13 Worst Gym Exercises & Mistakes. A Physical Therapist’s Persepective.

We’ll get to the list shortly, but I wanted to make a detour into the 2 Questions that I ask every single patient about their gym/ exercise routine as a starting point.

2 Things You Should Be Able to Answer About Your Exercise Routine

1. Why Are You Exercising?

I don’t really care what the answer is, but I feel like you should know why you are spending your time exercising.

Common Responses Include:

1. To Be Healthy
2. Because I Love [Insert Your Favorite Form of Exercise Here]
3. To Lose Weight
4. To Look Better (For Aesthetic Reasons)
5. For Stress Relief
6. Because I Need to Be Strong/ In Shape for My Job
7. Because I’m Supposed To

Technically, these are ALL good reasons. Knowing the answer to this question means you have sat down and had a conversation with yourself about why you are spending your valuable time exercising.

If we dive deeper into why this matters for Physical Therapy purposes, it allows us to ensure that you are doing exercises that suit your “Why”, while minimizing your injury risk.

Let’s rephrase this.

Take Home Point: Why don’t we choose exercises that achieve your exercise goal (your exercise “why”) and prevent you from getting hurt at the same time?

Seems like it should be a no-brainer, right?

2. What Does [Insert Exercise] Do for You?

When you are performing specific exercises in the gym or at home, it should be clear why you are doing it.

Example #1: Bicep Curls. “I am performing bicep curls to strengthen my biceps, so I can lift things more easily for my daily life.” Excellent! That is a great reason to do bicep curls!

Example #2. Leg Press. “I have difficult going up and downstairs. Making my legs stronger will help me go up and downstairs.” Excellent! That is a great reason to do the leg press!

Example #3. Dead Lifts. Crickets. Many people don’t know why they are doing an exercise and how (or if) it is even good for their bodies.

If you are coming to me as a patient wondering why your gym workout is giving you pain these are the first questions I’m going to ask you.

Exercises that Often Cause Injury

1. Dead Lifts

I have a love-hate relationship with Dead Lifts.

Dead Lifts and Overhead Presses (also known as Shoulder Press or Military Press) are by far the worst gym offenders. The bulk of gym workout pain comes from these two exercises.

Dead Lift Breakdown

What Do Dead Lifts Do? To me, the best answer is that they strengthen your glutes (butt cheeks) and eccentrically strengthen your hamstrings.

When I ask patients why we do Dead Lifts, they will commonly say the following:

1. “Dead Lifts are for My Back.”
2. “They’re a Whole Body Exercise.” This usually means they don’t know, but I asked them a question, so they want to give me an answer.
3. “I don’t know. It’s a popular exercise.”

Why Do Dead Lifts Cause Frequent Injury?

#1 Cause. People are Initiating the Exercise Using their Back Muscles. REMEMBER: This is supposed to be a glute-dominant exercise. The strength in each muscle is directly related to how big the muscle is, specifically looking at the cross-sectional area. Our back muscles/ extensors (what you would use during a Dead Lift) are similar in cross-sectional area to string cheese at best, whereas, our glutes are plump, juicy steaks. Let’s use the juicy steaks! Squeeze your butt cheeks or literally think of “thrusting your hips forward” to perform a safe Dead Lift.

#2 Cause. People are Not Breathing. We can survive potentially days without food and water. We can survive mere minutes without breathing. Yet, so many patients that I work with need to be reminded to breathe. When you perform a Dead Lift, YOU MUST blow out while you are exerting. This means, when you are doing the actual lift, you should blow out. Holding your breath, increases the pressure in your abdominal cavity dramatically. This exponential rise in pressure often leads to disc irritation and if the load exceeds the body’s tolerance, leads to disc herniation.

#3 Cause. You Are Lifting Too Much. As a Physical Therapist, I believe there is a ceiling to how much we should be lifting. Based on your age, size, and gender, I will recommend a maximum weight for each exercise that is designed to keep you functioning at your maximum capacity without increasing risk of injury. For the sake of your orthopedic happiness, there is not a single exercise that you should be trying to progress the weight of indefinitely.

