eyes in the biomechanics lab and on the street.
Deloading Strategy: With these individuals, I usually drop "traditional" squats and deadlifts and replace them with a lot of single-leg exercises. Or we might do deadlifts with a prolonged isometric hold at lockout.
Many individuals get into trouble because they use lumbar hyperextension to finish the lift when they should really be finishing hip extension by firing the glutes. With these folks, we just have them complete the lift and pull their butt cheeks together for a count of 5 or 6 at the top of each rep.
Of course, there's a ton of extra "core" work we do. And all of it's aimed at promoting stability, not mobility, at the lumbar spine. From side bridges to single-leg prone bridges to birddogs to landmines, and beyond, these exercises can provide a challenge while giving the lower back a week to recover.
Injury History: The Supinated Foot
Layman's Description: As with the lower back tightness, this isn't an injury... or even a "condition" really. It's a structural thing that affects a small portion of the population. I just so happen to be one guy in this delightful 2%.
And given that some athletes (baseball pitchers and tennis players, for example) can force their foot into a pseudo-supinated structure by continuously making it the propulsion leg, it seems worthwhile to mention.
Supinators tend to sprain ankles more frequently and have a higher incidence of stress fractures. Here is the two-sentence synopsis of subtalar joint function you need to know:
Pronation is for deceleration and supination is for propulsion. It's bad to propel off an excessively pronated foot, and it's bad to decelerate on an excessively supinated foot.
One easy, but not 100% perfect, way to check to see if you have supinated feet is to look at your callus patterns. In a supinator, you'll see calluses at the base of the first and fifth metatarsals (big and little toes).
My right foot is really supinated; check out the different texture on the big toe and slightly below it in the photo on the right. You can also look at toenail quality to see the difference. My right big toenail is really beaten up.
These photos were taken when I'm coaching athletes on a hard floor for 10 to 13 hours a day. You can see small cuts on my second and third toes, where I shifted some of the burden.
Supination does not make your feet hairy. I'm just half-Irish, half-chimpanzee.
Lastly, the wear on your actual shoes will tell you quite a bit. Check out the logo, or lack thereof, on my sandals. I don't even wear them all the time!
Deloading Strategy: In supinators, our goal during the prehab deload is to minimize the amount of ground reaction forces they encounter with lifting. A personal favorite strategy is to increase volume of plyos and sprinting in week 3 of a program, a type of intentional overreaching, and then drop them altogether in week 4 for the prehab deload.
Additionally, we remove all forward lunging variations and go with lower impact modalities in the deload week. Things like slideboard reverse lunges, Bulgarian split squats, and single-leg squat and RDLs.
If an athlete needs to continue with regular energy systems work, in place of sprinting, we incorporate low-impact modalities like the elliptical, rower, swimming, or cycling.
In terms of supplemental mobility and soft tissue work, I've found that supinators tend to be very restricted in the adductors, and often need to get work done on their hip joint capsules every so often. Many of them need solid manual therapy on the foot itself before you can really be effective with ankle mobilizations.
Above all else, supinators need good footwear. Asics tend to work well, especially those with soft, white bottoms (not the firmer gray material). I've seen good results by sliding a thick insole into my Nike Frees, too.
In fact, simply adding a $2 insole is a great option for many people in this situation. You just want cushioning, not the change in contour that an orthotic provides. I wear through one every three to four weeks.
Obviously, this is just the tip of the iceberg in terms of how I approach deloading and it certainly only scratches the surface on a wide variety of injuries and conditions you'll encounter.
If there's enough interest (and maybe some suggestions on what to cover), I'd be glad to address more scenarios in a future article.