Guide to Injury Prevention for Powerlifters

There are not a lot of things worse than getting an injury and not being able to train a certain lift, or worse, not being able to lift at all. That’s why I made this injury prevention guide. Because I believe most injuries are preventable, as long as you follow certain steps, use good form, and stay focused.

There are a lot of different types of injuries, and a lot of different places where they can happen. This guide will be addressing 8 of the most commonly injured areas/joints. The shoulders, back, elbows, wrists, hips, sacroiliac joint, knees, and ankles.

These joints can easily be injured on all three of the big lifts. Although injuring a joint such as the knee on the bench is uncommon, it can still happen apparently.

So lets start from the top and work our way down.

Shoulders

Shoulder injuries are oitsne of the most common injuries in powerlifting and in general really. This is simply because of the anatomy of the shoulder joint and its ability to move more freely than any other joint. There are several different reasons and ways that shoulders are injured such as shoulder impingement, bursitis, tendon/ligament tears, rotator cuff tears, etc. Below I will be addressing some of the most common injuries, how they occur, and how to prevent them.

Shoulder Impingement –  also called subacromialimpingement, painful arc syndrome, supraspinatus syndrome, swimmer’s shoulder, and thrower’s shoulder, is a clinical syndrome which occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space.

This impingement happens for a number of different reasons. Overuse, rounded shoulders, under recovery, and poor circulation can all contribute to shoulder impingement. If you are getting enough sleep, on a sound training program and diet, overuse/under recovery shouldn’t be a problem. So that leaves us with poor circulation and rounded shoulders being the main culprit.

These two can easily be corrected. For increasing circulation simply do light rotator cuff exercises before performing bench or any lift involving your shoulders.

Correcting rounded shoulders can take some time, but it is possible by simply training your back/rear deltoids more than you train your chest/shoulders. For every push movement you do, make sure you do a pull movement so you aren’t creating a muscle imbalance. In order to correct the rounded shoulders, you’re going to want to do more pulling movements. So if you’re doing 3 pushing movements, do 4 pulling movements. You can also try some stretches to help with this issue, as well as avoiding slouching in your chair, and maintaining good posture throughout the day.

Bursitis – inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

Shoulder bursitis usually happens due to overuse and/or under recovery. It typically happens to people who are benching/overhead pressing several times per week with not enough recovery taking place.

This, along with most injuries, is not one that you can “work through”. Continuing the motion that aggravated it in the first place will only make bursitis worse. This may mean taking several months off.

Ways to prevent bursitis in the shoulders, is similar to shoulder impingement prehab. Reduce your frequency of the movement that is causing/likely to cause you aggravation. Benching over 3 times per week isn’t ideal and will usually lead to an injury like bursitis. Only do what your body can handle.

Properly warming up your rotator cuffs, and making sure you don’t have any muscle imbalances is also vitally important in preventing bursitis.

Pectoralis Strain

Pectoral strains are probably the most common chest injury. They are usually caused by overuse of the pecs ie benching too much. This usually isn’t the actual cause of the strain though, the problem is usually a mobility issue, or a technique issue. Flare your elbows and use an extra wide grip and you’re pretty much just asking for a pec strain no matter how frequent you bench. I’ve gotten pec strains from benching only once per week, and I’ve also been injury free on programs that require me to bench 4 times per week.

It’s typically the combination of improper form and too much frequency that causes pec strains. So with that said, do yourself a favor and always use good form.

Strains can also happen from not warming up enough. If you haven’t figured it out by now, warming up is extremely important. Vital even.

Back

If you haven’t had back pain at some point in your life, you probably aren’t human. People get back pain from all sorts of things, sleeping wrong, bending over wrong, sitting wrong, etc.

Trying to pick 500 pounds off the ground puts an immense amount of stress on your body, more specifically your back. Using bad form with heavy weights simply isn’t an option.

You’ve probably heard it a million times, but using good form and keeping a straight lower/mid back is absolutely crucial to good back health. You will not be able to make it to the highest levels of powerlifting using bad form. Your body simply won’t allow it if you’re lifting with incorrect form. Form is EVERYTHING.

Doing yoga stretches is highly beneficial in maintaining good back health. Here’s a good article on that.

I’m going to stress properly warming up once again, and also picking up a good 10 mm or 13 mm belt. If you’re planning on competing in powerlifting, go with a four inch powerlifting belt in either of the above thicknesses. Lighter lifters typically choose the 10 mm, while heavier lifters tend to go with the 13 mm. But it’s all up to you.

I recommend getting a lever belt. Simply for the fact that you can wear it between sets and when you’re ready for your set just slide the lever down and you’re good to go.

