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I know it's a long article, and I don't know if it's been posted before, but defenitily worth reading for those who practice Powerlifting.

Powerlifting Injuries - An Overview

If there is anything that will stop your powerlifting program and results, it is an injury. A power lifting injury is much different then a contact injury such as football or high repetition overuse injuries like running.

Powerlifting injuries are caused by an accuumulation of microtrauma (small amount of muscle injury important for muscle growth and strength) that builds up to macrotrauma (large amount of muscle injury that is not important for muscle growth or strength and will actually stop your training due to pain). When a powerlifting injury occurs, this can cause a weakness. There are three reasons for a weakness due to an injury. They are the muscle, joint and nerve. The muscle may either be damaged, shortened or deconditioned. If the joint separates at all (such as the shoulder), the muscles that cross the joint are not as strong due to the fact that muscles will not fully function in an unstable joint. If there is any pressure on the nerve like a herniated disk, this can decrease the the neurological flow to the muscle and cause a weakness. Also some new research has shown that nerve tension can also decrease the muscle strength. You need to assess the muscles, joints and nerve supply to the muscles to determine if any of the structures are dysfunctional. If any of the structures are not functioning properly, they need to be fixed, then rehabilitated.

Over the next few months, we will discuss some new concepts like functional neurological strength and the implications in powerlifting injuries. Also some new treatment protocols from the Chiropractic field such as Active Release Technique that is being used on some of the top powerlifters. Also what can go wrong with the muscles, joints and nerve and how they can be fixed so they can be rehabilitated and you can get back to your weight training with improved strength & conditioning.




Powerlifting Injuries - Joint Injuries

How Joints Get Injured And How To Treat Them by Ken Kinakin, D.C., C.S.C.S.
This article will discuss two types of injuries that can happen to joints when powerlifting.

These injuries are either a compression or shearing injury that can happen to joints that can cause pain and multiple muscle weakness patterns.

In the compression type of injury, the trauma is directed mostly to the joint itself. This type of injury has little or no tearing of the tissues and swelling, if present, is limited to the joint capsule. The stress of the weight effects mechanoreceptors and nociceptors (little receptors that give the body information about position, load and pain) in the joint structure. This type of injury appears to affect the internal structures of the joint that can exhibit a common finding of multiple muscle weaknesses, especially muscles that cross that joint. Joints that can be affected by this is the ankle, knee, lumbar, thoracic, cervical joints. The exercises that can affect these joints are usually ones with heavy axial loading such as heavy squats, deadlifts, shoulder presses, etc. These heavy loads can compress the joints enough to create an abnormal firing of joint receptors and change the normal tone and strength of the muscles that surround that joint. Repeated joint traction of these joints can normalize the firing of the joint receptors and reestablish the normal tone and strength of the muscles.

The second type of joint injury can occur from a shearing - tearing action that can injure multiple structures. This the most common type of joint injury and occurs when joints and related structures are strained and twisted causing injury to muscles, ligaments, skin and receptors of the joints. Any joint in the body can be affected by a shearing - tearing injury by virtually any exercise. The shearing type of joint injury will cause a muscle weakness of the muscles that cross the joint. The weakness muscle pattern will cause a strain on ligaments which will cause residual pain over the ligaments. Ligaments are the structures that cross and stabilize the joint and when stressed abnormally, will cause a weakness in the muscles that cross that joint. There are certain receptors in ligaments that when they are overloaded will cause a reflex muscle weakness. This is because the muscles will not function properly or with full strength in a unstable joint. This is a protective mechanism that keeps the muscle weak preventing further damage to the joint. Depending on the severity of the injury and the length of time before initiation of treatment, the patient will adapt to their injury and require treatment for muscle incoordination and imbalances. This will cause a secondary reason for pain and weakness in the muscle when doing the exercise, long after the initial injury. Limitation of range of motion can indicate an imbalance of the prime movers and synergistics and antagonists. An example of this would be doing the squat improperly and inducing an injury to the knee. This will cause a abnormal stress on the knee ligaments and reflexly cause a weakness of the muscles that cross that joint such as the quadriceps and hamstrings. If the injury to the knee is not treated and rehabilitated immediately and properly, this can cause an imbalance between the quadriceps and hamstrings and create more pain and weakness. If the imbalance is severe enough or been for a long period of time, this can also cause a stress in other joints and can cause weaknesses in other muscles unrelated to the original injury. This can affect your training and can hamper your gains.

Again it is the usually the feeling that if you take a week or two off training or training the body part, that the injury will go away. In mild injuries, you can heal and restore normal function and muscle strength. But in larger injuries, it is important to get treatment as soon as possible to speed healing and prevent abnormal muscle weaknesses and patterns




Powerlifting Injuries -
- How Muscles Get Injured And How To Treat Them by Ken Kinakin, D.C., C.S.C.S.

