The Question

With some exercises and training methods, the risks just outweigh the benefits. But what exercise or training modality would you say causes the most injury?

TC Luoma – T Nation Editor

The one-rep max.

Unless you're a powerlifter, stay away from seeing how much you can lift for 1 rep. This ain't no party, this ain't no disco, this ain't no foolin' around. 1RMs are serious biz.

Unless you're one of those people who take gravity as a personal affront and dedicate every aspect of your training to lifting the heaviest weight possible, you're just begging for a huge ouchie. On the minor side of the injury scale are strained muscles or tweaked spines, and on the major side are broken bones, shattered trachea, ruptured diaphragms, and torn muscles.

I know of which I speak. Several years ago, while fudging around with a bench press 1RM, I tore my pec. And this wasn't some little, "Goodness, I tore a few fibers on my pec and it smarts like the Dickens" crap. This was a complete, phonebook being torn apart by an old-time strongman tear.

The blood pooled up into my arm and down to my elbow, from my pec down to my hip. It changed colors every few days for two months, from the traditional black and indigo to the more nuanced purples and umbers. My naked body could have been used as a display in the paint department at Home Depot. Young couples could point to parts of me and say, "We want the baby's room to be that color."

If I was Marvin the Moose, your dog's favorite chew toy, I could have been re-stuffed and stitched up, made almost as good as new, but it didn't work out that way. The pec tear couldn't be repaired because sewing up muscle is like sewing up wet toilet paper; even the slightest movement causes the stitches to tear loose. So now I have a hunk of gristle and scar tissue where my pec should be.

Look, I know that it's a perfectly natural impulse to see how much weight you can hoist off the ground, but it gets weird when you wrap up your self esteem in how much you can lift. I have the uncanny ability to tell when meat is done cooking just by looking at it, and as mundane a talent that is, it's still more useful to society than your 600-pound squat.

Besides, a big lift is often as much about technique and the sidestepping of physics (going to great lengths to reduce the distance the weight has to travel) as it is strength and power, hence all the comparatively teeny guys on Facebook and Instagram who can deadlift the weight equivalent of a small house.

None of this is meant to disparage a training program like Jim Wendler's 5/3/1 because the calculations are all based on 90% of your 1RM, not your true 1RM.

And if your program requires you to figure out how much weight you can lift for one rep, just take your 3RM and divide it by .93. That will give you a pretty damn accurate estimate of your 1RM and it will save you from incurring a really big ouchie. – TC Luoma

Tony Gentilcore – Strength Coach and Performance Expert

The kettlebell swing.

It's the exercise most people screw up. Whenever someone comes to me saying how much swings hurt his or her back, almost inevitably, I'll have a Dan John moment. (Dan often tells a similar story, albeit replace squats for swings.)

  1. Someone tells me swings hurt their back.
  2. I ask that person to show me their swing.
  3. My eyes bleed.
  4. I inform them that swings don't hurt their back, but that what THEY'RE doing is hurting their back.

Most people squat their swing rather than making it a "hip snap." The bell should never drop below knee level. Ever. When it does, you're increasing the arc of the swing and placing more stress on the lower back.

The fix is two-fold:

  1. People need to "control slow" before they "control fast." If someone is unable to perform a basic hip-hinge pattern – dissociating hip movement from lumbar movement in the presence of a stable spine – then adding speed and load and reps will hurt more than help.
  2. Piggy-backing on the above, you also need to stay upright for as long as possible on the return swing – essentially playing chicken with their nether region. The groin (or hips) should catch the bell. Again, the idea is to not have the kettlebell travel below the knees in order to spare the back. Here's a drill I like to use with people to help them understand the concept:

What about American (overhead) swings?

I'm not a fan. Why? Because more ROM doesn't necessarily mean better. And anyone who argues that it's a more powerful way to swing doesn't understand physics.

Plus, many people lack the shoulder flexion – due to stiff/shortened lats and/or lack of anterior core strength – to perform this variation in the first place. What ends up happening is people end up in excessive lumbar extension to make up for lack of shoulder flexion and then they wonder why their lower back hurts.

Stick with the "hard style" swing, where the bell doesn't go above chest or eye level (you should always be able to see above the bell). This is a more powerful swing and doesn't require going overhead, which most people aren't going to do well with anyways. – Tony Gentilcore

Bret Contreras – Strength Coach and Performance Expert

Powerlifting.

