Many people fear that weightlifting regularly leads to joint pain over time. All the squatting, pushing and pulling of hundreds of pounds day after day has to speed up the “wear and tear” on our joints and start breaking them down over time, right?

If you’re one of the many who are unsure of whether the rewards are worth the risk when it comes to weightlifting and don’t want to be that middle-aged guy always complaining about sore knees, stiff elbows or an aching back, then you want to read this article…

Exercise & Pain

There is such a high prevalence of exercise causing pain that it is easy to jump to the assumption that exercise is a risky behavior, bound to lead to eventual injury.

We’ve all experienced those days of excruciating soreness after a brutal leg day... where climbing a flight of stairs feels akin to summiting Mt. Everest. On days like these, you may even ask yourself, “If exercise is supposed to be so good, why does it cause me so much pain”?

That’s a dangerous thought process because it leads to some people actually believing that weightlifting is the cause of joint pain and therefore may not be worth the risk if they want to remain pain free; but does weightlifting actually cause injury?

Weightlifting can strengthen joints when performed correctly. What causes an injury is not the weightlifting itself but rather the selection of exercises and how those exercises are being performed.

You may be surprised that very common exercises that you see everyday in the gym are unnatural movements causing repetitive damage to joints, that over time will become a pathology.

The source of joint pain can remain elusive to the common athlete because the pain doesn’t come right away. Years of chronic misuse eventually catches up to you and then you can be in pain without understanding why.

Making matters worse, it could be due to something you thought was good for you all along making it difficult to believe it is the real culprit. The best time to make these adjustments are, of course, before any pathology develops, but then how do you know what exercises are wrong?

The unfortunate reality is that without a thorough understanding of human anatomy, and biomechanics, it is quite easy to do a movement and not understand the consequences of what that movement is doing to your body.

It is all too common to focus only on how an exercise targets specific muscles without being concerned about how the surrounding moving parts may be affected.

However, just because a particular exercise targets a desired muscle, doesn’t mean it comes without risk. Therefore not all exercises have a great benefit to risk ratio and should be eliminated or modified from your routine in order to keep your body and joints healthy.

Heavy Weightlifting Is Not The Culprit

Lifting heavy gets the worst reputation for all ensuing joint pain, but it’s not actually the weight that is causing the pain, it’s the biomechanics of the movement.

Lifting heavy weight with proper mechanics is actually associated with improved bone, tendon and muscle strength. In essence, heavy lifting can make the joints stronger.

However, with poor mechanics, heavy lifting may expedite the development of an injury or cause more substantial immediate damage. Lifting lighter weights of the same exercise, on the other hand, may have lesser symptoms in the short term, but make no mistake, the repetitive activity of a bad movement even at a lower weight will also cause joint deterioration in the future.

Additionally, because the lighter weights are often accompanied with higher rep ranges than with heavier weight, the increased frequency of repetitions may expedite the deterioration process.

Four Worst Exercises

I have highlighted what I believe to be the top 4 exercises where the risks on your shoulders and knees outweigh the benefit and overtime will lead to disability down the road.

1. Military Press

This is a great exercise to target the deltoid muscles, but what you probably do not know is you may be putting unnatural stress on your glenohumeral joint (the ball and socket joint in your shoulder) if you’re doing it incorrectly.

The reason is because of the anatomy of the shoulder joint. The head of the arm bone (humerus) represents the ball and the shoulder blade represents the socket.

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The socket of the shoulder blade actually faces forward by about 30-40 degrees. So when your arms are being raised directly beside you, the humerus is no longer centered in the shoulder joint and instead pressed against the posterior portion of the shoulder and straining the anterior side to get into that position.

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As you begin to raise your arms without the ball centered in the socket, you will start to pinch structures inside the shoulder joint and cause problems such as tendonitis, inflammation and bursitis.

The worst case scenario would be behind the head shoulder presses which represent the most extreme way to ensure rapid shoulder deterioration.

