You are a beast in the gym…that is, until a joint injury or flare-up from arthritis, bursitis or sprain threatens to deflate your motivation as a result of the pain. While it is always important to take preventative measures to protect the joints, such as warming up the surrounding soft tissues properly, using proper form during exercises, and taking supplements which promote joint health, there may be times when joint discomfort is so significant that a little TLC needs to be added to the regimen. The recommendation of complete rest usually falls on deaf ears when a fitness fanatic is the one suffering from joint woes, because the general mindset for such an individual is to push through the pain and continue training. However, in most cases, the pain and inflammation will throw a wrench in the works by adversely affecting range of motion and strength. As long as the joint pain isn’t severe, and is not caused by direct, acute injury to the joint, exercises can usually be modified to alleviate load stress on the affected area.
There are a number of exercise modifications which can be made to weightlifting exercises to minimize the loading on affected joints while still effectively training surrounding muscle groups. Bear in mind that you might not be able to perform certain exercises at all, even with a modified grip or stance. The most important thing is to pay attention to your body and stop doing anything which exacerbates the joint discomfort.
SAVE YOUR SHOULDERS AND ARMS
Since shoulder joint issues are relatively common, most of the suggestions made in this article for exercise modifications for the upper body will take this into account. Depending on the degree and location of shoulder pain, you might still be able to perform shoulder presses, but do not perform them behind the neck as they can cause impingement. Incidentally, you will also need to avoid pulling the bar behind your head when doing lat pulldowns. To perform overhead presses, use a straight bar with a grip slightly wider than shoulder width apart, or use dumbbells, and use a light weight. Another exercise which should be modified when shoulder pain is an issue is the bench press. Chest presses should be avoided on an incline bench due to increased abduction and a corresponding increased shear stress and strain on the glenohumeral joint.
Shoulder joint pain can also interfere with lower body barbell exercises like the back squat and lunges. Since the barbell must be stabilized across the back, the shoulder must remain in an externally rotated and abducted position. Even barbell deadlifts force the shoulder into a gravitational load in extension which can be enough to aggravate shoulder joint issues if a heavy weight is used. Modifications to these exercises include performing front squats while holding onto a kettlebell or dumbbell, and switching to dumbbells when performing lunges and deadlifts.
Most cases of shoulder pain from joint instability or arthritis can make it impossible to perform a plank for an extended period of time due to the superior-posterior stress across the shoulder joint complex, but this is easily remedied by modifying the plank so that you rest on your forearms instead of your hands, thus shortening the lever arm and decreasing the stress load.
If you have issues with your elbows, it is wise to avoid pullups, pushups, mountain climbers, overhead tricep extensions and planks, but bicep curls may also be difficult to do, especially as you supinate and flex the elbow. The elbow joint is a tricky one to train around, and the best approach is to completely avoid any direct movements which involve the elbow flexors if the pain is severe. If the pain is minimal, regular dumbbell bicep curls, hammer curls and cable tricep extensions can be performed with light weights. Using a false grip on dumbbells (in which the thumb is not engaged in opposition around the bar), using a cuff around the arm with a cable assembly, or switching to weight plates with a neutral (palms in) grip can also be helpful in minimizing the strain on the elbow stabilizers during delt training routines.
Wrist pain can often be eradicated by using lifting gloves which have wrist support to counteract some of the stress. Since bench dips can aggravate sore wrists, they should be avoided and replaced with cable tricep extensions, which can be performed without extending the wrist. Traditional pushups also force the wrists into a hyperextended position, but a simple switch in hand position, in which the fingers point out to the sides, with hands at least shoulder width apart, will minimize joint stress during the down phase of the movement.
WEIGHT BEARING JOINTS
If you have issues with the joints in your lower extremities (hips, knees, ankles, feet), ballistic movements, such as the ones performed in plyometrics and calisthenics, should be avoided. Unfortunately, exercises which are considered staples in a weightlifter’s regimen, such as squats, lunges and leg presses, can also wreak havoc on achy hips and creaky knees, especially if poor form and heavy weights are used. It’s best to trade these in, at least for a while, and instead turn to leg lifts on all fours, wall sits, front leg raises against a wall, and single leg deadlifts, all of which decrease the load on the hips and knees while still providing good isolation.
Since ankles and feet take the brunt of weight bearing, they should be babied when flare-ups occur, which means that calf raises, leg presses, and squats should be avoided and replaced with moves which do not require excessive joint motion under a loading force. Foot stance should be maintained at shoulder width to maintain the ankle position in a neutral plane and avoid any inversion or eversion. Mat exercises are also an excellent alternative to hardcore standard weight machines when dealing with joint flare-ups in the ankle or foot.
OHHHHH MY BACK
The incidence of low back pain is extremely high, especially among fitness devotees. Since it is usually triggered by extreme positions of flexion or extension, something as simple as standing with your heels on two weight plates and dropping the amount of weight lifted can be enough to maintain a more upright position and avoid the excessive lumbar flexion often seen with back squats. Another modification which spares the low back as well as the knee is performing Bulgarian squats, which keep the upper body in a vertical plane.
If you experience joint pain in your neck or upper back, you should avoid exercises mentioned earlier such as behind the head lat pulldowns and military presses, both of which cause excessive flexion in the cervical spine. In some cases, you will need to omit exercises which involve the use of a barbell behind the neck since this type of load increases flexion stress. You can modify these movements by using dumbbells or by switching to a machine, for example, switching from barbell squats to hack squats.
The most important thing to remember is to listen to your body and stop any movement if you feel sudden pain. By training wisely and making necessary modifications while your joints are inflamed, you will be able to bypass injury and continue to make gains at the gym.