How to deal with common weight training injuries

Weight training injuries are a fairly common occurrence for those who spend up to six days a week in the gym.

These injuries can occur due to numerous factors, including poor conditioning, errors in technique, structural immaturity – both soft tissue and bone – poorly periodised training and a lack of variety that can result in overuse injuries or overtraining.

These common acute weight training injuries range from sprains, strains, tendon damage, and compartment syndrome, to stress fractures or even dislocations.

Other non-musculoskeletal problems can include nerve damage, impingement or dysfunction and various cardiovascular complications.

So, what are the common injuries?

Fortunately, the more serious injuries are relatively rare in the gym environment, but that’s not to say they do not happen.

The more common acute weight training injuries are strains and sprains and due to their mild severity many gym-goers seldom seek treatment for them, at least initially.

It is only once the symptoms become more severe or are prolonged that they seek help, which means recovery times are often far longer than would initially be the case.

Sprains explained

Sprains affect ligaments, a form of fibrous connective tissue that connects two bones or holds together a joint, and are caused when these structures are twisted or wrenched violently.

This generally results in a stretching or tearing of the ligament, which causes localised pain, tenderness and swelling.

The severity can be graded by the degree of laxity, or ‘looseness’ of the injured ligament. In general, a grade 1 sprain is painful without ligament laxity. Grade 2 sprains involve slight laxity, and grade 3 injuries result in gross instability.

Medial and lateral collateral knee ligament sprains may occur during squats, leg presses, and lunges with high loads due to improper technique, muscle (strength and/or flexibility) imbalances or incorrect foot placement.

Complete ligament tears or ruptures due to weight training are not common as there are seldom extreme rotational forces involved.

Other common sprains occur in knee ligaments during knee flexion exercises such as hamstring curls and deadlifts.

What are strains

A strain is defined as a stretching or tearing of either muscle or tendon tissue. Muscle strains result in pain, muscle belly or myotendinous junction tenderness, limited range of motion, and relatively preserved strength.

Grade 1 and 2 muscle strains are quite painful and are distinguished by either the absence (grade 1) or presence (grade 2) of weakness. Hamstring and lower back muscle strains are the most common among weight lifters.

Muscle ruptures are essentially severe muscle strains and are classified as grade 3 strains. They are associated with significant weakness and possibly a palpable muscle defect at the myotendinous junction.

Tendon avulsions (a separation of tendon from bone) are less common in the gym, but in either injury, patients often report feeling or even hearing a sudden “pop”.

The other common soft tissue condition experienced by those who push their boundaries in the gym on a regular basis is acute compartment syndrome.

It is a painful condition resulting from the extreme expansion of muscle tissue within inflexible and inelastic fascial tissue caused by increased blood flow into the muscle cell or the build-up of water and fluid.

Symptoms of compartment syndrome include progressively more severe muscle pain and a build up of pressure during or following strenuous workouts, especially if eccentric exercises were involved. It may also lead to partial or mild paralysis, and abnormal nerve sensations.

In severe cases a fasciotomy – a surgical procedure where the fascia is cut to relieve tension or pressure – must be performed to minimise the risk of permanent nerve damage or loss of function of a limb.

Rhabdomyolysis – the breakdown of muscle cells resulting in the release of its contents into the blood stream – can also occur due to severe compartment syndrome and can be life-threatening because of the potential for acute renal failure and electrolyte abnormalities.

Dealing with fractures and breaks

While acute fractures account for only a small percentage of weight training injuries, stress fractures are becoming more common due to the shift in trend toward heavy high-intensity weightlifting and overtraining.

While more serious occurrences such as haemorrhages (a ruptured blood vessel) and strokes are rare, patients who have a known history of aneurysms and internal bleeding should avoid heavy weight training.

Acute radiculopathy is a nerve root condition that presents symptoms such as numbness, tingling and weakness, and is often associated with heavy lifting, which places gym-goers at greater risk. Acute radiculopathy due to heavy weight training also increases the risk of lumbar disc herniation.

How to treat injuries

Should you present with any of these symptoms, cease exercise immediately, then visit your physician as soon as possible. Do not attempt self diagnosis because prolonged training with any of the aforementioned injuries can result in an acute injury becoming chronic.

Following a medical diagnosis and the conclusion of the prescribed treatment protocol, a rehabilitation programme devised by a physio or biokineticist is essential to restore lost motor function and regain strength before a return to normal training is resumed.

Author: Pedro van Gaalen

When he’s not writing about sport or health and fitness, Pedro is probably out training for his next marathon or ultra-marathon. He’s worked as a fitness professional and as a marketing and comms expert. He now combines his passions in his role as managing editor at Fitness magazine.

When he's not writing about sport or health and fitness, Pedro is probably out training for his next marathon or ultra-marathon. He's worked as a fitness professional and as a marketing and comms expert. He now combines his passions in his role as managing editor at Fitness magazine.

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