A small adjustment you can make to your military press is to bring your hands closer together on the bar forcing your elbows forward slightly, or with dumbbells bring your elbows slightly forward by 30-40 degrees. This allows your shoulder presses to be in the same plane as your shoulder blade and result in a healthy mobility of your shoulder instead of fighting your own anatomy.

Military-Press

Using this technique will allow you to keep lifting heavy without having to compromise your shoulder.

Bonus Tip:

This is the exact same range of motion of a lat-pulldown with the forces going in the opposite direction. Never perform a lat-pulldown behind your head, for the same reason as discussed above. In order to keep the health of your shoulder joint, keep the pulldown bar in front of you.

2. Leg Extensions

Nearly all knee pain is caused by an imbalance somewhere in the leg. Sometimes the source of the pain comes from below the knee and sometimes it comes from above the knee. There are so many causes of knee pain, it’s too much to cover in this article. However, by far, one of the worst things you can do to cause or exacerbate knee pain is a leg extension for many reasons.

The first reason is that it is a completely non-functional movement that puts unnatural shearing forces on the femorotibial joint, compression forces on your patellofemoral joint, and compounded by a constant stress placed on the ACL ligament.

The sole purpose of the ACL ligament is to resist the forward movement of the lower leg (tibia) relative the the upper leg (femur). Unfortunately, the entire mechanic of a leg extension directly pulls the tibia forward relative to the femur, so the ACL is consistently under tension for the duration of the exercise.

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While you may not noticed severe pain when the weight is low, this is a terrible exercise to perform high-weight with due to the increased risk of ACL rupture. Moreover, the compressive forces on the patellofemoral joint forces bone on bone contact between the patella and the femur resulting in irreversible bone deterioration over time.

The second issue with the leg extension exercise is an imbalanced activation of the quadricep muscles. As the name implies the quadriceps are made up of four muscles. However, a leg extension does not equally activate each of those muscles so the result over time is an imbalance of the forces acting on the knee which will change the mechanics at the knee. Leg extensions favor the outside of your thigh and fail to optimize your inner thigh.

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This action may cause the kneecap to deviate outward from its normal track that eventually can result in a knee pathology called patellofemoral pain syndrome. Fixing an imbalance such as this is much harder to perform than preventing one in the first place.

The third concern about an open chain exercise such as this is the lack of hamstring coactivation. If you can imagine most other quadricep exercises, knee extension is coupled with hip extension causing a coactivation of the hamstring muscles providing a balanced activation of the musculature across the leg that restricts gross imbalance development. When quadricep strength outperforms hamstring strength, additional abnormalities will develop.

As a general rule about keeping the health of your knee in check, perform quad exercises with the force being transmitted through your feet, by having them planted on the ground or platform.

Also, pay attention that your center of balance is over your feet and not ahead of them. If your knees are ahead of your feet, it is likely that they are enduring unnecessary and unnatural forces that will inevitably cause you harm long term.

3. Upright rows

Back to shoulders again. The upright row is the one of the worst exercises you can do to cause damage to your shoulder joint. This exercise involves loading your arms in internal rotation.

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The internal rotation of the humerus in the shoulder joint puts your shoulder in what is called an impingement position.

Impingement is what occurs when a part of your humerus compresses some of the structures above them. To make matters worse, the upright row takes this position and then raises the arm to further exacerbate the impingement.

Over time, this will directly lead to impingement syndrome where the structures on the top portion of the socket becomes inflamed and further decreases any space for your humerus to move in the shoulder joint.

This in turn, creates less space for the rotator cuff tendons, the bicep tendon and the bursa.

Once this happens, even weightless actions at the shoulder will cause pain, as the humerus continues to compress inflamed tendons, the shoulder capsule and labrum.

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The worst thing would be to fight through that pain, as it would eventually cause structural tearing of the rotator cuff tendons and/or labrum.

There are far better methods to train your shoulders. As a general rule, to avoid impingement, never lift your arms in any palms down position.

Bonus:

Side lateral raises are susceptible to a similar concept. The next time you try a side lateral raise look at the position of your hands. If your thumb is pointed down, odds are that you are elevating your arms in an impingement position. As mentioned above, this is the worst thing you can do to your shoulder.

