The main focus of any weight training routine is to optimize the potential for strength and development. Many factors can create what is known as a weight training dysfunction, which can limit lifting potential. A weight training dysfunction is an abnormality in a structure or system that causes an alteration in how the body performs during weight training. Weight training dysfunctions can develop from a variety of sources such as:
- Poor lifting technique
- Lifting beyond one’s capabilities
- Training too often
- Insufficient rest or recuperation
An often overlooked cause is a previously injured area that does not heal correctly and becomes dysfunctional when an excessive load is put on it. To prevent weight training dysfunctions most effectively, three different approaches should be taken. The first approach is to use excellent lifting technique. The second is to make sure the exercises performed are not contraindicated for biomechanical reasons. The third is to test to make sure muscles, joints, nerves and biochemistry are all working optimally and have no dysfunction.
Micro Trauma and Macro Trauma
A weight training dysfunction is much different from an injury in a contact sport such as hockey or football and from an overuse injury in an activity such as running. Weight training dysfunctions can be caused by a lack of recuperation that causes micro trauma (small amounts of muscle damage important for growth and strength) to develop into macro trauma (a large amount of damage that does not contribute to muscle growth or strength but instead actually prevents training due to pain). Macro trauma can affect muscle, joint or nerve or create a biochemical problem. It is also the usual cause of weight training injuries. An injury in one or more of these areas can be present at the same time, causing pain, weakness and altered joint motion during an exercise. The more complex and chronic the problem, the more likely that multiple types of dysfunction are present at the same time. Four types of weight training dysfunctions can occur:
- Muscle dysfunction occurs when the muscle:
- Has been damaged and bears scar tissue
- Is imbalanced
- Is shortened
- Is deconditioned
- Joint dysfunction occurs when there is abnormal motion of a joint or a joint has become separated.
- Nerve dysfunction occurs when tension on or compression of the nerve has decreased or altered the action potentials of the nerve. Altered proprioception at the joint can also inhibit the potential strength of the muscle.
- Biochemical dysfunction occurs when overtraining or deficiency in specific nutrients causes a global lack of strength and recovery that can contribute to the chronicity of the injury.
Weight Training Readiness Tests
There are three tests that can be performed to assess the shoulder to determine if there are any dysfunctions. They are:
- The self test, which assesses the exercise range of motion without resistance.
- The exercise test, which assesses the exercise range of motion with resistance.
- The functional muscle test, which assesses the function of the muscle involved with the exercise.
These tests can be incorporated into your existing assessment of clients before they start a weight training program to determine if they are physically able to execute shoulder exercises, perform a shoulder assessment using various ranges of motion, etc. The following are the exercises and ranges you can check on your clients to assess if they experience pain or a decreased range of motion and to determine if they need treatment or rehabilitation before they start the program.
Dumbbell Fly Self Test
This motion will ascertain whether a dumbbell fly for the chest can be performed. Instruct your client to position the extended arm in front of the chest with the thumb up, then bring the arm back while keeping it shoulder height until the hand is behind the shoulder (see Figures 1A and 1B).
If the pectoralis muscle is shortened, the hand will end in a position in front of the chest (see Figures 2A and 2B).
Dumbbell Fly Exercise Test
Lie on a bench with the feet flat on the floor. Hold the dumbbells over the chest with the palms facing each other. Keep a slight bend in the elbow. Now, lower the dumbbells to the side in a semi-circular arc until the upper arms are parallel to the floor and the elbows are in line with the shoulders (see Figure 3).
Dysfunction in the pectoralis or subscapularis will cause the head of the humerus to shift abnormally anterior, forcing the elbows out of alignment with the shoulders (see Figure 4).
Dumbbell Fly Functional Muscle Test
Position your client in a seated position with the arm flexed at 90 degrees and the elbow extended and internally rotated so the palm is facing away from the body (see Figure 5). Stand facing your client and lightly grip the wrist of their extended arm, anchoring yourself with your other arm on their opposite shoulder. Instruct your client to hold the arm in position when acted upon with resistance. Push the extended arm laterally away from their body.
If the muscle is strong, it will remain in the Figure 5 position. If there are any dysfunctions, the arm will move laterally from the body (see Figure 6).
Bench Press Subscapularis Rotator Cuff Test
One of the muscles that can be frequently damaged in weight training is the subscapularis rotator cuff muscle. As an internal rotator cuff muscle, it is commonly too tight or shortened and therefore becomes dysfunctional when a load is placed on the shoulder. In the bench press, the subscapularis muscle prevents the humeral head from moving forward when the bar is in the bottom position on the chest. If the subscapularis muscle has scar tissue formation and adhesions (due to years of training), it will become dysfunctional and allow the humeral head to translate forward when the weight trainer is in the bottom position of the bench press, resulting in pain in the anterior shoulder. This is the most common cause of shoulder pain due to bench pressing and usually necessitates treatment of the subscapularis muscle as well as other areas.
A simple test can be performed to determine if the subscapularis is working correctly. Have your client place their hand behind the back, palm facing backwards. Then ask them to try and raise the hand away from the low back. This may reveal limitations in range of motion and show whether the subscapularis muscle is firing properly (see Figures 7A and 7B).
A shortened subscapularis muscle or thickened shoulder capsule will restrict the hand from going behind the back (see Figure 8).
Shoulder problems are among the most difficult injuries from which to recover since the shoulder is involved with so many ranges of motion and exercises. The tests described above will allow greater depth of client assessment to uncover any hidden problems that may be exposed during training. Adding the tests to your assessment program will aid in further analysis of the type of exercises your clients need.