Almost everyone I know has a chronic injury of some sort. Maybe it’s a lower back that needs extra warming up before a long day, a knee that gets stiff on cold nights, or a tweaked shoulder that prevents good overhead positioning. They’re usually not crippling, debilitating, or otherwise serious infirmities, but they are injuries that limit quality of life and performance. And all those people, to a person, got their injuries from training. My understanding is that this is true for most people who exercise regularly. Injuries happen to everyone.
It’s possible that I’m experiencing selection bias. Perhaps the injury history of the general exercising public isn’t anything like the history of my circle of ex and current endurance athletes, serious fitness buffs, Ultimate Frisbee enthusiasts, and otherwise active individuals. But I’d wager that most people who step foot into a gym have a nagging injury of some sort. The research suggests injuries happen quite frequently.
A recent survey of CrossFit athletes found that 73.5% had experienced an injury during training, 7% of which required surgery. But before the anti-CrossFit crowd starts gloating, realize that this injury rate is similar to Olympic lifting, powerlifting, and gymnastics and lower than contact sports like rugby. Similar polls in runners find that in a given year, 13% of runners experience knee injuries, 8% get Achilles tendinitis, 7% suffer hamstring pulls, 10% deal with plantar fasciitis, 10% have shin splints, 14% report iliotibial band syndrome, and 6% get stress fractures. There’s no way around it: engaging in non-essential, extracurricular bouts of physical exertion, also known as working out, carries some risk. Not working out carries its own set of (greater) risks, but that’s beside the point. As many a lauded strength coach has said, injuries are a matter of when, not if. And many of these injuries become chronic injuries that stay with you for the rest of your life.
But why single out workout injuries when painters are falling from ladders, people are getting into car accidents, high school basketball players are tearing their ACLs, and desk jockeys are getting carpal tunnel syndrome? Those are unavoidable. Painters have to work on ladders and software developers have to type to eat. High school kids are going to play high school sports. People drive to get to work, pick up their kids, run errands. Accidents will happen. With training injuries, we make our bed and choose to fall out of it. We try for that extra rep when we know we probably shouldn’t. We attempt the CrossFit WOD as Rx’d even though we’re completely gassed. We choose to train for a marathon.
There are also regulations in place to protect people as they go about their days supporting the machine of civilization. We want people driving to work safely, so we have road signs, traffic signals, and lane dividers. We have workplace safety legislation to prevent excessive maiming of employee limbs. High school sports have referees and rulebooks. But once you step under the bar or strap on those running shoes, you’re on your own. Whatever happens is up to you alone.
We’re going to work out. We’re going to stay active and move our bodies and challenge our limits, but we don’t want to get injured. How do we limit these injuries? How do we make good choices?
Barring discussion of specific exercise techniques, like “keep your weight on your heels” or “break at the hips, not the back” or “land on the mid-to-forefoot when running” (because those are beyond the scope of this post and would turn it into a book), what can we do? What should we watch out for? What shouldn’t we ignore? What should we ignore?
Trust your gut.
Most of my injuries were preceded by a gut feeling that I should stop the workout. It’s not always a physical signal, and actual pain isn’t necessarily involved. It’s a subtle sensation that something is amiss and proceeding would be a poor choice.
What’s odd is that I can’t remember an instance where ignoring that feeling turned out well. As far as I can remember, it always ends with a tweak, sprain, pull, twinge, failed rep, or worse. It’s never been worth it, and yet I’ve done it so many times. I bet you have, too.
So stop it. Heed those hints we get from our subconscious.
Train the deadlift, maintain the squat.
That’s what human movement expert Gray Cook recommends. Not everyone needs to place a heavy bar on their back, squat down, and stand up. But everyone should be able to squat unassisted and unweighted, whether it’s to poop while abroad, play blocks with your kid, or perform a nice morning Grok stretch. The comfortable squat is a good barometer for being human.
Determine why you’re doing what you’re doing and whether it’s worth the risk.
That triple set of 20 kipping pullups performed at the end of a long stressful work week would make a sweet Facebook post. But is it really worth it, or would a few sets of strict chinups achieve similar things while drastically reducing the risk you incur with the kips?
Do you really need to deadlift 500 pounds? Some people, yes. Most, no. Most would be more than strong enough with a double bodyweight deadlift.
Are you chasing big numbers or fast times or that marathon for a good reason? Get down deep into the nitty gritty and expose your true motivation. You may find that it’s still worth pursuing, but at least you’ll know for sure.
Mortal fear on the eve of a Tuesday workout is a bad sign, folks. You can certainly approach your training with a bit of apprehension, but all-out existential dread? You might want to reevaluate why you’re doing what you’re doing.
Leave some in the tank.
Not every training session has to be a breakthrough workout. Not every training session can be a breakthrough workout. You can’t go to failure every time.
Just back off. Don’t get the extra rep. Leave one, two, maybe even three in the tank.
Develop a bone broth habit.
Get into the rhythm of making bone broth on a regular basis. Or, make a bunch at once and freeze it for later. But even if bone broth isn’t a strong source of bone-relevant minerals, the collagen alone is important for keeping joints pliable, lubed up, and resilient, and the glycine in the gelatin can make your sleep more restorative and counter any potential inflammatory effects of specific muscle meat amino acids. Drink about a cup a day.
If you can’t do the movement unweighted, don’t do it with weight.
This is a pretty simple concept that many people ignore because adding weight can help you force your joints past a difficult spot. That’s just gravity exerting greater pull on you; it’s not evidence of improved mobility, and it’s probably not all that safe.
Learn the difference between pain and soreness.
Training can hurt. It can “burn” during the session. It can lead to extreme soreness for days after as the microtears in your muscle fibers repair themselves. But it shouldn’t cause pain. Pain indicates malfunction. It means danger. It suggests your tissues are rupturing, are about to rupture, or have already ruptured. Get to know pain so you know when to hold back and when to push through.
Don’t train through pain.
Once you’ve encountered and known pain, don’t ignore it. If you get a sharp stabbing pain in the back of your left knee during passive knee flexion, skip squats today. It simply isn’t worth it. There’s always tomorrow (or next month, if the pain’s bad enough).
Incorporate single arm and leg training.
Squats and deadlifts and overhead presses are great, but have you tried lunges, single leg deadlifts, and dumbbell presses? They work many of the same muscles as the bilateral movements while being a bit safer and forcing you to develop balance, mobility, and stronger stabilizer muscles.
Do a variety of exercises.
Repetitive motion breeds injury, whether you’re working at a mouse and keyboard for 8 hours a day, throwing fastballs, jogging the same route at the same pace, or doing the same four exercises for years on end. If all you’ve ever done is pullups, the occasional chinup won’t kill you. And it may even help.
If you’re at all hesitant about your technique, get evaluated by a professional.
Even though I said I wouldn’t discuss technique or form, this is more of a general recommendation. Chances are you’ve spent a lot of your life sitting in chairs, standing in heeled shoes, and doing other activities that impair your tissue’s ability to move freely and fluidly. You may need an expert’s eye before you can expose those tissues to training stressors in a safe way.
Want to do a basic 5×5 barbell program but your squat feels off? Don’t just power through it. Get a pro to look at your form and give you some tips.
Want to train for a marathon while wearing Vibrams? Don’t just launch into a training program. Check out a POSE running workshop, or look for a barefoot/minimalist running group or coach in your area.
Today, I want you to take a good long look at the way you’re training. Be honest with yourself: is it worth the risk? Do the rewards justify the threat of injury?
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Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.