Chronic Injury and The Rise of Functional Fitness

Train Hard, Get Injured, Repeat?

It’s quite common to hear athletes that have a few years of training under their belts complain of chronic injury including back, shoulder, or knee pain, or of simply feeling run-down. If you’re someone that is in the trenches training hard or even someone that has a lower training age you may have experienced some of these symptoms during your time under the bar.

In this day and age, seeing more athletes squatting, deadlifting, and pressing is much more common that it was 10 years ago. Although it’s amazing to see more athletes using compound movements, higher demand movements come at a cost if proper movement patterns are not in place and if muscular imbalance is not addressed. Overall, program design is constantly evolving there are many core-values that should be non-negotiable.

I can remember my days of being a personal trainer at a commercial gym where other trainers would often scoff at me when I was having my clients deadlift, box squat, and push press. Today the movement of “functional fitness” has swept the globe, with the rise of CrossFit and industrial style box facilities, but this revolution has some coaches ignoring other methods that may be just as important for their clients’ health and longevity.

It’s not uncommon to see coaches get pigeonholed into thinking there is only one way of doing things. The problem here is that the same folks that shit on other disciplines are simply not educated when it comes to the value of different training modalities and understanding the science behind other forms of training. To be clear, there is something to be taken from all forms of training regardless of what side of the fence you’re on. The overall result lends itself to feeling better, looking better, and hitting new personal records.

The 3 Most Common Injuries In Functional Fitness

Below I’m going to delve into what I’ve seen over the last 6 years of owning a CrossFit box and what methods we use now with gyms all over the world to ensure their clients don’t run into common issues using a concurrent system of training with derivatives of the Conjugate System. Unbeknownst to many, the Conjugate System used at the legendary Westside Barbell is a concurrent system of training that utilizes multiple modalities to ensure progression, recovery, and improving weak links, and is not only beneficial for strength athletes but also everyday general population athletes.

Lower Back Issues

The fundamental issue that many coaches and box owners make is that most expose their clients to compound movements too soon. In addition, most coaches prescribe inappropriate loading parameters for both experienced and inexperienced clients. Teaching someone to move properly is one thing, but most trainees that sign-up at a local box tend to be more anterior-chain dominant and haven’t used their posterior chain since 1983.

I’m not saying do not teach these athletes how to deadlift or squat; quite the contrary. Of course teach them how to move properly, but use single-joint movement so they can establish a mind-muscle connection with their glutes, hips and hamstrings and, of course, strengthen their primary movers first. The end result is people being able to actually use the musculature that was intended to be used when squatting and deadlifting. With athletes of all levels, I’ve found the below to be quite a effective for teaching and strengthening purposes:

The Solution

• The Wide Stance Goblet Box Squat: The purpose here is to teach people how to hip-hinge and engage their hips/hamstrings, as when we sit back on the box we are forced to contract and explode through concentric range of motion. Most will note that they can actually feel their hips and hamstrings working. That’s what we want.
• Single Limb Work: This goes without saying but this work must be implemented and is even more necessary for athletes with lower training ages. You can’t build a house without a foundation.
• Sledwork: I’ve talked about this quite a bit, but you can’t go wrong with the sled. Why? Because it does not require high-levels of skill requisite and carries zero risk of injury making it a necessary option for athletes of all levels.
• Core Work: Another non-negotiable but implementing static holds like plank variations, as well as movements like deadbugs, encourage and teach neutral posture and how to engage the anterior core. If your athlete can’t hold a side a plank for 10 seconds, should they really be deadlifting or squatting? Probably not.

Shoulder Issues

 Performing copious amounts of high-skill gymnastics work for general population is a recipe for injury. Within the functional fitness movement, the use of vertical pulling has increased drastically. In fact, there is a huge imbalance that exists in most functional fitness facilities: the balance between vertical pulling and horizontal pulling is skewed in favor of vertical pulling.

You’d be hard pressed to find many CrossFit boxes that regularly program row variations, but in reality, horizontal rowing should take precedence vs. vertical pulling. Of course, we aren’t debating the value of the pull-up, but what we are considering is the lack of development of the lats, rear deltoids, and rhomboids of most people and not being able to stabilize when performing dynamic movements. The solution here is pretty straightforward in which we can implement change without having to drastically modify our programming.

