Risk

It is ever present. Even choosing not to do something has its risks, at least in the form of a lost opportunity. The aim is not always to eliminate risk (impossible in many cases), but to lower it to the appropriate level. That is, in proportion to the desired outcome.

In the world of exercise and sport, lifting weights in a gym is one of the safest activities you can choose. Below are the injury rates listed for the sports involving lifting weights, listed as injuries per 1000 hours of participation (1):

Weightlifting - 3.2

Powerlifting - 4

Crossfit - 4.2

Strongman - 5.5

For comparison, here are some injury rates listed for other common activities/sports (2,3):

Soccer - 5

Running - 7.7 (recreational, trained) / 17.8 (novice) 

Hockey - 78

Football - 140

The point of this is not to discourage participation in sport, though you might hesitate to sign your kids up for hockey after reading it. The goal here is to help to increase the understanding of risk as it relates to exercise and training for sport and for general health. For this article, when I say resistance training, this will also refer to other, similar training modalities like plyometrics.

At this point, some of you may have a knee-jerk reaction like; “I know multiple people that have hurt themselves lifting weights”, or “I hurt my shoulder doing bench press just last year”.

Unfortunately, this (the availability heuristic) is not adequate evidence to say anything about the risk of an activity. We can not use one, or few acquaintances with a phenomenon to determine its general frequency or likelihood. If you make decisions based on that, you are likely going to make some poor decisions. In this case you will actually avoid the very activities that are most likely to reduce your injury risk, risk of chronic diseases, and improve your performance.

The current health guidelines (USA and CAN) recommend twice weekly full body resistance training as a minimum for good health (link). So that should be everyone’s starting point from which to make decisions. Doing no resistance training simply is not good enough. 

If you want to improve sport performance, increase muscle mass, lose a significant amount of body fat, or have more injury preventative benefits, 3 or more times per week is likely to be beneficial and in some cases, necessary. Though the sessions may cease to be full body each time. 

If you do not do any resistance training you are risking your long term health. You will have an increased risk of osteoporosis, obesity and type 2 diabetes, risk of falling, and you will likely lose your functional independence sooner.

If you do not do any resistance training, you are at an increased risk of injury during activity, especially sport. For example, a soccer or basketball player will have up to a 75% decreased risk of non-contact ACL tear with training (4). And that is despite, oftentimes the training programs used in the literature leaving some to be desired.

So get to the gym, or try to find a bargain for some home equipment. Do some basic strength training at minimum twice weekly - squat, bench press or pushups, deadlift, barbell row, pull ups etc. Add some extra bodybuilding work in there for more potential benefit. Add some plyometrics and other exercises for sport specific preparation. Cardiovascular training is equally important for health, but people are much more likely to do that without encouragement it seems.

You are not avoiding risk by opting out of exercise. You are actually increasing your risk. Risk of much more than just injury.

References

1. Serafim, T.T., de Oliveira, E.S., Maffulli, N. et al. Which resistance training is safest to practice? A systematic review. J Orthop Surg Res 18, 296 (2023). https://doi.org/10.1186/s13018-023-03781-x

2. Klimek, C., Ashbeck, C., Brook, A. J., & Durall, C. (2018). Are Injuries More Common With CrossFit Training Than Other Forms of Exercise?. Journal of Sport Rehabilitation, 27(3), 295-299. Retrieved Oct 15, 2024, from https://doi.org/10.1123/jsr.2016-0040

3. Videbæk, Solvej & Bueno, Andreas & Nielsen, Rasmus & Rasmussen, Sten. (2015). Incidence of Running-Related Injuries Per 1000 h of running in Different Types of Runners: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.). 45. 10.1007/s40279-015-0333-8. 

4. Padua DA, DiStefano LJ, Hewett TE, Garrett WE, Marshall SW, Golden GM, Shultz SJ, Sigward SM. National Athletic Trainers' Association Position Statement: Prevention of Anterior Cruciate Ligament Injury. J Athl Train. 2018 Jan;53(1):5-19. doi: 10.4085/1062-6050-99-16. Epub 2018 Jan 9. PMID: 29314903; PMCID: PMC5800728.