Out of all popular resistance training methods, powerlifting causes the most injuries. I'm not saying this to deter anyone from powerlifting or from performing squats, bench press, or deadlifts; I've always championed these movements.

What makes these exercises so effective at building muscle is precisely what makes them dangerous. They load a large portion of the body's musculature in a stretched position, thereby creating high joint reaction forces and lending themselves to compromised postures.

Combine this with the competitive nature of powerlifting, the constant desire to set PRs and hoist heavier loads, the hardcore mentality of the typical powerlifter, and the individual differences in anatomical mobility and soft-tissue strength, and it's easy to see how it can become a recipe for disaster for certain individuals. Almost every seasoned lifter I know has hurt themselves squatting and/or deadlifting – it's the nature of the beast, and it's what teaches us to respect these lifts.

I love powerlifting. If you do too and wish to compete, make sure you:

  1. Use strict form in training and save the sloppier attempts for the third lifts on the platform.
  2. Take regular deloads or just avoid going balls-to-the-wall 52 weeks per year.
  3. Don't get greedy with volume increases.
  4. Listen carefully to your body and make appropriate adjustments. – Bret Contreras

Paul Carter – Strength and Bodybuilding Coach

Running.

Namely, long distances. It seems like people who run shorter to mid-range distances for pleasure and general fitness do better keeping injuries to a minimum. Maybe the lower mileage helps them keep their technique from breaking down.

A simple Google search will give you a mile-long list of problems that just about every distance runner ends up sustaining.

  • IT band problems
  • Shin splints
  • Sciatica
  • Stress fractures
  • Hip flexor strain
  • Calf strain
  • Low back pain
  • Plantar fasciitis
  • Runner's knee
  • Achilles tendinitis
  • Blisters and chaffing
  • Hamstring pulls
  • Dog bites, bee stings, heat stokes
  • Amenorrhea in women, and potentially infertility

I could go on. And everything from the toes to the hips tend to take a massive beating because of the repetitive overuse required for both training and competing. – Paul Carter

Mark Dugdale – IFBB Pro Bodybuilder

The flat barbell bench press.

Dudes are obsessed with this exercise. Don't believe me? What's the question you always hear if a guy looks muscular? "How much do you bench?"

The reason this exercise accompanies injury is perhaps caused by that question alone. Every dude wants to boast of his bench press poundage and therefore will often try to lift beyond his ability.

The most common low-grade injuries include elbow issues from locking out and rotator issues from over-stretching at the bottom. Powerlifters are notorious for pec tears, and I admit to suffering a partial tear in 2010 on my second rep with 500 pounds. Dumb, I know.

Preventing the elbow issue can be relatively easy – stop short of locking out on all pressing movements. A locked-out elbow joint takes a large proportion of the tension off the pecs. Tension is something you want if hypertrophy is the goal, even if it forces you to decrease the weight.

In regards to avoiding shoulder issues, and the worst case injury, a pec tear, I found the floor press to be an excellent alternative. It prevents over-stretching at the shoulder joint and eliminates an excessively stretched pec tendon at the transition point from eccentric to concentric, thereby eliminating much of the danger-zone for pec tears.

Here's an example.

And here's another look.

– Mark Dugdale

Dan John – Strength Coach and Performance Expert

Doing everything at once, or CrossFit.

It's not really the exercises or the training methods that cause the most injuries, it's the attempt to chase too many qualities, which are those things like strength, endurance, power, speed, agility, mobility, flexibility, and on and on.

There's an old saying: "If you chase two rabbits, you go home hungry." It's the same with athletic qualities. Most training programs try to chase a dozen rabbits at once. Yes, the Olympic lifts need flexibility and lots of it; trying to build it with maximum loads is going to be an issue. And I'm sure cardio has merits, but as a discus thrower, it took me 1.6 seconds to deliver the disc after my right foot came up. So 1.7 seconds is cardio for me!

Trying to mix gymnastics, Olympic lifting, sprinting, and powerlifting is a formula for disaster. The wise coach and trainer learns that there's a time for every season under the sun. (I just made that up.)

Certainly, there are risks even if you specialize in one thing. A missed state record snatch can destroy your wrist, a cheap shot in a football game can ruin your leg, and a discus to the head can cause a serious concussion. These are just some of my personal experiences, but you don't need to repeat them to learn from them. People get hurt doing all kinds of things.

