Weight of Injury
Stephen Clark, PT, DPT, MHS, OCS, MBA

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Most often, people use too much weight or use improper techniques because they don't know better. Other times, they have poor flexibility or are overtraining because of unrealistic goals. For example, Brian has been performing the straight-bar, behind-the-neck shoulder press for years. The overload to the shoulder has caused degenerative changes of the acromioclavicular joint. Even though his shoulder has hurt from time to time, he continues to push through the pain.

On the other hand, Kris has injured her knees from placing her feet low and wide apart, with her knees close together, on the leg press machine. As a result, she's developed patellofemoral syndrome.

Protect the injured area. Once you've determined the actions that have caused injury, you can prevent injury exacerbation by doing the following:

First, educate and treat your patients by modifying their workout program so the injured area rests..The exercises that give patients pain contribute to the cause and continuance of the injury. So modify the reps, sets, loads and frequency until the exercise causes only mild discomfort, not pain.

If you can't modify the exercise to a discomfort state, try a different piece of equipment, such as a weight machine or dumbbell. If you still can't eliminate pain during or following the exercise, the patient will need to stop that particular exercise for a period of time.

Reduce inflammation. Whether patients are resting an injury or modifying the exercise load, use your treatment techniques to heal the injured tissue. Joint mobilization restores normal joint movement, which reduces abnormal joint compression and tendon or ligamen-tous strain. Neuromuscular re-education restores normal sequencing of movement, preventing overuse to muscles and tendons.