Sunday, December 28, 2014

6 most common workout blunders

The gym can be an interesting place to go to as a physical therapist. I am always fascinated by the many people who tend to make the same mistakes when working out. Here are the top six common workout errors I see both at the gym and when working with my patients

6 most common workout blunders

Being the new jock on the block can mimic the insecurities and trepidations experienced on the first day at a new school.
Being the new jock on the block can mimic the insecurities and trepidations experienced on the first day at a new school. iStockphoto

The gym can be an interesting place to go to as a physical therapist. I am always fascinated by the many people who tend to make the same mistakes when working out. Whether it’s overworking a group of muscles or performing an exercise that just won’t get you results, here are the top six common workout errors I see both at the gym and when working with my patients:

1)   Incorrectly sequencing a workout routine. When you walk into the gym, how do you typically start your workout? There is a lot of variability in people’s sequencing of a workout routine. But, if you are like many who open with strength training, you’re doing it all wrong. Typically, a workout routine should progress from active stretching, to gentle warm-up, to cardio, to strengthening, finishing with passive stretching.

2)   Performing sit-ups. Core strengthening is an integral part of any strength training program. However, sit-ups are generally not the most effective way to target the core musculature. Sit-ups tend to lead to short, over-recruited hip flexors and can contribute to a condition called diastasis rectus abdominis (a splitting apart of the abdominal muscles). From a function standpoint, it is preferable to strengthen the core in a neutral spine position, with activities like planks.

3)   Over-training the pectorals and under-training the muscles in the mid-back around the shoulder blades. The pectorals are the muscle group in the front of the chest, typically strengthened with exercises like a chest press. Often times, people will tend to over-train these muscles, causing them to become very short. This is exacerbated if the muscles in the mid-back are not targeted with strengthening. The under-training of the mid-back can lead to altered mechanics at the shoulder and postural dysfunction (shoulders rounding forward and arms rotating inward), which can ultimately cause shoulder impingement symptoms.

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4)   Over-training the deltoid and under-training the rotator cuff. Another common problem we often see in shoulder impingement is a deltoid that overpowers the rotator cuff. The deltoid is the group of muscles forming the rounded contour of the shoulder, most often worked in exercises like the overhead press and dumbbell fly. The rotator cuff is the group of muscles that start on the shoulder blade and wrap around the shoulder joint, ending on the humerus. Their job is to keep the humerus seated in the shoulder joint. When the rotator cuff is not able to counter the strength of the deltoid, the soft tissue at the top of the shoulder and upper arm can get irritated and painful, particularly with overhead activities. To strengthen the rotator cuff and avoid injury, try internal and external rotations on a cable machine.

5)   Under-training the gluteus medius. The gluteus medius is a small muscle that sits on the side of the hip joint. Its primary function is to keep the pelvis from tilting when standing on one leg (like when advancing one leg while walking or running). Most people aren’t strengthening this muscle group or are recruiting compensatory muscles, which commonly leads to dysfunction in the lower extremity or pain in the low back. An exercise as simple as sidestepping with an exercise band around one’s thighs or ankles can activate this muscle group, improving pelvic stability and lower extremity mechanics.

6)   Over-recruiting the upper trapezius. The upper trapezius is the triangular muscle that runs from the base of the skull into the shoulder area. In strength training, this is the muscle that contracts when we do a shoulder shrug. In cervical spine and shoulder dysfunction, the upper trapezius tends to work overtime (often compensating for weak deep neck flexors in the front of the neck or a weak lower trapezius). The error when working out is typically lifting with weights that are too heavy during activities like rows, resulting in a loss of technique as the shoulders move upwards.

Keep these six tips in mind the next time you head to the gym for a safe, pain-free workout!

Jennifer Zellers, P.T., D.P.T. received her Doctor of Physical Therapy degree from Columbia University and is an Advanced Clinician I at Thomas Jefferson University Hospital.


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Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Eugene Hong, MD, CAQSM, FAAFP Team Physician for Drexel, Philadelphia Univ., Saint Joe’s, & U.S. National Women’s Lacrosse
Martin J. Kelley, PT, DPT, OCS Advanced Clinician at Penn Therapy and Fitness, Good Shepherd Penn Partners
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Kelly O'Shea Senior Health Producer, Philly.com
Tracey Romero Sports Medicine Editor, Philly.com
David Rubenstein, M.D. Team Orthopedist for 76ers; Main Line Health Lankenau Medical Center
Robert Senior Event coverage, Sports Doc contributor
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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