#4 Cause. Your Form is Bad. When it comes to a Dead Lift, we want a “neutral spine”. That small natural arch of the back is what we are looking for. A rounded low back during a Dead Lift is bad. An excessively arched low back is also not great. Goldilocks is where you want to be. Your spine should be “in the middle” or “neutral”.

So What is the Verdict? Dead lifts are okay to do if you are: (1) using the right muscles, (2) breathing when you are exerting, (3) you are keeping the weight modest, and (4) you use good form. If I personally had a history of disc herniation or radiating numbness/ tingling/ pain into either leg, if I had osteopenia/ osteoporosis, or if I was over the age of 55, I would opt not to do Dead Lifts.

2. Overhead Press (Known Aliases: Shoulder Press or Military Press)

What is an Overhead Press For? I’m pretty sassy when it comes to the Overhead Press. It is an exercise I would prefer people eliminate from their exercise routine. I have had multiple patients tear their labrum (an anatomical structure that helps stabilize their shoulder) due to Overhead Presses. I even know someone who tore both his left and right labrum at the same time while doing Overhead Presses. One repetition. “Pop” “Pop”. A routine weight lifter, he said he was pressing about 50 lbs at the time.

So my initial response when I ask the question, “What is an Overhead Press For?” I want to cross my arms like a sassy 5 year old and say, “Nothing.” Overhead Presses are good for Nothing.

What are Overhead Presses Actually For? Overhead Presses strengthen multiple muscles around your shoulder: Anterior Deltoid, Middle Deltoid, part of your pecs, your triceps, and hopefully you are stabilizing your shoulder blades while you are pressing, so your Serratus Anterior too. The Biceps also comes into play when it comes to the Overhead Press though, which we will get to in a second here.

When I ask patients why we do Overhead Presses, they will commonly say the following:

1. “To Strengthen My Shoulders.”
2. “I Want Big Shoulders.”
3. “I Need to Be Strong Enough for My Work that Requires Overhead Lifting.”

When considering points #1 and #2, this is where our Take Home Point comes into play.

Take Home Point: Why don’t we choose exercises that achieve your exercise goal (your exercise “why”) and prevent you from getting hurt at the same time?

If you want to strengthen your shoulders or if you want a bigger look to your shoulders, there are SEVERAL OTHER exercises I would rather you do.

If you do Overhead Press for Point #3, keep on keeping on. This is the only population that I “recommend” performing Overhead Presses routinely because we want to prepare the shoulder for what your job requires.

Why Do Overhead Presses Cause Injury? It is very simple. The position that you end an Overhead Press in is a vulnerable position for the shoulder. When you add significant weight and then perform the action repetitively, you are putting significant tension on the biceps as it attaches to the labrum. Ultimately, the biceps can “pull” the top of the labrum (in whole or in part) off of the top of the socket (of your shoulder joint). They call this the “Peel Back Mechanism”. Sounds awful, doesn’t it?

So What is the Verdict? I prefer for people to discontinue Overhead Presses. If you have no emotional attachment to them and don’t know why you are doing them, get rid of them. If you plan to continue in spite of this recommendation, then: (1) keep the weight light and/ or (2) take it into a recline bench position.

Recline Bench Position? You take an adjustable bench and allow yourself to lean back 20-30 degrees. You still push the weight directly toward the ceiling. In this way, you perform a similar exercise to the Overhead Press, but YOU REDUCE THE VULNERABLE SHOULDER POSITION.

If you are performing Overhead Presses for work, please continue to strengthen. Keep the weight you practice with close to or even a bit below what you actually need for your work. For example, if you are UPS driver, you may have to lift heavy boxes overhead some of the time. There should be no need for you to do 3 sets of 15 repetitions of 50 lbs for an Overhead Press. I would hope that you would never have to lift 50 lbs overhead 45x within a span of a couple of minutes, so why would you workout that way?