But, you can avoid a LOT of issues by only trying to address one quality at a time. – Dan John

Christian Thibaudeau – Strength Coach and Performance Expert

Training hard without mastery.

To me, it's not so much an exercise as an approach. The exercises that hurt people are the ones they're not physical prepared for. A good example is the kipping pull-up which allows someone with basically no shoulder or back strength to do "pull-ups."

The problem? If you're not strong or stable enough to do regular strict pull-ups there's no way to make kipping work safely. You need the strength to control your body during that pattern. If you don't have that strength, how will your body handle a similar pattern with a lot of downward acceleration and also change in body position?

I'll use my wife as an example. She loves CrossFit. But she could never do it for more than two weeks in a row without getting injured. She had a powerful kip that allowed her to do a lot of pull-ups and handstand push-ups. But she was not structurally capable of handling it.

So she began to train three times a weak with me and doing CrossFit twice a week. We put a lot of emphasis on strict pulling and pressing exercises. We used a progression toward achieving strict pull-ups, strict dips, and strict handstand push-ups.

She hasn't been injured once in three months. Not only that, she went from not being able to do a single strict pull-up to being able to do sets of bar muscle-ups (without even practicing bar muscle-ups), and she went from doing no strict dips to doing sets of 10 with 15 pounds added.

Even lifters with decades of experience forget about the need for mastery. Heck, I got injured doing gymnastic rings work, because, even though I was strong, my body wasn't prepared for that type of effort. I'm still paying the price for that one as I still don't have full extension in my right elbow. Gymnasts take years to build the specific strength, control, and stability to do the skills safely (and they aren't 220 pounds). I was impatient and got injured.

Same with the Olympic lifts. They're great movements, and aren't as difficult to learn as people think, if they're properly coached. BUT they're still more technical than your basic strength lifts. The problem is that people see them as just another strength lift and approach them the same way: by gradually adding more weight to the bar. The problem is that most add too much weight too fast for their technique level and that's where injuries occur.

While any non-idiotic exercise can be done reasonably safely, any movement your body isn't ready for can be a serious injury hazard. – Christian Thibaudeau

Dr John Rusin – Strength Training Specialist and Performance Expert

Fitness and rehab trends that are spread through misinformation.

A few years back I wrote an article, The 4 Most Damaging Types of Training. But since it was published, not a whole lot has changed. But how could this be? How can a few years worth of positive developments in training methodology, research, and preventative techniques NOT make a major impact on the injury rate? Very simple, fitness continues to get flooded by poor information on the subject of injury prevention.

For every groundbreaking article that's published and method that's released by experts in the field, there are ten mainstream BS articles that feed the misinformation. And the general public isn't savvy enough to discern the difference between true battle-tested methods for pain-free exercise, and hoaxes that are just trying to make a dime off of ignorance.

My advice for banged-up meatheads: Stick to the methods of experts in the field who walk the walk, and have credibility in both the fields of rehabilitation AND strength and conditioning. Would you take legal advice from a non-lawyer? Probably not. So stop thinking you'll benefit from injury advice from that comes from those who have no knowledge on the subject. – Dr John Rusin

Dr Chad Waterbury – Strength Coach and Performance Expert

Any exercise!

When it happens, it's due to either inadequate mobility, inadequate motor control, or inadequate strength. Here's why.

Inadequate mobility: Soft tissue limitations within a joint and/or muscle. Forcing a joint or muscle to move beyond its available range can result in tears within the muscle, tendon or joint capsule. For example, hamstring tears most commonly occur when the athlete is extending the front leg before ground contact.

Solution: Determine if you have sufficient mobility within a joint before attempting to train within that range.

Inadequate motor control: Poor timing of muscle activation during movement. I like to compare movements in the gym to an orchestra. Your brain is the conductor, while your muscles and joints are the musicians. In order for the performance to go well, each player must receive the proper cue at the right time.

Shoulder injuries are frequently caused by poor motor control of the scapula, a bone without any ligamentous support that's connected to 18 different muscles. That's a lot for the brain to control, especially during movements that require high levels of speed or loading.

Solution: Move slowly at first so the brain can learn to properly control the muscles before you increase the speed.

Inadequate strength: A lack of force-producing capabilities required during a movement. It's a no-brainer that trying to lift a load beyond your capacity is akin to handing a teenage boy a bottle of Jack Daniels and keys to a Lamborghini. Really bad things can happen in a hurry. The best athletes keep their ego out of the training room and work within their available strength capacity that day.

