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Sports Medicine

Big Lifts for Bad Joints

Don't let bad joints keep you from doing the big lifts you love. Avoid injury by training smart not soft.

Many lifters swear by the “big three” lifts. Now, there’s nothing flat out wrong with that – I mean, if you’re going to choose movements to live by, at least you’re choosing good ones, right? Squatting, benching, and deadlifting neglect very few major muscle groups. But if you have crappy knees, hips, or shoulders, they can throw off all your major movements and cause unwanted pain, making every rep grimmer than the Raptors’ playoff hopes. Rather than ditching such important exercises, a few little tweaks can make a world of difference in keeping you moving pain-free and shift the focus back to putting on muscle.

Lower Body: Knees and Hips

Bad hips and knees plague a lot of recreational and competitive lifters. When it comes to adding size and training with an emphasis on volume, sometimes alternate methods need to be employed that don’t involve full range squatting… for the time being.

Box squat for size

Throwing box squats into the mix does a few things. First, they allow the shins to stay much more vertical. This prevents the knee from tracking too far forward and promotes more stimulation for the glutes and hamstrings on the way up. Second, they can often lessen the depth achieved so the knees can be salvaged until they’re in better shape. Thirdly, it’s a common thing for a lifter to be “loose” at the very bottom range of a squat rather than tight. This looseness compromises the tensile strength of the knee joints and the weight takes an unwanted toll as a result. Set up a box to ¾ your typical range and focus on firing up with the glutes and hamstrings on the positive half of the lift. Lighting up your posterior chain is the first step to avoiding hip and quad dominance, and sending knee pain to the crypt.

Lunge backwards

Lunging seems like it’s pretty straightforward, so who cares whether you do it forward or backwards? You end up in the same position either way, right? Wrong. Lunging backwards takes the emphasis off the hips and quads and places it on the glutes. As a bonus, the shin on the front leg, as with box squats, stays much closer to vertical. Second, in a forward lunge the forward momentum puts a lot more stress on the knee joint as the quads on the lead leg have to eccentrically contract a lot more strongly to decelerate the body in its forward motion. Try adding a deficit to your reverse lunge with a box or step and enjoy the added work the glutes have to go through. Be prepared for more energy expenditure. Here’s a video to help you get the idea:


The elbows and shoulders aren’t in the clear when the upper body is put under the spotlight. Here are a couple general rules of thumb that will help to avoid shoulder and elbow pain:

Train Your Upper Back – Bigtime!

Doing so will promote scapular stability so that your rotator cuff muscles will have strong bases of support in a tight upper back. Incorporate rows from all angles to accomplish this. The ratio of pulling to pressing work in your routine should be at least two to one.

Avoid Internal Rotation

We have to be aware of what positions our shoulders are in when we bear weight. Exercises like bench dips and upright rows can be contraindicated because of the compromising position it puts the shoulder in (more on that later). Remember to look at the body from a holistic approach. Taking a look at muscles that surround pain sites are a good place to start.

Low Incline Dumbbell Bench Press (aka, Your New Best Friend)

It’s been exhaustively researched that the bench press has the least functional application out of any of the big barbell movements. But it’s just so fun! The universal “indicator” of upper body strength, the flat barbell bench press remains a staple in every lifter’s training program as a primary chest developer. The truth is, for people with bum shoulders, it can do more harm than good. We’re not being friendly to our shoulders in this exercise for a few reasons. First, we’re once again bearing load from an internally rotated position. That causes grief for the poor bursae that rest in the shoulder capsule and rotator cuff muscles alike. This position gets worse when benching incorrectly with an insufficient back arch, very wide grip and a deep elbow position at the bottom of the rep.

A Quick Tip

When it comes to bench pressing, technique can be the make or break factor. Make sure you’re tucked in with a solid arch, your chest is high and your elbows aren’t flared. Take a width that’s slightly narrower than you’re used to using and see if the movement still causes you shoulder pain. If it does, then some alternatives may be the trick.

Use a football bar


Hopefully you have access to one of these handy accessories. If not, they’re a great investment. The football bar enables a lifter to lift heavy using a hammer grip. The head of the shoulder can roll backwards to a much more desirable and pain-free position, which will place more of the stress on the chest and triceps during the bench press.

Load Up the Pin Press

Pin presses allow the lifter to go heavy without worrying about the bottom few inches of the ROM. This is a blessing in disguise for a lifter who struggles with shoulder pain. The fact that the elbow doesn’t have to drop below the plane of the bench means it’s further away from impingement territory. Pin presses can be your new best friend. To do them, set up the safeties in the power rack about 4 inches off the chest and load a barbell with your desired weight. Slide a free bench in the power rack and position the bar over the chest. Get tight, and drive the bar up to a full bench lockout. Lower the weight back to the pins. You can let them crash – just make sure those safeties are secure!

Use More Dumbbells

Often times people think dumbbell training is harder on the joints because you’re now relying more on your connective tissue to stabilize the load for each limb rather than a barbell. In the case of the bench press however, they present a great feature for ensuring integrity of movement at the elbow joint. If you can’t get hold of a football bar, using dumbbells is the next best thing. With dumbbell presses your elbows can be brought in closer to your sides because your arms and hands aren’t limited to a fixed position on the barbell. You can therefore find your comfortable area and way to bench. On top of this, the pecs and triceps can’t compensate for one another.

Elbow Stress: Rarely from Arm Training

People often tend to think that elbow pain comes from an imbalance in biceps and triceps training. Truth be told, the answer lies in other exercises. If the tissue on the front side of your body is in bad condition, it’s going to affect the ROM you can achieve at the shoulders. Tight pecs and shoulders will have a negative effect on exercises like squats and presses where the hands and shoulders need to be in a very externally rotated and flexible position for the lift to be performed correctly and safely. When your hands are confined to a bar (say, on your back), your elbows will take a lot of stress if tight muscles aren’t making that position comfortable. As further measure to avoid muscle pain before big lifts, get into the routine of using a foam roller to loosen up deep tissue in the pecs, shoulders and lats.


In general, we don’t have to avoid big lifts and train like a softy because bad joints are giving us the heave-ho. We just need to train smarter. A few subtle shifts to common classics can keep you building muscle and adding size while staying pain-free. So you can jump for joy…well, on second thought, do it once you take care of those knees.