Powerlifting injuries can come from a variety of sources. Examples of this may be poor lifting technique, lifting beyond your capabilities or training too often without proper rest or recuperation. All of these sources can lead to microtrauma, or small injury, that can get worse over time. Because you don't recognize that the is injury there, you reinjure yourself frequently. This repeated microtrauma can eventually have a profound effect on the specific action of the joint and the surrounding tissues. The effects of the microtrauma include the microtearing of the muscle, the sheath around the muscle and the adjacent connective tissue, as well as stress to the tendon and its bony attachments. The microtearing of the muscle tissue leads to microscopic bleeding, all of which affects the entire area around the injury, contributing to what is commonly know as inflammation. Most people assume that inflammation can be easy to detect like the swelling around a badly sprained ankle. This is not always the case however. Microtrauma causes a corresponding low level of inflammation that cannot be seen or palpated.

The body responds to this myofascitis, inflammation of the muscle and fascia, by forming fibrous adhesions, or scar tissue in the muscle, between the sheaths of adjacent muscle groups and between the fascia and the muscle sheaths. These fibrous adhesions limit the ease and range of motion of muscles and joints and can decrease the muscles lengthening and shortening capabilities. Once the normal biomechanics of the joint is altered, this can lead to further inflammation and the pattern becomes a vicious cycle of long-term wear and tear.

This fibrous adhesion pattern can be seen in people who do certain exercises such as bench press and complain of the same pain in the exact same spot. This doesn't happen by chance. The fibrous adhesion formed in the shoulder muscle is preventing proper motion and pulling on the various soft tissue structures like muscle, fascia, tendon and bursae when trying to perform the bench press.

Taking time off lifting will decrease the chronic inflammation, but it will not decrease the fibrous adhesion. As soon as you start lifting again, the fibrous adhesion will increase the inflammation and stop you from doing this exercise due to pain. An analogy would be if your car tire hit the curb on a icy road altering the tire alignment causing the tire and car to shake when driving. Putting the car in the garage for one month and not driving will prevent further damage to the tire and steering linkages, but it will not fix the wheel alignment. You have to take it to a mechanic that will properly assess the altered wheel alignment and then he balances it until it spins perfectly again. The same thing occurs when you have an injury. You have to identify all the possible fibrous adhesions in the muscle, then perform some soft tissue therapy on the muscle to break up all those fibrous adhesions in the muscle, muscle sheaths, tendons, ligaments and fascia. This will restore normal motion to the muscle and joint allowing proper movement and function. One of the latest soft tissue techniques that is being used on athletes all over the world is call Active Release Technique (or A.R.T.) that was created by Dr. Micahel Leahy D.C.. A.R.T. is aimed at manually breaking up adhesions, the scar tissue that can entrap muscles, tendons, ligaments and even nerves.

The new procedure is similar to some massage techniques, only it's more aggressive. You must be able to locate the adhesion and know how to use active motion of the body part to break them up. To break up an adhesion, you must actually put your thumb or fingers on the scar tissue and make it move in a way that breaks it away from the tissue it has adhesed to. Depending on the amount of chronic inflammation and severity of the adhesion, the pain can be minimal to quite intense, but the procedure is only done a few times and the relief from the injury can be almost immediate at times. Sometimes with less severe injuries only three to six sessions are needed to restore normal muscle and joint function along with proper guidance of exercise technique, stretching and diet to prevent the injury from reoccurring. More severe injuries can take longer and other forms of therapy must be regularly performed to fully restore normal muscle and joint function. After the adhesions are broken up, a rehabilitation program should be used to strengthen the muscles since certain muscles in the point will have been not properly strengthen due to altered biomechanics.

This has been a very useful and common sense therapy that has worked very well for my patients and complements all the other treatment modalities I use. It has allowed many of my patients to get back to the weight room pain free, full strength or runners back running at their full potential. If you have a current injury that will not go away, even with other forms of treatments or rest, this maybe an appropriate therapy for you to try.


Powerlifting Injuries -
How the Nerves Can Decrease Your Power

When a muscle becomes weak and gets injured, there are many factors to consider. In previous articles we discussed the impact of muscles becoming dysfunctional by having adhesions, and joints getting injured through either through compression, shearing or both. Another reason that is sometimes overlooked is the influence of the nerves on the muscles.