3. Long Arc Quad Machine (The “Kicking” Machine)

What is this Exercise For? Quadriceps (Thigh) Strengthening.

Most people know what this exercise is for, but let me tell you what I don’t like about it.

What is Bad About the Long Arc Quad Machine? I actually like Long Arc Quads as an exercise in general, but I typically use it for low level quadriceps strengthening after someone has had surgery. It is a great way to isolate the quadriceps. The maximum weight I use is typically around 5 lbs and then people are ready and sufficiently healed for something like squats or the leg press.

The rub when it comes to the machine is the amount of stress it places on the knee joint. Because the weight (the leg bolster) is applied typically down near the ankle, using heavy weight will create a “gapping” stress at the knee joint. Sounds yucky. Your quadriceps are supposed to be insanely strong and should be able to control hundreds of pounds of weight. That’s A LOT of gapping stress at the knee.

What is the Verdict? I would rather everyone strengthen their quadriceps using squats (you never need to squat deeper than 90 degrees in my opinion) or the leg press. Both are highly effective, relevant to function, and low risk for injury!!!

4. Sit Ups

What are Sit Ups For? Sit ups strengthen your abdominals, primarily your Rectus Abdominis. The Rectus Abdominis is the muscle responsible for giving you that 6-pack or 8-pack appearance.

Common Reasons People Do Sit Ups:

1. “I Want a Six-Pack.”
2. “I Was Told I Should Strengthen My Core to Decrease My [Body Part] Pain”.

Why are Sit Ups Bad? Most people know that Sit Ups and crunches are good for your abdominal strengthening. Nowadays most people even know that abdominal or core strength decreases low back pain/ injury.

What people still don’t know is that we have TWO different groups of abdominal muscles. The Superficial Set (the Rectus Abdominis primarily) and the Deep Set (the Transversus Abdominis). Because the Rectus Abdominis literally only covers the front of your belly, it is leaving the rest of your core (your middle) unspported. The Transversus Abdominis wraps around from back to front like the body’s natural corset and can help support everything.

So, for people who are after core strengthening, Transversus Abdominis Training and progressions thereof are a better solution.

If you have significant osteoporosis, repetitive flexion (aka sit ups or excessive bending motions) can cause fracture of the spine. I do not recommend sit ups for anyone who has osteopenia or osteoporosis.

So What is the Verdict?

If you are in the “I Want a Six Pack” group. You are not wrong. If you want a Six Pack, sit ups are a good exercise for that aim. I typically prefer exercises where your spine stays neutral (the same) such as planks or crunches (which is closer to an isometric/ non-movement exercise for the abdominals and spine).

If you have Significant or Chronic Low Back Pain. You should not be doing sit ups. See a Physical Therapist to get you on a Core Stabilization program that will actually work for you. Sit Ups will at best not help you and at worst, make you worse.

If you have a Diastasis Recti. If you have splitting of your abdomen following pregnancy and childbirth, sit ups will make this worse. You need a deep core stabilizing program!

If you have a History of Hernia (Abdominal or Inguinal). Sit ups will usually increase intra-abdominal pressure and increase hernia stress.

If you have a history of Lumbar Disc Herniation. Sit ups will increase that intra-abdominal and lumbar disc pressure.

5. Preacher Bicep Curls

What is this Exercise For? Has Biceps in the title, so hopefully it’s obvious this is for your biceps.

Why are Preacher Curls Bad? I hate any exercise that puts a joint in a stressful position and then requires you to lift weight in that position. Just like the Overhead Press, this is an awkward position for the shoulder joint and then you add a biceps contraction on top of it. I’m shaking my head “No”. I don’t like it. Bad for the shoulder.

FUN FACT! To a Physical Therapist, the biceps is primarily A SHOULDER MUSCLE! Yes, it bends your elbow, but it is also essential to raising your arm up in front of you. So yes, to me the biceps is (1) a shoulder muscle and (2) an elbow muscle.

What is the Verdict? Don’t do Preacher Curls. There are so many other ways to work on biceps strength without stressing the shoulder joint. Case open and shut.

