Injuries and Overuse Syndromes in Powerlifting

Abstract

Powerlifting is a discipline of competitive weightlifting. To date, no investigations have focused on pain encountered during routine training. The aim of the study was to identify such pain, assign it to particular exercises and assess the data regarding injuries as well as the influence of intrinsic and extrinsic factors. Data of 245 competitive and elite powerlifters was collected by questionnaire. Information regarding current workout routines and retrospective injury data was collected. Study subjects were selected from 97 incorporated powerlifting clubs. A percentage of 43.3% of powerlifters complained of problems during routine workouts. Injury rate was calculated as 0.3 injuries per lifter per year (1 000 h of training=1 injury). There was no evidence that intrinsic or extrinsic factors affected this rate. Most commonly injured body regions were the shoulder, lower back and the knee. The use of weight belts increased the injury rate of the lumbar spine. Rate of injury to the upper extremities was significantly increased based on age >40 years (shoulder/p=0.003, elbow/p=0.003, hand+wrist/p=0.024) and female gender (hand+wrist/p=0.045). The daily workout of a large proportion of powerlifters is affected by disorders which do not require an interruption of training. The injury rate is low compared to other sports.

Key words

powerlifting - overuse syndrome - exercise pain - squat - bench press - dead lift

References

• 1 Anton MM, Spirduso WW, Tanaka H. Age-related declines in anaerobic muscular performance: weightlifting and powerlifting.  Med Sci Sports Exerc. 2004;  36 143-147
• 2 Bahr R. No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports.  Br J Sports Med. 2009;  43 966-972
• 3 Bahr R, Reeser JC. Injuries among world-class professional beach volleyball players. The Federation Internationale de Volleyball Beach Volleyball Injury Study.  Am J Sports Med. 2003;  31 119-125
• 4 Baltzer AW, Ghadamgahi PD, Granrath M, Possel HJ. American football injuries in Germany. First results from Bundesliga football.  Knee Surg Sports Traumatol Arthrosc. 1997;  5 46-49
• 5 Bhatia DN, de Beer JF, van Rooyen KS, Lam F, du Toit DF. The “bench-presser's shoulder”: an overuse insertional tendinopathy of the pectoralis minor muscle.  Br J Sports Med. 2007;  41 e11
• 6 Bjorneboe J, Bahr R, Andersen TE. Risk of injury on third-generation artificial turf in Norwegian professional football.  Br J Sports Med. 2010;  44 794-798
• 7 Brown EW, Abani K. Kinematics and kinetics of the dead lift in adolescent power lifters.  Med Sci Sports Exerc. 1985;  17 554-566
• 8 Brown EW, Kimball RG. Medical history associated with adolescent powerlifting.  Pediatrics. 1983;  72 636-644
• 9 Brynhildsen J, Ekstrand J, Jeppsson A, Tropp H. Previous injuries and persisting symptoms in female soccer players.  Int J Sports Med. 1990;  11 489-492
• 10 Caine CJ, Caine DJ, Lindner KJ. The epidemiologic approach to sports injuries. In: DJ Caine, CG Caine, KJ Lindner, (eds). Epidemiology of Sports Injuries. Champaign: Human Kinetics; 1996: 1-13
• 11 Calhoon G, Fry AC. Injury rates and profiles of elite competitive weightlifters.  J Athl Train. 1999;  34 232-238
• 12 Cholewicki J, McGill SM. Lumbar posterior ligament involvement during extremely heavy lifts estimated from fluoroscopic measurements.  J Biomech. 1992;  25 17-28
