Exercise is like investing, you want to get the most benefit with the least amount of risk. I am constantly surprised by how many patients I see who have hurt themselves with exercise.s that are ill advised. I think it is worthwhile to review some factors that can minimize your risk of injury with exercise.

To minimize your risk in exercising, you should ask yourself a few simple questions:

Why am I using this machine?
Does this exercise put a vulnerable part of my body in position of jeopardy?
Does this exercise reduce muscle imbalance in my body, or does it make it worse.
Is this exercise likely to put an area of degeneration in my body in a position of jeopardy?
Is this exercise functional?

In general, I encourage people to avoid exercise while sitting on a machine. Sitting is the new smoking, and as a culture, we still sit too much. Sitting is the main contributor to muscle imbalance in our body (see muscle imbalance page).

It helps to understand which regions of our musculoskeletal system are vulnerable to degeneration, and should be spared repetitive loading in exercise. The three main areas I encounter are the intervertebral disc in the spine, the rotator cuff in the shoulder, and the menisci in our knees. The disc is significantly loaded during flexion of the spine, particularly when carrying a weight. This makes exercises like dead lifts potentially harmful to the disc, if not performed with perfect technique. Exercise with the arms over ones head, such as a military press, stresses the stability of the shoulder and causess impingement on the rotator cuff. Knee flexion beyond 90 degrees, such as a deep squat, puts a great deal of pressure on the meniscus in the knee and generates a great deal of pressure behind the kneecap, putting a load on cartilage that is often damaged.

Younger people have fewer worries when it comes to difficulties with degenerative tissue and exercises. But as we age, the areas of the tissue degeneration can be easily provoked in the gym. If we have a little bit of gray hair we should consider the following recommendations:

-Try not to sit when you exercise.

-Avoid regular overhead movements.

-Avoid deep squatting through the knee joint.

-Be cautious with forward bending exercises of the spine.

-Try to activate as many muscles as possible with your exercise routines.

-Try to incorporate core activation, and balance challenges with as many exercises as possible.

It is my hope that you can get the most out of your investment and exercise, with the least amount of risk.

To help you on the road to recovery, I have prepared some exercise videos.  The exercises are grouped in the areas of rehabilitation of the spine, hip, shoulder and knee.


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