Solution: Always start a new exercise with less load than you think you can handle, and add weight in small increments over the course of weeks and months. – Chad Waterbury

Lee Boyce – Strength Coach and Performance Expert

CrossFit.

It can be argued that since its inception, CrossFit has been doing a better job with quality control and coaching of the major movements, and possibly even refining program design. But that doesn't excuse the numerous problems that can come from repeatedly using poor technique, acute injury, or overtraining.

I personally still see many people attempt difficult CrossFit workouts who don't possess the prerequisite fitness level to allow them to get through this unscathed. There's also a reason a number of my clinicians are still being kept busy treating recreational or competitive CrossFit competitors.

Just this year, I started working with a new client who was a product of this training method. Her knees were beat up from a combination of bad, fatigued squats, and failed clean attempts. The kicker was that she was 6'1" and 28 years old. People with situations like this would do well to realize that their leverages can put them at an even greater risk if they're not careful. The reward isn't always worth the risk.

With the exception of the odd gifted physical outlier, there are "ideal" body types for most sports. Most elite 100 meter sprinters are under 6 feet tall. Most Olympic lifters have long torsos and shorter arms and legs. Most elite powerlifters also do better with shorter leverages, and they usually aren't anywhere close to 6'8".

If your body type is at odds with what's typical for a competitive athlete or pro who gets paid to do the same movements, then enjoy practicing the lifts, but tread carefully. Being aware of this truth will make the difference between injury-free lifting and a world of pain and discomfort. – Lee Boyce

Bronwen Blunt – Nutrition and Strength Coach

Smith machine squats.

These cause lifters to use improper form and can lead to injury down the road. Even though they might look like a safe alternative for squats, they're not ideal.

The Smith machine forces your body to follow a bar path that's not a natural movement and leads to compression in your spine and puts other unnecessary stress on your joints. It also eliminates any stability work that you'd do using free weights. My advice is simple: Learn how to squat!

There are many types of free weight squats you can try that are superior to the machine. If you're a beginner, work with your own bodyweight until you become comfortable with the movement using full range of motion, then add weight whenever your body's ready for it. Squatting with free weights (barbell, dumbbells, kettlebells etc.) will allow you to work on stability, practice your technique, and get better glute and hamstring activation during the exercise. – Bronwen Blunt

John Romano – Competition Coach, Former Muscle Mag Editor

CrossFit.

The official message board on its website has an entire section dedicated to reported injuries. If you engage in a training method that requires you to become proficient in over 100 exercises, and makes every workout a competition, sustaining an injury is just a matter of time.

I personally have nothing against CrossFit, but that message board has almost 37,000 posts. That makes the topic the 10th heaviest forum on a board with over 1.25 million posts. And that's only the people talking about it. Some suffer in silence.

It's obviously not the most dangerous thing you can do, but I hear from enough people who've gotten CrossFit related injuries to comfortably say that, if you really want to get hurt, you should probably find a box. – John Romano

Jake Tuura – Collegiate Strength & Conditioning Coach

Heavy-loaded barbell jump squat.

When athletes are looking to add load to a plyometric move, they often choose the barbell jump squat. Walk over to a squat rack, add some 25s or 45s, get the bar on your back and jump – it's simple. For proficient jumpers and experienced lifters, this movement offers a new stimulus of greater force and impulse compared to normal vertical jumps.

The issue I have isn't with the exercise itself, but instead with nonsensical loading. For most athletes, landing with 185-225 extra pounds on the back leads to spine jarring and knee caving. And if acute injury doesn't occur, the athlete sets himself up for long-term wear and tear and faulty movement patterns.

So how can athletes get the force and impulse benefits of weighted jumps without the downside? Light trap bar jumps. Take a look:

One study recommended a load of 20% 1RM of your back squat (this produced greater peak power than normal vertical jumps) for the trap bar jump.

To prevent replicating horror movie scenes, let the trap bar unload after jumping. This takes the load off the spine and allows athletes to focus on triple extension and maximal jump height without concern for landing safely. – Jake Tuura

Related:  8 Ways to Never Get Injured Again

Related:  The 4 Most Common Injuries For Lifters

Reference

  1. Swinton, P. A., Stewart, A. D., Lloyd, R., Agouris, I., & Keogh, J. W. (2012). Effect of load positioning on the kinematics and kinetics of weighted vertical jumps. Journal of Strength and Conditioning Research, 26(4), 906-13.