A simple adjustment is to do lateral raises with your thumb above parallel. This makes sure that your shoulder is not in a compromised position during the lift. By externally rotating the arm, the head of the humerus will have more space to move and therefore will avoid irritation to the various tendons crossing the joint.

In order to target the various heads of the deltoid, this can then be achieved by manipulating the bend at your waist. An upright posture with external rotation will target the anterior deltoids, a 30 degree bend at the waist will target the middle deltoids and a 90 degree bend at the waist will target the posterior deltoids.

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All these varieties can be done while the arm is in external rotation to prevent injury to the shoulder all while optimizing gains in the deltoid.

4. Squats

Now, let me clear things up here, I’m not telling you not to do squats, because they can be the most impactful exercise known to weightlifting.

However, many injuries can be caused from doing squats if careful consideration is not taken. To make matters worse, there are so many different pieces of advice and tips about squatting that it’s next to impossible to know if you have been giving correct advice.

Some people even retire from doing squats because it causes too much pain in their knees.

However, if performed correctly, you should still be able to squat without knee pain even if you already have bad knees. All you have to do is pay attention to the form.

The most common issue with performing squats is the knee collapsing inward during the squat (often referred to as valgus or “knock knees”). This is particularly common for those with flat feet or fallen arches.

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This is because without prominent arches in your feet, your stance becomes everted. Eversion of the feet causes a medial rotation of the lower leg and consequently causes your knees to point inward.

Squatting with your knees pointing inward unevenly wears down the knee joint and put excessive stress on your meniscus, causing deterioration. The meniscus of the knee provides a cushion between bones. Therefore, damage to the meniscus of the knee ultimately leads to bone on bone contact and the degradation of bone tissue that eventually would need a replacement.

Common suggestions include using a wider stance or pointing your feet slightly outward to prevent this.

Unfortunately, these suggestions do not directly address the issue as your knees may still lead to a collapse in during a squat.

In fact, instead you need to use your brain more to correct the issue. With your feet firmly planted, approximately shoulder width apart and straight ahead, apply some external rotational tension on the legs; this will cue your knees to point straight ahead when initiating a squat.

This means as you sit in the squat, focus on your knees pointing outward without moving your feet. This mental attention to your knees will actually allow for the proper mechanics for this and all similar movements, including jumping and other athletic maneuvers.

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Bonus:

This concept can be applied to similar exercises such as all varieties of leg press, and lunges. Focusing on keeping your feet pointed forward and your knees bending straight ahead or slightly outward will enhance your performance in the long term. This is especially important for single leg exercises like lunges.

It may feel unnatural at first, but with practice not only in the weightroom but anytime you sit down, stand up, or go up stairs, it will become second nature and your knees will be better for it.

Conclusion

The take home message is that lifting heavy weights is not what causes joint pain.

Resistance exercise actually stimulates the synthesis of bone growth and supports the health of your bones and joints.

Applying tension to bones, tendons and ligaments with the correct forces ultimately leads to them becoming stronger along with the muscles they target.

However, not all exercises take the biomechanics of your joints into consideration.

In many cases there are better options to choose to preserve the health of your joints while not sacrificing any gains. There is always a risk benefit ratio when it comes to exercise selection.

In terms of shoulder health, a general rule is to avoid any exercises that involve internal rotation of the humerus with elevation. Knee health can be maintained by making sure they bend outward instead of inward for most leg exercises.

Bear in mind, these are only two of the most common joint areas affected and you can run into joint issues in any of the joints, so be sure to take into account how exercises might affect your joints as well as your muscles when developing your training routine to ensure optimal results in muscle building as well as longevity of joint health.

Hopefully you found this article very informing and perhaps came across some solutions to the joint pain you may have been having, along with some solid strategies to prevent future issues down the road.

If you enjoyed this article and want to give us feedback or have any questions or comments about this or future RadLab Article topics, feel free to send us an email at radlab@bluestarnutraceuticals.com and we’ll get back to you with a response or perhaps write up a whole new RadLab article to cover the topic and answer your question.