No pain, no gain. Believe it or not, that saying doesn't always apply at the gym, because dropping a 30-lb dumbbell on your foot, dislocating a joint, or tearing a muscle will offer only misery—and will force you to take a seat on the sidelines that can seriously trip up your progress.
“Every New Year, hopeful exercisers make the resolution to train hard and transform their bodies," says Scott Weiss, D.P.T., C.S.C.S., a New York physical therapist and athletic trainer. "Unfortunately, many of these people lack experience or guidance—and others will approach their goals with more enthusiasm than muscle. Injuries ensue.”
So we asked experts to talk about the scariest workout injuries they see—and how to prevent them. Study up. And if any of these happen to you, see a doc ASAP. (We mean it, tough guy.)
1. Pectoral injury
Typically a tear of the chest muscle or of its tendon off the upper arm, this injury often results from losing control of the dumbbell or barbell while bench pressing, but it can also occur while attempting to perform dumbbell flies with a weight that’s heaver than you’re accustomed to lifting—and that you’re not quite strong enough to handle yet, says David Geier, M.D., orthopedic surgeon and director of sports medicine at the Medical University of South Carolina (MUSC). "You'll feel a tearing sensation, and the chest and upper arm often turns black and blue," says Geier.
Prevent it: Only work with a load you can control—you'll know it's too heavy if it wobbles and feels as if it's going to drop—and use a spotter for heavy sets.
2. Bicep tendon rupture
This tendon attaches the bicep muscle of the arm to a bone in the forearm, and if you attempt to curl a too-heavy weight or suddenly drop the barbell or dumbbell, you’re risking a tear. "The arm turns black and blue, and the biceps muscle actually appears larger," says Geier.
Prevent it: As with the chest muscle tear, work with a weight you know you can handle and always engage the help of a spotter.
3. Labral tear
Ever hear a catching or clicking sound deep in your shoulder while on the chest press or military press? This could spell trouble brewing. More specifically, the cartilage bumper that surrounds your glenoid—the shoulder’s ball-and-socket joint—could be giving way. (Say it with us now: ouch.)
Prevent it: Labral tears typically don't happen overnight, so if you hear that dreaded click—or feel any uncomfortable popping or pain deep in your shoulder—don’t be a dummy. Get that shoulder get checked ASAP, says Geier. (Relax. You'll likely just need to make some simple modifications to your workout until you're healed, such as reducing your range of motion.)
4. Sternum fracture
If you’re a butterfingers on the bench press and that bar comes crashing down on your chest, your sternum (that’s the bone right in the middle) pays the price. "Performing a bench press and being unable to lift the bar to the safety point is one of the most common gym nightmares," says Weiss. Even worse: a dropped bar could do further damage if it rolls up to your trachea and cuts off oxygen. (Yes, this happens—most often during unsupervised home workouts.)
Prevent it: Use only weight you can handle and always employ a seasoned spotter, who knows the proper power stance and hand position. Also be sure to tell him how many reps you think you can do on your own ahead of time, says Weiss, so that he knows when to jump in.
5. Joint dislocations
Not paying attention to your form or loading the bar with too much weight can lead to a dislocated hand, shoulder, elbow or knee, says Weiss. How? All that excess pressure on the ligaments forces the bones out of their normal positions, creating what Weiss calls a medical emergency. (Yes, that’s right. If this happens, seek professional help—not a buddy who claims he can pop it back into place.)
Prevent it: Train your muscles in multiple directions in each workout, or be sure to alternate exercises for any one muscle group from one workout to the next. For example, instead of doing only chest presses, add incline or decline presses or flyes—and keep weight low enough to maintain proper form and technique, says Weiss. "You should be able to press or pull in a smooth and steady motion to complete the set.”
6. Back strain
Lumbar—aka lower-back—strains can have many causes, but one of the biggest culprits is simply not paying enough attention to your warm-up and stretching, says David Fabi, M.D., an orthopedic surgeon with San Diego Orthopaedic Associates Medical Group. "When not properly warmed up, the muscles of the back are not able to absorb the energy imparted to the back during weightlifting,” he says. “This is especially true when lifting heavy weights." Poor form—like arching your back while attempting a heavy bench press—will also cause strain.
Prevent it: Stretching, core strength and proper technique are vital to preventing back pain, says Fabi. "If you are not experienced, consult an expert or hire a personal trainer to teach you proper form and technique." For some lower-back stretches to get you started, see our video on Injury prevention for the lower back.
Holding your breath while squatting may make it feel as if you can lift more weight, but all that increased pressure on your internal organs—not to mention the boost in blood pressure—can cause internal organs to punch through their encasings, says Weiss. “This pushes your organs into a place they don’t below—and is a major medical emergency.”
Prevent it: Long-term, strengthening your core stability and abdominal muscles is key for hernia prevention. And in the moment, make sure you’re lifting only weight you can handle—and check in with your breathing to make sure it's steady, says Weiss.