The Solution

• Horizontal rowing: Replace some of your vertical pulling with horizontal rowing. There is a long list of row variations that can be done with a barbell, dumbbells, and kettlebells so use all of them at your disposal. We include horizontal row work at least 2x a week in our Affiliate Programming in relatively high doses.
• Band work: An easy way to offset pressing and vertical pulling volume is include high-volume band work. A standard rule of thumb that I learned from Dr. Rusin is that horizontal rowing should equate to 3:1 of pressing volume and 2:1 horizontal rowing vs. vertical pulling. This can easily be accomplished with high volume banded pull-aparts and banded facepulls. We recommend 100 reps of each done twice a week.
• Opt for more dumbbell variations: A lot of times people can’t get their heads around scaling a movement. If you’re having issues then scaling should be your friend. For instance, many trainees that complain of front deltoid pain can be exacerbated by barbell work with a pronated grip such as the bench press or shoulder press. An alternative is using dumbbells with a neutral grip taking a lot of the stress of the front deltoid and allowing people to use the musculature of their triceps as a primary mover. Many find that they can comfortably press with dumbbells using a neutral grip and don’t incur the same discomfort. If a movement is causing you pain, then that movement will have little value for you at that moment in time. And if you don’t train smarter you’ll always be “broken”.

Knee Issues

Squatting everyday to make gains?! Sure, you’ll get some circumference on your quads, but at what cost? The notion of squatting everyday I see more regularly than I would like. Too much of anything is a bad thing and squatting multiple times a week alternating between front squat, back squat, and overhead squat leaves a lot on the table. This theory of squatting heavy everyday is probably one of the dumbest thing’s I’ve ever heard actually. If your goal is be injured and broken then go for it, but if your goal is to get stronger you’ll need a better plan.

The reason why athletes’ knees act up with so much squatting is due to joint angle. All of those variations I listed place a great deal of stress on the patella tendon and can contribute to knee issues and if you’re en endurance athlete just getting into strength training it’s common that you may have already had some knee issues at one point or another.

The Solution

• Have a plan that allows for built in recovery: Repeating heavy sessions in too close proximity to each other is recipe for overuse injury and overtraining. Allow for 72 hours between your most demanding sessions. This will allow for proper recovery and put you in a better position to succeed.
• Alternate between hip and knee dominant movements: Rotating your max effort work is paramount to avoid accommodation and keeping you healthy. I recommend performing your max effort work on the same day every week (we perform our max effort lower body work every Monday) and rotate between squat variations and pull variations. In addition, including variance among our compound movements is incredibly important so don’t just stick to the classic variations, go outside your comfort zone and then retest your classic variations every 12 weeks.
• The wide stance box squat: The wide stance box squat puts the shin in a vertical position placing more load on the posterior chain and less pressure on the front of the knees so including this in your programming will not only help people in terms of teaching them how to use their posterior but also mitigate the risk knee injury. If you’re someone that already suffers from knee issues then this variation is a must. Secondly, we cannot load the box squat as heavy as the classic squat simply because we are purposefully breaking up the eccentric and concentric phase of the lift which decreases axial loading which will give your joints a much needed break.

Feeling Rundown?

Decreased motivation to train is a classic sign of overtraining and if you avoid these warning signs and fail to listen to your body, the risks can be deleterious. Indeed the value of high-intensity training goes without saying, but too much of anything is a bad thing. The need for Aerobic training carries a long list of benefits and contrary to popular belief you won’t lose your “gainz” if you engage in some low intensity work a few times a week.

Aerobic work is crucial for facilitating recovery by promoting blood flow and improving the cardio-respiratory system, but also instrumental in improving work capacity. Your ability to increase volume comes at a cost and if your aerobic system is not on point, you’ll be limited by how much volume you can inevitably tolerate. Moreover, being well-rounded is important to developing multi-faceted fitness and only training anaerobic qualities won’t do much for improving your ability to recover and the ability of your aerobic system to replenish ATP.

The Solution

Focus on 1-2 sessions a week that include low intensity steady state work between 30-60 minutes in length. The benefits of this training in addition to facilitating recovery is increasing cardiac output by building the left ventricle of the heart so not only will we able to sustain more volume down the road but we’ll also be able to replenish ATP more quickly for explosive movements like max effort squats or deadlifts. Also, it’s likely you’ll feel more “recharged” and ready to take on your other training. If you use a heart-rate monitor try to keep your heart-rate between 130-150 BPM during these sessions.

In short, if we follow these basic tenets of efficient programming we can avoid many issues that can potentially take us or our clients out of the game. Overall, implementing single-limb work, increase our volume of horizontal rowing/banded pull-aparts, separating our lower-body strength work by 72 hours, implement the wide-stance box squat as well as rotating our variations consistently, and including low-intensity work weekly we’ll have you well on your way to feeling better, looking better, and living longer!

About The Author

My name is Jason Brown and I have been fitness professional for nearly 15 years. I have owned my own facility, trained a wide-range of clients ranging from soccer moms, military personnel, law enforcement, CrossFitters, Powerlifters, and professional athletes. My area of specialization is providing a system of concurrent fitness geared toward the general population in a group setting. Currently, I own BoxProgramming.com and write programming for over 200 facilities world-wide.