When a nerve is either stretched or compressed it can have a major impact on the strength of the muscle it innervates (supplies). The best example of this is when you fall asleep with your arm above your head and it stays there all evening. In the morning, someone calls you on the phone that you have next to you on the night table. You go to pick up the phone, but notice that your arm doesn't move. It has "fallen asleep" and you have to pick it up with the other arm and shake it out until "feeling" comes back into the arm with "pins and needles" type of sensation. Only then do you have enough "strength" to reach over and pick up the phone. The same can occur in any powerlifting injury. An example of this is when you push yourself too hard one workout and overstress the shoulder joint and cervical (neck) region from doing press behind the neck . The next day you go to do chest and start out with barbell bench press and notice that your right arm is lagging behind the left when pressing up with the heavier sets. You think nothing of it and just feel that you haven't recovered from the shoulder workout and will go heavier next week. But next week you experience the same thing and your strength is going down and you have a little twinge of pain in the right shoulder as it lags behind the left again. No problem, next week it should be fine. But alas next week comes around and it is still weaker and now it has affected the strength when doing any shoulder work and you are starting to feel more pain. You finally succumb to taking a week off to heal and get stronger. Sometimes that works, but as soon as you go heavier, the weakness shows up again and not far behind is the pain. Even more confusing is that it is your right arm, which is your dominant arm, should be stronger.

What Happened? Well as some of the research that has been done over the past few years is showing that the nerve supply to the muscles can be decreased causing less strength and creating a possible scenario for pain. What happens is if the nerves have any compression
or more importantly any tension, the nerve supply from the spine to the muscles will be decreased and therefore the strength will also be decreased creating a lack of performance and increased possibility for an injury if heavier weights are used. Just think of the example of sleeping with the arm above the head at the beginning of the article. The same thing occurs but only when you start to use heavier weights as that is when the nervous system is tasked more and needs to work one hundred percent and any deficit will be exposed. The question is often asked "how much compression or tension is needed to create this type of weakness?" Latest research has been quite suprising and will answer a lot of questions. In the prestigious orthopedic journal Spine in 1992 revealed that compression of 10 mm of mercury ( the weight of a dime on the back of your hand) caused a decrease in action potentials ( power ). The "National Institute of Health" found that 10 mm of mercury of compression on a nerve decreased the action potentials (power) to 60% of its initial value. That is a decrease of 40% in nerve power strength and can definitely cause a weakness pattern. You can also have a problem with the nerve supply if it is under tension. The Journal of Bone Joint Surgery in 1992 revealed that if a nerve has only 6% strain (tension) that the action potentials were decreased by 70% leaving you with only 30% power to your muscles.

These compression and tension problems usually occur by the spinal column but can also manifest anywhere the nerve travels. The best example of this is the latest occupational injury carpal tunnel syndrome caused by repetitive work either on the manufacturing line or when using a computer. The pain, tingling and weakness in your hand maybe caused by the nerve being compressed or tension applied at the wrist, elbow, shoulder joint, under the clavicle, off the cervical spine, off the thoracic spine or any combination of these or even all of these. The same can occur when your shoulder power decreases in your right arm when you are benching and starts causing you pain. The nerves that exit out of the mid cervical (neck) go down to your shoulder and chest muscles and if there is any abnormal compression or tension on the nerves, the action potentials (power) to those muscles can be decreased and will remain decreased until the abnormal tension or compression is taken off. This is why taking time off training will not work in this scenario because the decreased strength and pain return once you start training heavy again. That is why it is imperative that with every powerlifting injury the muscles, joints and nerves be examined to find out which is causing the problem or quite often all three are involved and have to be treated at the same time. I have found clinically that I have to treat the muscle, joint and nerve at the same time more and more especially with injuries that have been there for years. Also, many compensation (adapting) patterns are created by not treating the original injury or not treating the original injury properly. That is why sometimes physiotherapy works well when they are working on the muscles and joints if the problem is a muscle and joint problem and chiropractic does not work as well. And sometimes if the cervical spine is involved and physiotherapy only focuses on the shoulder joint, no change may occur until they go to a chiropractor and the nerve tension in the cervical spine is decreased and the shoulder strength returns and the pain decreases. You have to do the right treatment, at the right time, at the right region by the right professional. That is the only way you get the problem resolved and can train full tilt with no pain. If any area is missed, it will create a weak link and will decrease the strength and create pain. The body is really smart. It will decrease the strength so you don't screw up the joint even more and cause even a larger injury. So be thankful that the strength has decreased allowing you to realize that something is wrong and something needs to be done. Think of pain and decreased strength as the oil light going off in your car. You know something is wrong and something has to be done about it. Unfortunately, when training, we tend to rely on pain medication to knock out the pain therefore possibly causing even more damage as you can train through the injury. That is equivalent to disconnecting the wires to the oil light and seeing how far you can go. Eventually it will cause large enough damage that it will not allow you to go on any farther It is better to get the injury properly assessed, treated and rehabilitated so no further damage will occur. You sometimes can get away with it by taking pain medication, but the possibility of an injury is increased if there is a problem with the muscle, joint, or nerve. It is better if you deal with the injury quickly and properly so you can push your training even farther for better gains.