• 13 Cholewicki J, McGill SM, Norman RW. Lumbar spine loads during the lifting of extremely heavy weights.  Med Sci Sports Exerc. 1991;  23 1179-1186
• 14 Echegoyen S, Acuna E, Rodriguez C. Injuries in students of three different dance techniques.  Med Probl Perform Art. 2010;  25 72-74
• 15 Escamilla RF, Fleisig GS, Lowry TM, Barrentine SW, Andrews JR. A three-dimensional biomechanical analysis of the squat during varying stance widths.  Med Sci Sports Exerc. 2001;  33 984-998
• 16 Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises.  Med Sci Sports Exerc. 1998;  30 556-569
• 17 Escamilla RF, Francisco AC, Fleisig GS, Barrentine SW, Welch CM, Kayes AV, Speer KP, Andrews JR. A three-dimensional biomechanical analysis of sumo and conventional style deadlifts.  Med Sci Sports Exerc. 2000;  32 1265-1275
• 18 Fees M, Decker T, Snyder-Mackler L, Axe MJ. Upper extremity weight-training modifications for the injured athlete. A clinical perspective.  Am J Sports Med. 1998;  26 732-742
• 19 Gabbe BJ, Finch CF, Bennell KL, Wajswelner H. How valid is a self reported 12 month sports injury history?.  Br J Sports Med. 2003;  37 545-547
• 20 Gabbett TJ, Godbolt RJ. Training injuries in professional rugby league.  J Strength Cond Res. 2010;  24 1948-1953
• 21 Gill IP, Mbubaegbu C. Fracture shaft of clavicle, an indirect injury from bench pressing.  Br J Sports Med. 2004;  38 E26
• 22 Goertzen M, Schoppe K, Lange G, Schulitz KP. [Injuries and damage caused by excess stress in body building and power lifting].  Sportverletz Sportschaden. 1989;  3 32-36
• 23 Goeser CD, Aikenhead JA. Rib fracture due to bench pressing.  J Manipulative Physiol Ther. 1990;  13 26-29
• 24 Granhed H, Jonson R, Hansson T. The loads on the lumbar spine during extreme weight lifting.  Spine (Phila Pa 1976). 1987;  12 146-149
• 25 Grenier SG, McGill SM. Quantification of lumbar stability by using 2 different abdominal activation strategies.  Arch Phys Med Rehabil. 2007;  88 54-62
• 26 Harman EA, Frykman PN, Clagett ER, Kraemer WJ. Intra-abdominal and intra-thoracic pressures during lifting and jumping.  Med Sci Sports Exerc. 1988;  20 195-201
• 27 Harman EA, Rosenstein RM, Frykman PN, Nigro GA. Effects of a belt on intra-abdominal pressure during weight lifting.  Med Sci Sports Exerc. 1989;  21 186-190
• 28 Harriss DJ, Atkinson G. International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.  Int J Sports Med. 2009;  30 701-702
• 29 Haykowsky MJ, Warburton DER, Quinney HA. Pain and injury associated with powerlifting training in visually impaired athletes.  J Visual Impair Blin. 1999;  93 236-241
• 30 Heckmann A, Lahoda LU, Alkandari Q, Vogt PM, Knobloch K. C-type scaphoid fracture in a elite power lifting.  Sportverletz Sportschaden. 2008;  22 106-108
• 31 Keogh J, Hume PA, Pearson S. Retrospective injury epidemiology of one hundred one competitive Oceania power lifters: the effects of age, body mass, competitive standard, and gender.  J Strength Cond Res. 2006;  20 672-681
• 32 Keogh JWL. Weightlifting. In: DJ Caine, P Harmer, M Schiff, (eds). Epidemiology of Injury in Olympic Sports. Oxford, England: Blackwell; 2009: 336-350
• 33 Killen NM, Gabbett TJ, Jenkins DG. Training loads and incidence of injury during the preseason in professional rugby league players.  J Strength Cond Res. 2010;  24 2079-2084
• 34 Kingma I, Faber GS, Suwarganda EK, Bruijnen TB, Peters RJ, van Dieën JH. Effect of a stiff lifting belt on spine compression during lifting.  Spine. 2006;  31 E833-E839