Exercises that Are Just Silly (A Waste of Time)

These exercises don’t typically lead to injury, but don’t do much for you either. Your time is better spent on other things.

6. Hip Abduction and Adduction Machines at the Gym

You know these awkward butterfly-like machines. The ones that you have to either squeeze your legs together against resistance or push your legs out against.

What they are Supposed to Be For?

Hip Abductors. Your gluteals, outer buttock, and thighs.

Hip Adductors. Your inner thighs.

Why Shouldn’t I Do Them? They do not do a great job at actually strengthening the targeted muscles effectively. There are much better ways to strengthen your hip abductors (e.g. Clams) and honestly, adductors don’t often need to be strengthened because they tend to be tight rather than weak in most people. The way that the machines are set up also encourages exercisers to move excessively through the low back. So if you have low back pain, this is another reason to steer clear.

Exercises that Are “Good”, But Form Gets You in Trouble

7. Chest Press (Known Alias: Bench Press)

What Does the Chest Press Do? Strengthens your pectorals (your chest muscles).

Is this Important? My Exercise Physiology professor in Graduate School always chuckled over Bench Press. When it comes to Physical Therapy, we are always thinking about why something matters in relation to function. Dr. Schroeder thought Chest Press was so funny because so many weight lifters focus on this lift. They use it as a measure of how strong they are, when in actuality, we don’t need these muscles to be that strong for us to function. To him Bench Press is a competition in who can give the strongest hug.

Joking aside, Chest Press is valuable for pushing motions. Say you needed to push heavy things for your job, then Chest Press is a great exercise for you. If your job/ recreation involves you needing to crawl or get up and down from the floor (say you need to get into house crawl spaces), then Chest Press is a great exercise for you.

How Can I Improve My Form to Decrease Injury?

1. Don’t drop your elbows below the plane of your body (or if you’re vertical using a machine, behind your body).
2. Make sure you can perform the exercise with your neck “relaxed”. If you have neck pain and you feel like you cannot keep your neck from “hulking out” while you’re pressing, drop some weight, it’s too much for you.

*This is a good rule of thumb for decreasing anterior shoulder pain/ injury for ALL upper body exercises.

8. Squats & Leg Press

What Do Squats & Leg Press Do? They strengthen your quadriceps and your gluteals.

How Does this Help Me Functionally? I LOVE SQUATS!

They help with many of our critical functional activities, including:

1. In and Out of Chair
2. On and Off Toilet
3. In and Out of Car
4. Up and Down from Couch
5. Getting Up & Down from the Floor
6. Going Up & Downstairs
7. Walking
8. Walking Inclines/ Declines
9. Jogging & Running
10. Need I Go On?

How Can I Improve My Form to Decrease Injury?

1. Never Squat Past 90 Degrees. I meant what I said and I said what I meant. After 90 degrees of knee bend, the stress on the menisci increases and as we approach the end of our knee bending range our knees MUST TWIST (this is normal), which increases meniscal stress further. Additionally. If you have ANY hip or ankle tightness and you try to perform deep squats, your body has to compensate and you are setting some part of your body up for injury. Hip Tightness can lead to Hip Impingement (anterior hip pinching). Ankle Tightness can lead to compensation higher up, resulting in Hip Impingement, Patellofemoral Pain, or even Shoulder Instability (if you are combining movements and doing an Overhead Squat).
2. Knees Stay Behind Your Toes. Excepting walking downstairs or downhill, we can perform ALL of our activities keeping our knee caps behind our toes. This decreases anterior knee pressure and pain significantly. Save your anterior knee stress budget for when you are walking downhill or going downstairs.
3. Knee Cap in Line with Your Second Toe. The knee is a hinge joint. It was designed to move forward and back. When you let your knees knock inward or bow outward excessively, your ligaments and menisci undergo increased stress.

9. Tread Lightly

If you are on the treadmill, we should be able to hear the machine of the treadmill running, the squeal of your sneakers contacting the belt, and some mild impact noise when your foot touches down.

