Injury Risk Reduction

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As a physical therapist, I witness the benefits of treating injury risk—and the cost of ignoring it—all day, every day. I see people who follow proper injury risk reduction programs and lead vibrant, active lives feeling capable and independent, and able to participate in physical activities they love. Meanwhile, I see other patients who have had to pull back, either partially or entirely, from their job, workout routine, or favorite activities due to injury that might have been less likely to happen had they been engaging in a balanced training program. While you can’t truly prevent all injuries, reducing your risk is always better than treatment.

The value of being prepared to perform functional activities and respond to situations requiring extra effort cannot be underestimated.

Building strength, as well as increasing mobility, stability, balance, endurance, and overall health is critical to injury risk reduction. In my mind, smart training that addresses all of those qualities prepares your body for almost any physical demand—whether it’s shoveling snow on your driveway, carrying all the groceries into the house in one trip, or even saving your life (and the life of someone you love) in an emergency situation.

I often think about my friend, Jamie Scott’s account of the 2011 earthquake in Christchurch, New Zealand. Because he was fit and had good endurance, Jamie was able to dig his car out from under a landslide, carry his necessary belongings to the car, and leave the city as the roads began to break apart. As a result of his functional training, he was able to dig, lift, carry, pull, climb and jump—and ultimately get to safety. His story still gives me chills and has heavily influenced my own training over the past several years. This is an extreme example, and hopefully most of us will be fortunate to never find ourselves in a similar situation, but it emphasizes what a difference being physically prepared and confident in your strength and ability can make. If you can feel prepared to act in a situation like this, chances are good that you’re prepared for other less extreme, everyday activities.

Our goal for lifting weights should not be to simply get good at deadlifting at the gym. A better goal is to build strength, power, and endurance in order to function with confidence in everyday—as well as unexpected or emergency—situations. A strong deadlift at the gym is just a bonus.

Here are some of my favorite types of exercises for building the kind of functional mobility and stability that can help you reduce your risk of injury:

Carries

The ability to carry weight over a distance is useful in everyday life. You can train your grip strength and gradually increase your ability to carry loads through exercises such a farmer’s carries and waiter’s carries. These exercises also train deep core stability, and variations such as the bottoms-up carry train scapular and shoulder stability even at light weights. Training deep central stability and scapular stability give you a stable foundation from which to carry groceries, heavy bags of mulch, and babies in heavy car seats without a second thought!

Hip Hinges/Deadlifts

Learning the hip-hinge pattern helps you harness the power of your glutes and entire posterior chain (instead of “lifting with your back”) during lifting activities—plus, the ability to pick up heavy items from the floor means that you will not require assistance to lift and move furniture! Deadlifts can be performed with a kettlebell, barbell, sandbag, or as a pull-through with a band or cable attachment. I use these variations every day with my patients. I have even taught an 80-year-old female client how to deadlift in order to put her husband’s wheelchair in the car without assistance.

Squat Variations

Squatting is necessary for basic functions of daily life such as picking up items from the floor and coming to stand from a low surface. Many adults tend to lose the ability to squat deeply as they age. This can happen for a variety of reasons, but in general as people age, they become less active. Inactivity can lead to joint stiffness and pain, not to mention a loss of muscle strength. Maintaining mobility in the hips, knees, and ankles allows us to perform activities such a gardening and bending to pick up children or pets. Beneficial squat variations can include body-weight squats, kettlebell goblet squats, barbell front and back squats, and overhead squats, the last of which have the added benefit of building shoulder stability and thoracic spine mobility.

Pressing (or Pushing) Exercises

I love upper-body presses, particularly single-arm, for strength and stabilization. They train us to be able to lift items overhead, such as placing a carry-on-suitcase in the overhead bin on an airplane.One of my favorite press variations is the half-kneeling landmine press, which works shoulder and deep core stability. Other variations of pressing include planks, push-ups, and dumbbell overhead presses.

Pulling Exercises

Pulling exercises such as rows and pull-ups work grip strength, forearm strength, and develop the ability to generate tension throughout the deep central stability system, incorporating the upper back muscles (rhomboids, traps and scapula), the lats the abdominals and the pelvic floor. The ability to hang on and support your full bodyweight is an exceptionally useful skill, and having a strong back and shoulders will help protect you against injury whether you’re pulling yourself out of the pool, spending the day at the rock climbing gym, or walking an easily distracted dog that tends to pull on the leash! You can use bands for assistance as you work on increasing your pull-up strength, and gradually move toward unassisted pull-ups. Plus—getting that first unassisted pull-up is a powerful feeling!

Rotation/Anti-Rotation Exercises

Training the deep central stability system (the diaphragm, pelvic floor, deep abdominals, and spinal stabilizers) allows you to harnesses the power of your “core” while preventing stress urinary incontinence (a problem which affects one out of every three women). Training this system can be accomplished by rotating your trunk (or preventing trunk rotation) with exercises such as the Pallof press, as well as band or cable chop and lift variations, just to name a few. You will also reap anti-rotation benefits from certain pushing and pulling exercises such as the single-arm dumbbell row or cable row and single-arm dumbbell bench press or cable chest press; they all involve the core and require that you resist against the body’s natural tendency to rotate with a unilateral load.

By including these movements in your training program you will build functional strength, mobility, and stability. Stay safe by moving well and moving often!

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