Panel Discussion: Controversial Exercise
What exercises do you shy away from, and why? Why is it that some people can do these exercises for a lifetime without incident, and some of us cringe at the thought?
Moderated by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS
This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on June 29th, 2010
Gabriel GdmFitness Martinez, June 29, 2010 at 10:51am: Dam overhead pullovers hurt my shoulder and back
Matthew Allen, June 29, 2010 at 11:06am: Dumbbell French Press. While bringing it back around after finishing the set I pulled a muscle in my neck and had to go to the hospital. It was the beginning of my neck woes - never again.
Derrick Price, June 29, 2010 at 12:09pm: What makes an exercise controversial? What purpose does it have in a person's program? Does the controversial exercise fit the needs, wants and capabilities of the client?
Brent Brookbush, June 29, 2010 at 12:19pm: Maybe I should have given an example for everyone to apply these thoughts too. Derrick can you pick an exercise to apply your criteria to? Examples… Is a Dip a good or bad exercise? Is a behind the neck shoulder press or lat pull down ever appropriate? Are ballistic leg bilateral leg raises good for any goal?
Gabriel GdmFitness Martinez, June 29, 2010 at 12:22pm: I developed an impingement due to overhead pressing and the bench press. I take it slow while working these exercises now.
Derrick Price, June 29, 2010 at 12:56pm: All exercises can be considered controversial, i.e. good or bad. A push up for example can be a fantastic exercise for some people but for others it can be disastrous. The same can be said for squats, lunges, rows, etc, etc. It all comes down to are we selecting exercises that meet the client where they need to me met. In other words, are we taking into consideration who the client is, what do they want, what do they enjoy, what are they capable of. Most people train outside of what Gary Gray calls their Sphere of function so ultimately performing an exercise beyond this sphere (threshold) can lead to an injury. Why not just keep the person within this sphere while performing the exercises you select?
So for your example, is a Dip a good or bad exercise? The answer is either or! Depends on what the client is looking for in their program, what is their capability, what purpose does it have? We can debate on whether it's good or bad or how functional the exercise is but ultimately what does the client want? Maybe they like dips? Maybe it's their favorite exercise? So then it's our job we give them programs they enjoy/want and they perform the exercise with appropriate amount of acute variables, range of motion and rhythm and timing that allow for healthy movement.
Mikal Payne, June 29, 2010 at 1:04pm: Mine is straight arm lateral raises, I teach lateral raises but I keep the weight down/low and bend the arm at the elbow. I think I have seen too many people throw the weights up not lift the weight and you can think "IS back injury" I also cringe when watching people do sit-ups, that one I just people doing wrong so often.
Marty Miller, June 29, 2010 at 1:06pm: DP I agree with you, but what I want to add in, is that we now have a great understanding of biomechanics and upon applying these concepts to common exercises we can safely say some are much higher risk than others. Just because a client loves an exercise does not mean I will just give in and let them do it. It is my role as the professional to be able to educate them on why there exercise may be high risk, and what a better alternative maybe.
Use dips for example. We know that no matter how you do them they will place a tremendous amount of strain on the anterior shoulder capsule. The tricep extends the shoulder and elbow. There are many ways to load that motion without placing all that stress on the shoulder capsule. Now if there is a functional reason they need to do dips, then I would reconsider my previous statement.
As an Athletic Trainer and I hope this goes at least ethically to Personal Trainers one of my main job goals is to not cause harm.
Marty
Mikal Payne, June 29, 2010 at 1:10pm: I agree Marty
Mikal Payne, June 29, 2010 at 1:12pm: But some people just look at you like you have 3 heads and say but I been doing it this way for years. So how do you impress/imprint a new way of doing an exercise on them?
Marty Miller, June 29, 2010 at 1:25pm: They way I do it is first I explain what is going on in the shoulder joint. Then I explain what the triceps do, then I give them a great alternative and ask them how there triceps feel after our new exercise. Most people like the way they feel after an exercise, more than the exercise itself. So if they get a great new exercise it lessens the blow.
Eric Beard, June 29, 2010 at 1:28pm: You can always find an exercise that is not right for a certain individual and that is our job, to avoid those. Dips are at the top of that list for most people and there are endless variations of movement that can produce similar if not better results.
Barbells behind the neck are contraindicated for just about everyone other than competitive Olympic weightlifters. There are a small pool of people that can sustain prolonged exposure to those movements, but why persist with them to figure that out?
