What are the potential complications of weight lifting?

Potential Complications of Weight Lifting

Weight lifting can cause significant musculoskeletal injuries and cardiovascular complications, particularly when performed with improper technique or by individuals with pre-existing medical conditions. 1

Musculoskeletal Complications

Acute Injuries

• Fractures and dislocations: Particularly during aggressive use of free weights 1
• Sprains, strains, and muscle tears: Most common type of injury (65.1%) 2
• Meniscal injuries of the knee: Can occur with improper form or excessive weight 1

Chronic Injuries

• Rotator cuff tendinopathy: Common in shoulder from repetitive movements 3
• Stress injuries to the vertebrae, clavicles, and upper extremities: Due to repetitive stress 3
• Intervertebral disk herniation: Can result from improper lifting technique 1
• Spondylolysis and spondylolisthesis: Stress fractures in the spine 1

Neurological Complications

• Peripheral nerve injuries: From direct trauma, compression by muscle hypertrophy, or excessive stretching 4
• Thoracic outlet syndrome: Compression of nerves or blood vessels in the neck/shoulder area 3
• Suprascapular neuropathy: Nerve compression from muscle hypertrophy 3

Cardiovascular Complications

Blood Pressure Concerns

• Excessive blood pressure elevations: Particularly with high-intensity resistance training (80-100% of 1-RM) performed to exhaustion 5
• Weight lifter's cephalgia: Headaches associated with vascular changes during lifting 3

Device-Related Complications

• Pacing lead fractures and dislodgment: Can occur with repetitive upper body movements in patients with cardiac devices 5

Special Population Considerations

Cardiovascular Disease

• Increased risk in patients with heart conditions: Patients with cardiovascular disease should only participate in low to moderate-intensity resistance training if they have acceptable functional capacity (≥4 METs) 5
• Risk of acute cardiac events: Patients with mild atherosclerotic disease should be evaluated on a case-by-case basis 5

Diabetes

• Retinopathy complications: Vigorous resistance training is contraindicated in individuals with diabetic retinopathy as it may trigger vitreous hemorrhage and retinal detachment 5
• Neuropathy concerns: Individuals with diabetic neuropathy are at greater risk for orthostatic hypotension and musculoskeletal injuries due to inadequate proprioception and pain perception 5

Hypertension

• Moderate to severe hypertension: Individuals with stage 2 or 3 hypertension should be restricted from highly static competitive sports until blood pressure is controlled 5

Genetic Cardiovascular Diseases

• Hypertrophic cardiomyopathy: Individuals with this condition should avoid intense weight lifting 5
• Marfan syndrome: Static (isometric) exertion may increase wall stress and weaken the aortic media 5

Risk Factors for Weight Training Injuries

• Age: Older individuals (>28 years) have 2.48 times higher risk compared to those ≤22 years 6
• Training volume: Higher amounts of weight training per week increase injury risk 6
• Gender: Men are 7.4 times more likely to experience weight training injuries compared to women 6
• Technique: Poor lifting technique significantly increases injury risk 1

Safety Recommendations

1. Start with low intensity: Begin with low to moderate-intensity resistance training, especially for beginners 5
2. Use proper technique: Ensure correct form and breathing technique; avoid Valsalva maneuver 5
3. Choose machines over free weights: Machine-based lifting is safer than free weights, particularly for those with musculoskeletal limitations, advanced arthritis, severe osteoporosis, or neurological conditions 5, 7
4. Appropriate supervision: Good coaching and proper supervision can minimize musculoskeletal problems 1
5. Gradual progression: Allow time for musculoskeletal adaptation before increasing intensity 5
6. Medical screening: Individuals with pre-existing conditions should consult healthcare providers before starting a weight training program 5

Common Pitfalls to Avoid

• Ignoring warning signs: Stop exercise and seek medical consultation if experiencing chest discomfort or undue shortness of breath 5
• Excessive weight: Using weights that are too heavy for current fitness level 1
• Inadequate rest between sessions: Not allowing sufficient recovery time between training sessions 3
• Neglecting proper warm-up: Failing to prepare muscles and joints for resistance exercise 1
• Overtraining: Excessive training volume increases injury risk 6

Weight lifting injuries are projected to continue increasing, with shoulder injuries alone estimated to reach 22,691 cases nationally by 2030 2. Proper education, technique, and individualized programming based on health status are essential to minimize these risks while obtaining the benefits of resistance training.