is easy to denounce an exercise or movement as 'dangerous', particularly
if an injury has occurred during its execution. When someone
sustains an injury while performing a particular exercise, we
should not assume that a particular exercise is necessarily a
'bad' exercise. Likewise, we should not judge a particular exercise
or movement as 'bad' if an exerciser experiences pain during
its execution before an injury has healed, allowing for proper
rehabilitation to be administered.
Trainers often tell their clients not to perform a particular
exercise through full
range of motion. Take for example, allowing the elbow to
travel behind the shoulders during a bench press or chest press.
These guidelines may be appropriate for those with a Shoulder
Transverse Adduction / Flexor Inflexibility and/or an Infraspinatus Weakness.
However, this same advice is inappropriate for those with no
impairments relating to the structures in question.
Perhaps, a trainer was told by their client that their physician
ordered them to avoid a particular exercise or a specific range
of motion due to an orthopedic problem. More commonly, trainers
offer these over-generalizations because their 'Cracker Jack'
certification recommend such practices despite the ability of
most people to safely perform these movements. Certainly, some
individuals should not perform a particular movement due to a
recent injury or an orthopedic issue, but to suggest a movement
is inappropriate for all people 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."
Take for example, sprinting, or even running. These modes
of exercise could be considered contraindicative for many people,
yet we understand there are those individuals that are certainly
capable of performing these activities relatively safely. We
also can understand the need to prescribe these forms of exercise
for those with particular fitness or sports performance goals.
For this reason, we should not dismiss other exercises or activities
as dangerous for all individuals. Certainly, one can find numerous
studies supporting the injurious
effects of running or sprinting. One could even make the
argument than nearly all runners or athletes that run have occurred
an injury sometime in their careers. But are we to deem running
contraindicative for these reasons?
Even swimming, generally considered one of the safest forms
of exercise, has a surprisingly high rate of injury at the competitive
level. The reasons for injury are multifaceted, but they can
often be attributed factors other than the activity per se. See
Its interesting to note that many individuals apparently perform
certain exercises thought to be dangerous without incident. It
is certainly plausible that factors other than a particular questionable
exercise play a concomitant, if not a dominate role in the risk
of injury. See Weight
Training Risk Factors. We know of no studies that explain
or even explore how certain individuals who regularly use these
so called contra-indicative exercises experience few if any injuries.
Perhaps there are specific anti-risk or protective factors at
play offering a certain degree of immunity to the unaffected.
Although certain movements should not be performed by those
with a current injury or even those with particular predispositions
to certain orthopedic complications, for those with 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 a movement or a particular range of motion
during exercise may actually increase the risk of injury, particularly
if the joint ever experiences greater load than what it is accustomed
to, through these particular ranges of motion, either in real
world situations or in training. See example of effects of range
of motion restrictions:
- Avoiding knee lockout during squat, leg presses, etc.
- Avoiding full shoulder extension / abduction (lower range)
during shoulder presses
- Avoiding full shoulder extension / transverse extension (lower
range) during chest press or bench press
- Avoiding spinal extension under load
- Erector Spinae Weakness
- Degeneration of joint structures in spine (Nelson 1993)
- Greater vulnerability to low back injury (Nelson 1995)
what does an exercise instructor do when working with a group?
Instead of announcing to the class that a certain movement is
'bad', educate your class why certain movements may not be ideal
for some but might be OK for others. With certain 'higher risk'
movements, instruct those who have had certain knee or shoulder
problems to do it one way (having them follow the advice
of their physician) and have the remaining participants perform
the movement through the fuller range.
Typically, restrictive guidelines given to 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 injure
themselves avoiding a movement they believe to be dangerous (full
range of motion, locking out, etc.) when they inadvertently perform
that movement, as compared to someone that implements that movement
following sound training
principles and adaptation
criteria. The appropriateness of an exercise should be assessed
on an individual case-by-case basis. See Common
Biomechanical Impairments and Dangerous
Exercises Essay and Squat Safety.
Kolber MJ, Beekhuizen KS, Cheng MS, Hellman MA (2010).
Shoulder injuries attributed to resistance training: a brief
review. J Strength Cond Res. 24(6):1696-704.
Livingston S (2004). Contra-indicated People Versus Contra-indicated
Exercise, Society of Weight Training Injury Specialists (SWIS)
Nelson, B.W., O'Reilly, E., Miller, M., Hogan, M. Wegner,
J.A., Kelly, C., (1995). The clinical effects of intensive, specific
exercise on chronic low back pain: a controlled study of 895
consecutive patients with 1-year follow up. Orthopedics, 18(10),
Nelson, B.W. (1993). A rational approach to the treatment
of low back pain. J Musculoskel Med, 10(5), 67-82.