• 35 Kolt GS, Kirkby RJ. Epidemiology of injury in elite and subelite female gymnasts: a comparison of retrospective and prospective findings.  Br J Sports Med. 1999;  33 312-318
• 36 Lander JE, Hundley JR, Simonton RL. The effectiveness of weight-belts during multiple repetitions of the squat exercise.  Med Sci Sports Exerc. 1992;  24 603-609
• 37 Lander JE, Simonton RL, Giacobbe JK. The effectiveness of weight-belts during the squat exercise.  Med Sci Sports Exerc. 1990;  22 117-126
• 38 Molsa J, Kujala U, Nasman O, Lehtipuu TP, Airaksinen O. Injury profile in ice hockey from the 1970s through the 1990s in Finland.  Am J Sports Med. 2000;  28 322-327
• 39 Pochini AC, Ejnisman B, Andreoli CV, Monteiro GC, Fleury AM, Faloppa F, Cohen M, Albertoni WM. Exact moment of tendon of pectoralis major muscle rupture captured on video.  Br J Sports Med. 2007;  41 618-619; discussion 619
• 40 Quinney HA, Warburton DER, Webster A, Calvert R, Haykowsky MJ. Powerlifting injuries associated with elite powerlifting training.  Can J Appl Physiol. 1997;  20 49
• 41 Raske A, Norlin R. Injury incidence and prevalence among elite weight and power lifters.  Am J Sports Med. 2002;  30 248-256
• 42 Reeves RK, Laskowski ER, Smith J. Weight training injuries: part 1: diagnosing and managing acute conditions.  Phys Sportsmed. 1998;  26 67-96
• 43 Reeves RK, Laskowski ER, Smith J. Weight training injuries: part 2: diagnosing and managing chronic conditions.  Phys Sportsmed. 1998;  26 54-73
• 44 Risser WL, Risser JM, Preston D. Weight-training injuries in adolescents.  Am J Dis Child. 1990;  144 1015-1017
• 45 Seil R, Rupp S, Tempelhof S, Kohn D. Injuries during handball. A comparative, retrospective study between regional and upper league teams.  Sportverletz Sportschaden. 1997;  11 58-62
• 46 Stocker D, Pink M, Jobe FW. Comparison of shoulder injury in collegiate- and master's-level swimmers.  Clin J Sport Med. 1995;  5 4-8
• 47 Teitz CC, O’Kane J, Lind BK, Hannafin JA. Back pain in intercollegiate rowers.  Am J Sports Med. 2002;  30 674-679
• 48 van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts.  Sports Med. 1992;  14 82-99
• 49 Vanderburgh PM, Dooman C. Considering body mass differences, who are the world's strongest women?.  Med Sci Sports Exerc. 2000;  32 197-201
• 50 Vera-Garcia FJ, Brown SH, Gray JR, McGill SM. Effects of different levels of torso coactivation on trunk muscular and kinematic responses to posteriorly applied sudden loads.  Clin Biomech (Bristol, Avon). 2006;  21 443-455
• 51 Wilson F, Gissane C, Gormley J, Simms C. A 12-month prospective cohort study of injury in international rowers.  Br J Sports Med. 2010;  44 207-214
• 52 Wood MB, Dobyns JH. Sports-related extraarticular wrist syndromes.  Clin Orthop Relat Res. 1986;  93-102
• 53 Wretenberg P, Feng Y, Arborelius UP. High- and low-bar squatting techniques during weight-training.  Med Sci Sports Exerc. 1996;  28 218-224
• 54 Yu JS, Habib PA. Common injuries related to weightlifting: MR imaging perspective.  Semin Musculoskelet Radiol. 2005;  9 289-301
• 55 Zazryn T, Cameron P, McCrory P. A prospective cohort study of injury in amateur and professional boxing.  Br J Sports Med. 2006;  40 670-674
• 56 http://www.wpfpowerlifting.com/records.htm (update 7th June, 2010)
• 57 http://www.wpfpowerlifting.com/approvedequipment.htm (update 9th December, 2010)
• 58 http://www.wpfpowerlifting.com/rules.htm (update 9th December, 2010)

Correspondence