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If you go to the gym to get healthy and fit, look good, feel good and pamper your ego, then I urge you take a minute to think about something,

Do you remember the old adage, "People like to do what they are good at and comfortable with"? Are you living that old adage at the gym? Most people do. They have a set routine at the gym and it's that routine coupled with the mechanics of the equipment that can lead to trouble--either very quickly or over time.

Here is the problem. Working out can lead to injury, no question. The challenge is in knowing how it can happen and how to prevent it. There are two basic categories of injuries: the sudden accident (a.k.a. trauma) and what can be described as the Process Injury (in other words, the long, slow development of a condition.) My goal is to protect you from both types of injury.

Traumatic Injury at the Gym
Let's start with the 5 basic concepts of working out in order to show you how easy it is to injure yourself in a traumatic way.

• Intensity: How hard you work out.
• Frequency: How often you work out.
• Duration: How long you work out.
• Progressive Resistance: Using more resistance with each set you perform.
• Progressive Overload: Starting at a higher level of resistance at subsequent workouts.

Each one of these principles has the ability to cause injury. But when you couple them with having a trainer or workout partner egging you on to eek out one more rep as you get fatigued, you go into all kinds of contorted positions to get the job done. All of a sudden, Bam-O! A hundred different injuries can happen. And they will take a long time to heal. You will have defeated the entire purpose of going to the gym in the first place.

Please understand that the body can tolerate a lot of abuse before you pay the penalty of an injury. Just know that injuries can happen in seconds and the effects can last a lifetime.

Injury as a Process
Traumatic injuries do happen. But more often it is the slow progression injuries that are far more sinister and very well may be the root cause of some traumatic injuries. So I would like to focus on what happens over the long term so that you can make a change now to prevent injuries.

I have spent the last 10 years of my life dealing specifically with what are called muscle imbalances and their effects on the back and body. In describing the concept I will use some examples and try to make you aware of what possible injuries you could be facing.

Let me begin by describing what muscle imbalances are and then give you an example. Muscle imbalance can be defined as strength and flexibility of one muscle group compared to the opposite muscle group. So if you compare the strength and flexibility of the quadriceps to the opposite muscle group, the hamstrings, in nine out of 10 people the quads will be overly strong and overly tight compared to the hamstrings. That's the definition of having a muscle imbalance.

How Back and Body Injures Start!
The quads are always going to be stronger then the hamstrings, so you may be wondering what is wrong with that. Let me give you some possible examples of what can happen if your quads are out of balance with your hamstrings. As I give this example, understand that there are other imbalances that often happen at the same time to develop this condition. For example, the hip flexors and the glutes can be out of balance too.

When the quads are out of balance with the hamstrings, there can be uneven and excessive wear and tear on the cartilage and ligaments of the knee. The knee will not function correctly and conditions will develop to the point were running or physical activity will be impossible.

Second, balance between the quads and the hamstrings keep the pelvis in a neutral and stable position. But when you have overly strong and overly tight quads, your pelvis will be pulled in several different directions. In some cases the whole pelvis is pulled excessively forward. In other cases one side of the pelvis comes even more forward and the hip goes too high, causing the pelvis to rotate. This is very common in physically active women over 40.

When the pelvis is not in the most neutral and most stable position possible, the spine may go into abnormal curvature. It is that abnormal curvature caused by the muscle imbalance that can set you up for hip problems, SI joint problems, back problems and sciatica.

How Does This Happen?
The very equipment you are using at the gym is either directly or indirectly helping you develop your muscle imbalances and setting you up for future problems.

Let me give you some examples. You cannot help but develop raw quad strength when you use the leg extension machine. As I asked you before, do you stick to exercises that you like to do? Let's face it, everyone hates to work the hamstrings because they are weak and it is hard to do. So most people overwork their quads and under-work their hamstrings.

Another example is the calf raise machine. Again, the calf muscle will always be stronger then the muscles in front of the shin, but when you blast your calves and do not work the muscles in the front of the shin you are setting yourself up for planter fasciitis, heel spurs, Achilles tendonitis and even knee problems.

Let me recap. Working out with gym equipment puts enormous unnatural force through the joint, restricts movements to linear motions and can very easily overdevelop muscle groups. This combined with the development to muscle imbalances—is a hidden root cause of most if not all physical injuries at the gym.

Action Steps
As with any new desire to make a change in your life, you must first have a starting point. There is no easer way to get started then to take an inventory of where you are right now. It will not help you at all to make subjective assessments about yourself and not be honest, so I have a few suggestions:

• Take photos of yourself. I would not always recommend this. But in cases were your health and wellness are at stake, why not? Here is what you can do. Put on a bathing suit and have someone take photos, front, back and both sides, making sure that you see head to toe. Then take a look--not with a judging eye but a caring eye, looking for areas that are not in balance. For example, is your head straight? Is your head over your shoulders or is it forward of your shoulders? Are your shoulders level? What about your hips, are they level? (Look at your side view and suit line as a guide.)

  Those are just some of the areas that you can gauge yourself on. You can also use the photos as a reference of how you are now so you can look back at how you were then.

• Feel the pain. The best way to assess pain is by asking yourself how you feel in the morning, during the day and at night. With this one you will need to be honest with yourself, and I suggest that you write this down. You can even mark up the photos you took by writing on them at the body part or parts where you feel pain.

• Listen to your body. If you are working out and you feel a little something and you're not quite sure what it is, rest assured it's your body telling you it does not like what you are doing to it.

• Build your awareness. If you live with fear, worry or doubt about your weight, health or medical condition, the best way to overcome that it is to build your knowledge on the subject. Study what others already know. And remember to always stay enthusiastic about the process. That is the secret to achieving your goals.

If you do not mind I would like to end with a short story of one of my clients. She is a 43-year-old professional with a desk job. One day she decided that she was going to lose 20 pounds by summer. So she joined the gym, where she took a spinning class, used weights and at the same time trained for a 6K run on Memorial Day. She did this for about four months. Fast-forward to race day. She starts the race and within the first mile she knows she is in trouble. But she decides to finish the race because the pain is not that bad.

I get a call that night. She tells me that she cannot walk and asks if massage would help. I go over that same night. When I get there she is on crutches. She cannot walk. She has foot pain, knee pain and the effects of Piriformis irritation. I agree to work with her and only do what she can tolerate. I then urge her to see a doctor. On Monday morning, she does. At the appointment she was diagnosed with a bone spur in her heal, a stress fracture on her tibia by the knee and wicked Piriformis Syndrome. As I write this, two months later, she still has not been able to return to any physical activity.

Listen to your body: it's telling you something...

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