Weightlift Safely to Prevent Back Pain or Injury While Bodybuilding

by Jeffrey R. Carlson, MD
Besides being an Orthopaedic Spine Specialist, I have many interests outside of the operating room. I really enjoy weightlifting and used to compete in bodybuilding events in my younger days.  While bodybuilding involves committing to a specific nutrition plan with little fat intake, taking lots of protein supplements and getting adequate rest, lifting weights or using resistance to build muscle is also very important.  In this article, I will address weightlifting and bodybuilding, preventing injury and also how to treat common back injuries once they occur.
Few bodybuilders will ever look like Arnold Schwarzenegger in his prime.  That is why many bodybuilders take steroids to increase muscle size.  Muscle is built naturally by injuring the muscle slightly during training by working it to exhaustion.  These micro-tears to the muscle cause soreness, usually a day after training.  The body repairs these muscle micro-tears naturally, and the repair process is actually what causes the muscle to grow.
Doing this over and over will cause the muscles to get larger over time; however, the body will adapt to exercise and muscles will become less sore with time.  That is why body builders have to change their weight-lifting routines often AND challenge their muscles with heavier weights or more resistance to keep the muscle building process going. This constant struggle to achieve muscle growth can make bodybuilders or weightlifters especially prone to injury.
Weightlifters use free-weights, weight or resistance machines or resistance bands to build muscle.  Those who use free weights tend to be more at risk for injury because of the need to maintain perfect form and posture while weightlifting to prevent injury.  While many weightlifters tend to start their routines safely, as they become tired, form and posture often suffer, setting them up for injury.
Certain free weightlifting moves are known to be more dangerous, such as the clean-and-jerk, the snatch, squat or the dead lift.  It is important to always train with a buddy and/or spotter and to not train above your conditioning and fitness level.  If you are new to weightlifting, it is often recommended that you use machines only until more experienced, as they help you to maintain proper form and posture while lifting.  Lifting free weights does help to improve one’s balance and stability, but only do so with a spotter or under supervision to avoid injury.
The most common injuries to the back and neck while weightlifting are muscle or tendon strains and ligament sprains.  While moderate, after-workout soreness is desirable, the pain should go away in a day or two.  If you have lingering pain or dysfunction in your back or neck, you may have overdone it in your workout and suffered a muscle strain or sprain.
At home treatment should include some rest, the use of an ice pack intermittently for the first 48 hours and heat thereafter, and you should take an OTC anti-inflammatory, such as Aleve or Ibuprofen, for pain relief. Even though you may have severe pain, do not get in the bed and stay there for a week.  Modify your activities as needed, but keep moving.  You will recover more quickly.
If at home treatment doesn’t help and pain persists, it is time to see me for a consultation.  I will order x-rays of your back or neck.  While x-rays don’t show a soft tissue injury, they will show me if you have spinal arthritis, bone spurs, tumors or other problems, which may be aggravated by weight lifting. I commonly will prescribe muscle relaxants for spasms, non-narcotic pain medications and Physical Therapy to help my patients build strength and flexibility.  Recovery usually takes about two weeks.
Obviously, it is better not to injure yourself while lifting weights instead of recovering from injury.  Rome wasn’t built in a day and you becoming Mr. or Ms. Olympia won’t happen overnight, either.  Taking it slow and steady with your weightlifting is the way to go.  Find a mentor at the gym to help you develop a muscle building regimen.  Workout with your buddies who can spot you while lifting.  Be careful with your form and posture and take all appropriate precautions while weightlifting.  Who knows… you may be posing your muscular physique onstage competitively before you know it!