Should You Eliminate These 5 Things In The Gym?
⌚️ read time: 5 minutes
After years of seeing patients for hand and upper extremity injuries, various patterns start to emerge. For instance, I fix tons of broken wrists (slipping on the ice) and torn thumb ligaments (falling with ski poles) in the winter. Spring and fall are all the overuse injuries from gardening (tennis elbow, De Quervain's tendinitis). Summer months bring broken collarbones from mountain bikes and so so many dog bite hand injuries.
And on and on.
So you can imagine I also see my fair share of injuries from the gym. Sure enough, the vast majority of these also fall into their own patterns.
Let me tell you the five no-nos that echo in my brain every time I go to the gym (and the ones my physical therapists gripe about incessantly):
1. Bicep curls in full supination
Who doesn't like a good bicep curl? Perhaps the most common exercise at the gym can be made infinitely safer with one small switch.
Don't perform this exercise in full wrist supination.
Translated into English? If you're holding dumbbells, look down at your hands. Are your arms rotated all the way out so that your palms are facing directly in front of you? That's full supination.
Or think of the 'palm up' motion you would use to accept change at the convenience store. Palm up is full supination.
This position puts a tremendous strain on the ulnar (pinky finger side) of your wrist. Now add the weight of the bicep curl to this highly tensioned wrist position. This is a recipe for overuse, tendinitis, and even soft tissue tears on that side of the wrist.
Just turn those palms in a little bit. Even just a few degrees will take significant tension off of your wrist. I typically do my curls with my palms turned in about 45 degrees.
And in reality, you can apply this to more than biceps curls. Weightbearing in full supination is a highly strained position no matter which exercise you are doing.
Pro tip: Preferentially choose dumbbells over barbells. Barbells force you into this fully supinated position to perform the exercise. And if you really want to use a barbell, use the "EZ" bars (pictured above) that allow you to grip the bar properly.
2. Reverse bicep curls
It's probably a pretty good rule of thumb (see what I did there?) to avoid most exercises with the word 'reverse' in the name.
Reverse, as in 'not what your body has evolved for millions of years to do.'
The problem I have with this exercise is the unbelievable force it puts on your wrist extensors. And for those in the back...what's an overuse injury of the wrist extensors?
Tennis elbow!
I will go deep into tennis elbow in future posts, but essentially this is a miserably painful elbow condition that lasts 1-2 years on average.
Yep, you read that right. 1-2 years. It's caused by an accumulation of small injuries of the wrist extensor muscles that all anchor themselves at the outer elbow.
So unless you want to bring the risk of long-term nagging elbow pain into your life, I'd skip this one. Plenty of other (exercise) fish in the sea.
3. Wrist curls
Let's flip to the other side of the elbow. Every time you flex your wrist (curl it in the palm direction), you activate the wrist flexor muscles that anchor on the inner elbow.
This group of muscles is naturally quite strong, particularly with isometrics. Isometric means 'contracting but not moving.' Imagine the work these muscles do to keep the wrist from flopping while you do bicep curls, even though the wrist isn't moving.
Now do me a favor. Curl (flex) your wrist in the palm direction as far as it will go. Have you ever done anything functional in life with your wrist in this fully flexed position??
Absolutely not.
This position is leftover from when we were apes grabbing onto branches (Learn about the palmaris longus, a muscle currently evolving out of our arm, here.)
So please don't go to the gym and try to power-flex your wrists with wrist curls. Nobody needs this exercise. All this will do is set you on a path to 'golfer's elbow' or medial epicondylitis, another painful and limiting condition that will set up shop in your elbow for a year or two.
Just say no.
4. Quick transition reps
Have you ever noticed when you start to tire during an exercise (say on rep 8 of a 12-rep set), you tend to speed things up?
Resist that urge.
One, you're shortchanging your workout. Stay slow and deliberate and you will get the ultimate benefit from your set.
But more importantly, your injury risk skyrockets as you quicken the pace.
If you doubt this, pay really close attention next time you do this. Let's take cable tricep pushdowns as an example. If you're rushing through this, you can feel the almost twinge-like tension in your triceps at the top of the motion, right before you initiate another pushdown.
This is called eccentric force and, when applied in quick jolts, is highly dangerous to your soft tissues.
If you've been around gyms long enough, you've probably heard a story of someone rupturing their biceps tendon. During biceps curls, this always occurs at the very bottom of the rep during an eccentric transition.
Even if you're not injuring yourself as dramatically as a snapped biceps tendon, you are accruing micro-damage when you rush through quick eccentric transitions.
Slow your roll.
Get the maximum upside and minimize the downside.
5. Push through any pain (other than that glorious muscle burn)
No pain no gain, right?
In most cases...wrong! If you're working out and a certain motion, a certain position, or a certain exercise gives you a reliable twinge, you need to pay attention.
What begins as a small pain can easily snowball into a months-long tendinitis. One small injury here or there is unlikely to doom you to pain. But when you feel that little painful tweak, your body is giving you a clue that something is off. Remember what mom always said?
Listen to your body.
So if you feel that twinge, pause. Evaluate your form. Can you modify and relieve the pain? Are you using too much weight? Can you work a different muscle group today and circle back after a few days to re-evaluate?
Don't push through! Nobody's awarding you 'toughness' points.
The key is catching it early. Because the twinge that you push through today, becomes the wrist that's swollen tomorrow, becomes a Google search in two weeks...
The only exceptions I would make here are
Muscle burn (what you came to the gym for)
Sore joints from arthritis
In general, it's best to keep arthritic joints moving and that may require working through some soreness. Still, pay attention to sharp pain, but try to move through the achy soreness as safely as you can.
Takeaways:
'Reverse' anything exercises are probably not a good idea
SLOW DOWN and avoid quick transitions - you'll maximize your pump and minimize your injury risk
Don't push through pain. But you probably knew that already, deep down inside :)
There you have it. The (top) five concerns that rattle around in my brain when I'm at the gym.
My patients are always a bit surprised when I tell them not to do bicep curls (or any form of lifting) in full supination. And yet, implementing this change almost always cures the wrist pain they came to me for in the first place.
