This is an issue that is becoming more common with today’s workouts. The idea of pushing one’s body to fatigue is a common idea in recent exercise programs. With fatigue comes some wonderful physiological advantages such as an increase in muscle gain, a decrease in blood sugar levels, slower fatigue during sporting endeavors, a quicker response to anaerobic activity, etc. However, we have seen a dramatic increase in injuries resulting from workouts where participants are pushing into (and past) fatigue. These injuries range from simple strain/sprains to serious injuries such as labrum tears, stress fractures, muscle tears, severe tendinitis, and enthesopathies (a disruption of the junction between a muscle and bone). The cause of these injuries can be traced back, in many cases, to poor form. As the participant fatigues, intrinsic muscles that are designed to protect joints become compromised. If intrinsic muscles become fatigued, proper form is impossible to maintain. When this occurs, the joints become vulnerable by absorbing stress loads that they are ill-equipped to manage. It is at this point that injury becomes possible because the muscles are unable to protect the joints.
So, the take-away from this discussion should be the maintenance of proper form during lifting, no matter the program. In my office, I do not discourage the athlete from pushing themselves to fatigue. As mentioned above, there are many benefits to reaching fatigue during exercise. However, I am adamant that my patients maintain proper form at all times. Fatigue is reached when the athlete can no longer perform the particular exercise with proper form. At this point, the athlete is encouraged to cease that particular movement and any others that rely on the same intrinsic stabilizers. An example would be that if an athlete reaches fatigue after performing squats, dead lifts and cleans/snatches should be avoided for the rest of that particular workout. If there are any questions, concerns, or comments about this idea, please relay them.
All the best,
Nathan Williams, DC, MS, TPI-med3