If you are significantly louder than everyone else or sound like a hippo stomping in boots, you are putting too much pressure on your joints. When we walk, touch down impact of our foot on the ground in a HEALTHY/ FUNCTIONAL human is about 3x your body weight. When you run this number jumps to 7x your body weight. This is in when using GOOD FUNCTIONAL PATTERNS. If you are noisy, you are dramatically increasing the amount of forces your body is contending with.

There is no magical tip or cue to make this people respond to for this recommendation. I don’t mean that you should be tip-toeing. You need to figure out how your body can make less noise walking and running. Start with slowing down. Even if this means taking you from a run or a jog to a walk, if we can avoid you needing a knee or a hip replacement when you’re 70 y.o. because of your heavy stomping please walk for now.

Final Words on Exercise Form & Technique

10. Neck Position. Neck Position. Neck Position.

Keep Your Neck Neutral. You should be aware of your neck position no matter what exercise you are doing. Your goal should always be to start and end in a neutral neck posture. Meaning, your neck should look like it is a continuation of your spine. It is instinct for us to keep our head constantly vertical in relation to gravity. We’re used to this orientation and our head likes it there, but it can be stressful for the neck.

Don’t “Finish” an Exercise with Your Chin. Many of us will “finish” an exercise by subconsciously adding a chin jut. This can definitely stress and pain at the neck. Especially if you have a history of neck pain, you should take note!

11. Transversus Abdominis Recruitment

ALL strengthening exercises are improved with engaging your Transversus Abdominis first, breathing second, and then performing the exercise.

When you do this, you purify the exercise. Meaning, you are targeting what you are looking for.

When patients actually follow this recommendation, they are usually surprised by how much harder the exercise becomes. They typically have to lift less weight.

Improve your abdominal strength and decrease spinal stress with every exercise you do!

Exercise SMART, NOT HEAVY!

12. Protecting Your Wrists & Forearms

When it comes to weight lifting or exercising and keeping your wrists and forearms happy and healthy there are 2 Main Principles:

1. Neutral Wrist. If your arms are hanging comfortably down by your sides that is neutral wrist. This is the position that your wrist should be in for ALL upper body exercises that are not actual wrist exercises. Performing exercises consistently out of neutral wrist will give you wrist, forearm, or elbow pain and decreases the likelihood that you’ll get what you were hoping for.
2. As Much As Necessary, As Little As Possible. When it comes to gripping especially, you want to use as much grip strength as you need to be safe and successful, but as little as possible. Don’t waste your grip squeezing a bar or a dumbbell excessively when you don’t have to, you’ll wear out your forearm muscles and give yourself Tennis Elbow (outer elbow/ forearm pain) or Golfer’s Elbow (inner elbow/ forearm pain).

13. Breathe!

If you are holding your breath when you are exerting, you are heading for a hernia of some kind. Disc herniation in the low back, abdominal hernia, or inguinal hernia are the most common possibilities.

What Does Hernia Mean? Excessive pressure causes part of a structure to get pushed outside of its typical or preferred anatomical boundary.

If you cannot breathe normally while you are exercising, you are trying something that is too difficult for you. Decrease the intensity until your body legitimately has the strength to perform what you are asking.

Bringing It All Together

Exercises that Cause Injury/ Should Not Be Performed By Everyone

1. Dead Lifts
2. Overhead Press
3. Long Arc Quad Machine
4. Sit Ups
5. Preacher Bicep Curls

Exercises that Are Silly (A Waste of Time)

6. Hip Abduction & Adduction Machines at the Gym

Exercises that are “Good”, But Form Can Get You Into Trouble

7. Chest Press
8. Squats & Leg Press
9. Tread Lightly

Final Words on Exercise Form & Technique

10. Neck Position. Neck Position. Neck Position.
11. Transversus Abdominis Recruitment
12. Protecting Your Wrists & Forearms
13. Breathe!

I’ll See You in the Gym!