Exercise Safety

Causes of Injury

Both extrinsic and intrinsic factors can increase the risk of injury. Extrinsic factors include training errors, faulty technique, poor environmental conditions, incorrect equipment and surfaces. Intrinsic factors include biomechanical deficiencies including, malalignment of limbs, muscular imbalances, degenerative processes, and other anatomical factors (Crown LA, et. al., 1997).

Biomechanical Deficiencies may contribute to orthopedic injury when combined with other factors than may negatively effect joint integrity (eg hyper-mobility, structural weakness, insufficient adaptation of joint or muscular structures, acute or chronic over training, etc). See Adaptation Criteria.

Common Biomechanical Deficiencies

The biomechanical deficiencies are listed for precautionary measures only so they may be identified and possibly corrected in attempt to prevent athletic injuries during exercise or physical activity. A physician may need to establish if a biomechanical deficiencie is structural, muscular, neuromuscular, or due to some other pathology. The corrective exercises assume a muscular imbalance (flexibility and strength). Only a qualified physician should diagnose and give prescription for an existing injury. In some circumstances, an attempt to correct a biomechanical deficiency may irritate the injury and prolong recovery, particularly if certain exercises are initiated too soon after an injury has occurred. Even after the underlying biomechanical deficiencies have been improved, the injury may require the attention of a physical therapist under the advise of a physician to restore total functionality. See Injury Prevention Tidbits and Sports Injury First Aid.

Over Generalizations

It is easy to denounce an exercise as "dangerous", particularly if an injury had occurred during its execution. When we occur an injury when performing a particular exercise, we should not assume that exercise is necessarily a bad exercise. Certainly we would exacerbate the injury if we continued to perform the exercise before it has healed or before it was rehabilitated. But for some reason people mistakenly judge an exercise as bad if an injury occurred during a particular movement. Certainly past injury is the best predictor of future injury, but to suggest a movement is inappropriate for another person, under perhaps different circumstances, is an erroneous assumption.

Livingston, CSCS (2004) explains "The justification of contraindication is derived from the philosophy of training at the level of the lowest common denominator. There are very few exercises that should be contraindicated. There are lots of people who should not be doing certain exercises."

Although certain movements should not be perform by those with a current injury or even those with certain predispositions to certain orthopedic complications, in relatively healthy joints, these movements may actually decrease the occurrence of injury, particularly when the joint is moving through this particular range of motion, perhaps even inadvertently or subtly. Conversely, avoiding this range of motion during exercise may increase the risk of injury if the joint ever experiences greater load than what it is accustom through these particular ranges of motion.

Typically restrictive guidelines given for injured individuals or those with biomechanical deficiencies are commonly misconstrued and unnecessarily recommended for orthopedically healthy individuals. Ironically an injury free individual may be more likely to injury them selves avoiding a movement they believe to be dangerous (full range of motion, locking out, etc.) when they inadvertently perform that movement compared to someone that implements that movement following the principles of progressive adaptation. The appropriateness of an exercise should be assessed on an individual case by case basis. See Common Biomechanical Deficiencies (above) and Dangerous Exercises Essay.

Controversial Exercises

Sample Exercise Questioned Position Considerations
  • Ballistic movements

Crown LA, Hizon JW, Rodney WM, (1997) Musculoskeletal Injuries in Sports, The Team Physician's Handbook, Mosby, 2: 361-370.

Livingston S (2004). Contra-indicated People Versus Contra-indicated Exercise, Society of Weight Training Injury Specialists (SWIS) Symposium.

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