Coming from a person with a medically trained eye who has tried their fair share of workouts, ranging from kickboxing to rehabilitation-based resistance training to cross fit and everything in between, it can be very frustrating seeing people in all fitness settings doing the wrong things for their bodies.  It takes every ounce of my self control to walk away, because when you're at the gym, you're not a physical therapist anymore. 

From personal experience, work schedules in this area of the medical field can make it difficult to be able to attend scheduled fitness classes on a regular basis, so I use equipment at a fitness center to create my own workouts.  It's here that I've recognized with just a few simple facts, a lot of people could make their workout routines much safer and more effective for their bodies. Today we will focus on:

The "Don't's"

1. Weighted Machines

Let's first address the larger picture: many of the weighted machines are likely not going to be as good for your body as using free weights or body weight. These machines isolate singular muscles or muscle groups, and while that can be effective for muscle groups that are slightly weaker due to an injury, it is more likely that strengthening individual muscle groups at a time will  increase your chances of your musculature being off-balance. 

The musculature of the body, in peak form, has balanced counterparts; muscle length and tightness is similar, and both concentric and eccentric strength is similar. 

Concentric Strength: Force exerted by the muscle while the muscle length is shortening/decreasing
Example: Flexing your arms in a Hercules pose is concentric strength of the biceps. 

Eccentric Strength: Force exerted by the muscle while the muscle length is lengthening/increasing
Example: Slowly lowering yourself to sit in a chair is eccentric strength of the hamstrings and glutes. When eccentric strength is weak, a person may not be able to control the movement the entire way, and will end up just dropping to the seat of the chair. 

Counterparts of musculature include biceps and triceps, or quads to hamstrings. 

Certain isolating weight machines also put a very large force upon the muscle group, as the machine is designed to affect one muscle group only. Many daily activities will never require movements that isolate a single muscle group - so therefore, these machines are not only functionally less effective, but can even be harmful. 


Knee Extension Machine (Quads)

This machine is particularly dangerous, as it is extremely easy to put so much strain on the muscle group that it causes damage. It has been proven that the increase of force and tension on the patellar tendon is so much so that if someone puts too much weight on for the tendonous insertions to handle, they are at an increased risk for quadriceps tendon tears, contusions, patellar mis-tracking, hip flexor tightness, and even ACL tears and tibial tuberosity fractures. 

Knee Flexion Machine (Hamstring Curl)

This machine is more ineffective than dangerous because it is truly not a movement we do in our daily lives, but there is a recorded increase risk in hamstring tightness, which can lead to pelvic rotation, hip pain, and back pain, and even a higher risk of PCL tears and hamstring tendon tears.

Adductor/Abductor Machine

I cannot express how many people I see doing these machines at the gym.  I'll start by saying that neither of these machines are particularly bad for your body. Hip abduction strength is crucial to a healthy hip and gait pattern, and even in a rehabilitation setting, we do seated hip abduction - but it is only helpful for so long. The body, in general, reacts quickly to strengthening in muscle groups that are not reached on a daily basis by someone who leads a more sedentary lifestyle, whether it be due to injury or just habit. This is the reason we start someone out with seated hip abduction - but after about a week, being seated is no longer beneficial since the muscles have adjusted.  Since everyone doing these machines at the gym are likely going to the gym too often to be considered sedentary individuals, and therefore seated hip abduction is not really beneficial or functional for their body.  

Now seated hip adduction is another story.  Like me before I started working in this field, I thought the seated hip adduction machine would make my inner thighs slimmer, and more toned. I, like so many others, was searching for a "thigh gap".  The truth is - it doesn't do any of that.  Like doing abs, this machine won't magically remove the stored fat from your inner thighs, just like doing abs won't give you a six-pack. 


This is most evident when watching someone do bicep curls. Someone who starts with their elbows in 90 degrees flexion and just pulls weight up to their shoulders is likely not going to get the results they're looking for unless they're maxing out on weight and doing minimal reps every time. This is minimal momentum.  Someone who is lifting using the full 180 degrees provided by the elbow joint, so the weight starts closer to the thighs, but who uses their entire body weight to  throw the weight up is using excessive momentum. This will also not likely lead to the results they're looking for, as they're recruiting so many other muscle groups that it no longer is primarily a biceps exercise. Not only is this ineffective, but can also put straight on the back if the core is not tight. The correct way to perform a bicep curl involves using almost the entirety of the elbow joint range of motion at a predetermined speed.  Faster contraction (pulling the weight up toward the shoulders and bending the elbow) is good for explosiveness, and increasing muscle mass, but it is equally as important that the bicep eccentric strength is improved by lowering the weight slowly to its return position. The arm should never be fully relaxed - therefore the weight should never return all the way to the thighs - just slightly above to keep some contraction in the arms. 

This is also very evident watching "Lat Pull-downs" as many people will use their entire body to pull the weight down, as opposed to just their arms and back. There shouldn't be any "rocking" as the weight lowers - the body should be almost entirely still.  This is true regardless of whether the lift is being performed standing or seated. 


More often than not, many individuals coming in for physical therapy who live active lifestyles are only injured because they need to make a few slight adjustments to their lifting and performing technique. Lifting doesn't necessarily mean lifting heavy weights, it can be as simple as picking a pencil up off of the floor, or putting a jug of milk in the refrigerator. 


To activate as many muscle groups as possible while protecting the joints in the lower extremity, the joints need to be "stacked" so that a load is never more overbearing on one joint compared to another. The most common is probably the knees driving too far forward. When the knees drive further over the toes, the pressure on the anterior aspect of the knee joint is astronomical. Especially in this flexed and loaded position, the ACL (anterior cruciate ligament) is at it's longest and carrying the majority of the load. 


More often than not, if you ask someone to do a push-up, it'll look like this: elbows out away from the body as if to be in a "T" position.  This position rotates the scapulae, or shoulder blades, out in a winging formation. While the body descends lower toward the ground, the shoulder joint is shifted forward and upward, into what is called external rotation. With the scapulae winging and the shoulders in external rotation, this is the position also known to cause impingement. Impingement syndrome is the result of slight damage to a rotator cuff tendon.  The damage causes swelling, which in turn, leads to blocked blood supply and pinched nerves because the tendons are so intricately weaved throughout bones in the shoulder joint.