How about floor cobras? Who are they controversial for? The assessment drives us where to go and we can nimbly adjust during the course of a session, but there will always be a few that we have to steer clear of for most people.
Like…triangle push-ups? How many people have ideal range of motion at the wrist?
What others do you like to not like Brent?…other than shrugs as you have posted before:)
Jonathon Schetzsle, June 29, 2010 at 2:18pm: Good or bad exercise? Or well and poorly executed movements? Although dips and stability ball pikes are bad for me and my shoulder :)
Mikal Payne, June 29, 2010 at 2:21pm: I agree Eric.
Gabriel GdmFitness Martinez, June 29, 2010 at 2:28pm: There are others ways to develop a muscle if that's what you are trying to do by way of something like a "dip" or a "behind the neck" press… Honestly my shoulder development was crap no matter how many presses I did until I started doing lateral raises.. I don't even press overhead anymore and my shoulders are bigger than they have ever been.
Brent Brookbush, June 29, 2010 at 3:50pm: This is awesome…I love everything that everyone is coming up with. I am shocked how many people mentioned the supine dumbbell tricep extensions. I am going to throw in a couple considerations based on our understanding of Human Movement Science.
1) If the exercise exceeds an individual's flexibility in the joint or joints involved - compensation and an increased risk of injury will be the result. This is similar to the sphere of function DP was referring to. For example, dips are on the top of most people's "do not do" list, because it requires more than optimal shoulder extension and will result in shoulder girdle compensation.
2) Certain exercises have a tendency to promote hyper-activity in muscles prone to tightness and hyperactivity. For example, as we discussed in an earlier post. Shrugs have a tendency to trigger levator scapulae and upper trap hyper activity. If you have neck issues this is a definite "do not do"… if you don't want neck issues, this may be a "do not do".
Gabriel GdmFitness Martinez, June 29, 2010 at 3:58pm: I do moderate shrugs with about 60lb dumbbells or so and pare them up with scaption to teach my shoulder-girdle their proper movement patterns. I base my bodybuilding training with strategies like these.
Brent Brookbush, June 29, 2010 at 4:35pm: Does your shoulder girdle elevate while doing scaption?
Gabriel GdmFitness Martinez, June 29, 2010 at 4:40pm: if I want it to. I play around with it while In the upwardly rotated position.
Derrick Price, June 29, 2010 at 6:41pm: Great stuff guys, I agree that the exercises we are discussing do have a higher risk for most people in our population. But it doesn't mean we need to classify exercises as good or bad, right or wrong. Exercise is nothing more than a Movement plus Force. If we want to make an exercise less risky, all we need to do is modify the movement and/or the forces being applied during the movement (i.e. less force, line of force application, type of force).
I personally am not a fan of putting my expertise above my clients enjoyment and experience. Invalidating a person by telling them they are choosing a poor/bad/wrong exercise only makes the person feel frustrated and decreases their exercise adherence. This leads to a decreased rapport between the client and trainer. We, the trainer, can have the best rationale as to why to do//not do an exercise but at the end of the day, it all comes down to how the client is enjoying their experience and what they want. How many times have you recommended someone not do an exercise but they end up doing the exercise regardless?
Again, it all comes down to the questions I asked earlier. Who is the client? What do they want? What do they enjoy? What are their capabilities? Most people in the gym just want to look and feel better so YES, I agree "controversial" exercises such as dips are probably not the best choice initially for this type of client but doesn't mean they should be completely excluded or classify them as bad exercises.
However, I do feel dips have a benefit when used appropriately and this great discussion just gave me an idea on how to use a dip as a mobilizer for the client that needs to be flexible and mobile while in a protracted, extended position (gymnasts, break dancers…). Thanks guys!
Marty Miller, June 29, 2010 at 7:51pm: DP I hear what you are saying, but something tells me a gymnast who performs a few hundred dips each week in their activity may not need to continue to overload high risk patterns. I see this with my athletes all the time. They think it is best to add weight to a movement they do every day. I like to think of it as we should re-balance their bodies so they can continue to overload it in their sport.
And a modified dip is a push-up, so why not just do push-ups.
Derrick Price, June 30, 2010 at 10:52am: Agreed which is why we should 3 Dimensionalize the dip to place different force vectors through the body and avoid pattern overload. Here's an example of taking a movement and 3Ding it to up-regulate different tissues and mobilize and release others. Notice how his regular swing has better rhythm and timing and fluidity afterwards.
//www.youtube.com/watch?v=ONQsPDGeqZQ