A Modern Meathead recently emailed me and asked: “Ben, how do I manage joint pain when lifting?”.

And while there isn’t a single, blanket answer to this question that applies equally to everyone…

The purpose of this Newsletter is to attempt to answer that question on a generalized, principle-based level so that you can troubleshoot your own pain in the gym.

Where do we start?

Assess Comfortable Ranges Prior to Loading

Many people make the mistake of haphazardly grabbing a pair of dumbbells or sitting down onto a machine with heavy loads without having assessed whether their body is comfortable with the positions that an exercise requires.

This often leads people to load motions that they can’t “get into” without a substantial amount of load “shoving" them into the positions that an exercise demands.

As a rule of thumb, I like to always take people through an exercise without any added load to begin with to ensure that their joint structures initially agree with where we’re trying to move.

For example, if someone is performing a leg press, I’ll first have them sit down without un-racking the weights, and I’ll ask them to move their leg(s) through the intended range of motion before even putting their feet onto the platform.

Another example: prior to executing a pull-down, I’ll have someone reach upward toward the cable to find where their hands and shoulders naturally move, so that we can start from a place that feels safe to their body and brain.

This doesn’t mean that these “non-loaded” positions are the be-all-end-all positions you should always use, but they serve as a good starting point for any motion.

Forces and our body’s response to them will undoubtedly change what feels comfortable for an individual, but I find that it never hurts to assess what ranges feel comfortable to begin with, without the added load first. Use the positions initially that feel more natural for a given motion.

Move Slowly Before Quickly

It might seem obvious, but more often than not, I find that people are not paying any attention to tempo (people with and without joint pain alike).

While there’s nothing inherently wrong with attempting to move a weight quickly, during initial learning and pain scenarios, I find it especially helpful to slow the exercise down and lighten the external load to promote pain-free relearning.

Slowing down the tempo of a lift - not at a snail’s pace, just in a controlled manner - will allow you concentrate on control.

But what is control? And how can we define it?

Controlling an exercise means that you’re resisting the resistance at every point in a motion.

That’s a mouthful. But think about it…

If you’re doing a bench press, the resistance is pushing your hands downward, toward the floor.

Many people “lower” the weights, though, without ever thinking about the fact that they need to be actively “pushing” as the bar moves down.

And this often results in people not moving the weight with control, but rather “dropping” the weight and then “catching” it in the bottom position - the position of highest joint force, regardless of tempo.

So, in the context of a bench press, control means always being able to resist (pushing up) the resistance (pushing us downward) at every point in the range.

You can apply this principle to any exercise:

• In a squat, it means always remembering to push yourself “upward” by keeping pressure downward, through the feet.

• In a lateral raise, it means always raising “upward” against a dumbbell even when you’re lowering your arms.

• In a pull-down, it means always pulling against the handle downward, even when you’re allowing the bar to move upward.

This kind of intent is completely natural during the concentric (shortening) portion of any exercise, but highly unnatural during the eccentric (lengthening) portion of any exercise because the resistance and where we’re moving are in opposite directions.

In short - slow down, and focus on resisting the resistance when you need to.

Adjust Resistance Direction & Joint Position

If you’ve taken care of the two principles above, but you’re still experiencing joint discomfort, it’s time to adjust resistance direction and joint positions.

Let’s look at the bench press example again.

Imagine you’ve done all the troubleshooting you can with finding the comfortable unloaded positions and controlling tempo (resisting the resistance), but something still feels off.

Now it’s time to play around with how the resistance relates to your joints.

To do this, you can do two things:

1. Adjust the resistance direction

2. Change the joint position

You may NEED to do both of these to do one of them, but not in all cases.

First, you could start by changing your grip width and arm path.

If you were pressing with a relatively wider grip before - and it’s painful - try to narrow the grip a little and see how that changes things.

If your elbows were flared before, maybe try tucking them more toward your sides.

If that doesn’t help, try adjusting the angle that you’re pressing at.

Sometimes, even a 5-10º difference in bench angle can make all the difference.

If the 5-10˚ angle still doesn’t feel great with the newer arm path/grip width, try to see how your original grip feels, but with the new bench angle.

You can continue to play around with these angle and grip width/arm path adjustments, and it’s likely that there will be some positions that feel completely fine while others still feel crummy.

The name of the game here is simply being willing to adjust these two variables until you find that combination that feels just right.

There is no “one-size-fits-all” position that everyone will feel great with. Investigate what feels right for you and your body.

As long as the exercise is generally targeting the muscles you’re trying to train, these kinds of adjustments have tremendous application.

Adjust ROM

Sometimes, all of the angle-adjusting, load-adjusting, and arm path/stance width adjustments just don’t seem to do it.