Elbows

The most common elbow injury is elbow tendonitis, or tennis elbow. This injury is most commonly due to overuse.

First things first, cut back on whatever you’re doing to cause this pain. Make sure you properly warm up so that your muscles are absorbing the force and not your tendon. Wearing an elbow sleeve or some kind of wrap would be a great way to keep your elbow warm, and provide support and compression.

You also can’t go wrong with icing your elbows after you work out and maybe taking an OTC non-steroidal anti inflammatory drug, or NSAID, such as Ibuprofen or Naproxen. Make sure you take these as often as it says you can on the bottle to really take full advantage of the anti inflammatory affects. Taking these sporadically will not bring down swelling and inflammation as much as taking these consistently throughout the day will.

Be careful though, as heavy NSAID use has been shown to cause liver damage. So only use when necessary.

Wrists

Wrist injuries typically only affect pressing movements, but can also affect your squat as well. Wrist injuries are mostly caused by lack of a proper warm up and simply lacking flexibility and mobility in the wrist. Using bad form on presses can cause wrist pain. When doing movements such as bench and overhead press, make sure the bar is directly in line with your forearm, and bending your wrist back and out of line with your forearm. This article by Stronglifts explains it very well.

A quick fix for wrist pain is simply wearing wrist wraps on any movement that causes pain or discomfort in the wrist. These can be picked up fairly cheap.

However, if you don’t want to rely on wrist wraps, you can start by doing some wrist stretches and making sure your wrist joints are fully warmed up before doing any sort of exercise. Here’s a great article with some helpful videos.

Hips

Hip pain is typically caused by lack of mobility, or a posterior weakness like weak glutes. When I say weak glutes, I doesn’t necessarily mean your glutes are weak, you may have strong glutes but the problem is, is that they aren’t firing correctly and aren’t being utilized to their full extent.

I could write about all the things you can do to correct these problems, but this article at Breaking Muscle already did a great job and provided several very helpful videos of correcting these two issues.

Sacroiliac Joint

The Sacroiliac Joint, or SI joint, is what connects the spine to the pelvis and is formed by the connection of the sacrum and the right and left iliac bones. Although this is part of the back, I figured I would give it its own section based on my own personal experiences with SI joint injuries.

The SI joint is most commonly injured while deadlifting or squatting. This can be one of the most painful/debilitating injuries, but good news, it’s avoidable.

Of course the first thing you should avoid is form breakdown. I know I’ve said it several times already but using proper technique is absolutely crucial in powerlifting. All it takes is one sloppy rep, and you could be injured and unable to lift for several months or even the rest of your life. The more weight you’re lifting, the more important proper form is.

There are also several exercises and stretches you can do to prevent SI joint injuries. If you’re already experiencing SI joint pain, it would be a good idea to make these a part of your daily prehab routine.

Knees

One of the most commonly injured joints. Not just in powerlifting either. Most injuries involve one of the ligaments being sprained but other injuries such as tendonitis and cartilage tears are also fairly common as well.

Warming up should be your first step to avoiding knee injury, but also making sure your posterior muscles are getting worked as much as you’re working your quads, in order to avoid any muscle imbalances.T Nation put out a really great article on dealing with knee pain that gives several things you can incorporate into your routine to keep your knees nice and healthy.

You could also try wearing some knee wraps. These will keep your knee warm and provide support/compression. I recommend either Rehbands or SBD’s.

Ankles

Once you injure your ankle, you are more likely to injure it again compared to someone that has never injured their ankle before.

Beyond properly warming up, there are exercises you can do to increase ankle stability and strength.

Working your tibialis anterior using the exercises found here. And working your soleus by doing seated calf raises.

General Injuries

These are injuries that aren’t subject to one specific area of the body, and can happen in any of the big three lifts.

Tendon Tears

Tendon tears may seem like an injury that is unavoidable, but that’s just not true. The main causes for tendon tears are not warming up properly and improper technique.

When a muscle isn’t warmed up enough, or is too tight, it can’t effectively absorb the force (weight) that is being placed on it and it then transfers that force to the tendon, and that is when your tendon tears.

This can be prevented by always thoroughly warming up, doing a lot of mobility work, and using correct form/avoiding form breakdown. This means knowing when to call it quits and not trying for that one extra rep. Every single repetition should be completed with perfect form, otherwise you’re risking injury.

Try using a foam roller, or using a lacrosse ball to break up knots in your muscles, and loosen them up before lifting. Both are very cheap and highly effective. You can also go with one of these quadballer rollers if you have the extra dough to shell out.

TL;DR

Proper technique is everything. Always get in a proper warm up. Use a foam roller or lacrosse ball to loosen muscles. Stretch to increase mobility.