In my personal experience, I’m typically able to get someone out of pain immediately with all of the adjustments above, but with more stubborn cases, it won’t always work out cleanly.

Adjusting the range of motion that you utilize is another key variable to focus on when you’re trying to make strides in the painless direction.

If you’ve gone through a ton of different loading angles and you’ve changed the joint positions without much success, it might be time to investigate how abbreviating the range of motion feels to the problem area.

Continuing with our bench press example…

Let’s assume you’ve changed the pressing angle and arm path slightly, and you’ve helped your joint pain get to a 2-3/10 instead of a 6-7…but the joint pain only seems to appear in one portion of the range.

While seemingly obvious, I often find that people are reluctant to removing portions of range of motion, even when that portion of the range is painful.

Secret: you can just cut out that portion of the range and use the range that isn’t painful!

This doesn’t mean that you should avoid that portion of the range forever, but some issues require a temporary removal of the trigger in order to see positive results.

Back to the bench press - imagine that only the bottom 3-4 inches of the range hurt…just cut out that bottom portion, and use the range that’s pain-free!

You may find that utilizing the abbreviate range immediately opens up more range which is pain free - perhaps your body just needed a sign that it wasn’t in any real danger, and using the shortened range does just that.

What Else?

In addition to changing the joint positions and resistance directions, it’s important to remember that a joint is a joint, regardless of the direction that you load it.

For example…if you have elbow-related pain when you do biceps curls, but you don’t have elbow-related pain when you do triceps extensions, take advantage of the fact that you can still load the elbow in a direction, pain free.

Regardless of the specific muscles that you’re training, if you have a painful joint, it’s almost always a good idea to introduce force and motion to the problem area if you can.

This means that if you can’t find any way to do a curl that doesn’t hurt, that doing other elbow and forearm exercises is likely to aid in the healing process, as long as those motions are pain free.

In the case of elbow pain during curls: forearm curls and extensions as well as triceps extensions still all train the joints that the biceps do, just in a different way.

Another example of this…

I had a bout of acute back pain a couple of weeks ago. My left lower back pinched when I went to bend down to pick up my cat off the floor (I know…).

I didn’t panic, I assessed which spine motions felt ok and which didn’t, and for the next couple of days, I was back to pain-free living.

As soon as the “pinch” occurred, I felt that spinal extension (arching) and flexion (rounding) hurt, but side-bending and rotation didn’t.

So I went into the gym that day, and I trained side-bending and rotation motions, avoiding any flexion-extension pain triggers.

In my estimation, this dramatically reduced the timeline of pain, and I was back to loading flexion-extension directly after 48 hours.

A similar example in the case of the person with elbow pain while curling: instead of trying to do curls with the palm upwards, see how it feels to do curls with the palm in a “neutral” position, where the palm faces left or right, instead of toward the ceiling. You can also see how “palms down” curls feel, too.

Sometimes, training slightly different joint positions makes all the difference.

But there’s one more variable we can adjust within the context of the goal - resistance direction!

Let’s imagine that you’re only getting that elbow pain with standing DB curls, and that it hurts no matter how you adjust your grip and arm position.

Instead of using a DB, try using a cable, where the resistance direction is different depending upon where you’re standing. Or, try changing how the resistance of the DB interacts with you by using a preacher bench or something similar.

In any case, adjusting the resistance direction on its own may do the trick for you in the immediate-term, and you can get back to doing DB curls the way you were doing them after some time with these other variations.

Conclusions

I want to make it clear that all of the above are strategies that have worked for me personally and for clients over several years.

In the back pain example, I was able to troubleshoot the pain and work around it in a very short period of time. This likely means that the issue wasn’t severe at all, but this might not be the case for you or clients that experience similar things.

So, keep in mind that these strategies may not work for you. These strategies are ultimately my original methods for troubleshooting this stuff, which means that it may be difficult to translate this text into practice without specific application to your problems and clear visual demonstrations of what I’m illustrating across multiple contexts.

Some of you may be experiencing issues which have nothing directly to do with how you’re performing exercises. These issues are beyond my scope of practice, and you should seek professional help from physical therapists that have experience working with people that resistance train on a consistent basis.

Some issues may also simply need time to heal and trying to troubleshoot problematic exercises may be fruitless in the short-term. I’ve personally experienced joint pains that needed several weeks off from intense loading, and could only progress after that needed time off.

In any case, I hope this guide was helpful to serve as a general framework for troubleshooting pain and discomfort.

It isn’t going to be a “quick fix”, but understanding the principles in this Newsletter will certainly give you an advantage in troubleshooting pain and recovering from injury.

-Ben

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