What is Powerlifting?

Powerlifting consists of 3 disciplines; squat, bench press, and deadlift—and 2 divisions. In the classic division of powerlifting, the only supportive equipment allowed is a lifting belt, neoprene knee sleeves, and wrist wraps. In the equipped division, a squat and deadlift suit, knee wraps, and a bench-press shirt are allowed.  In competitions, the powerlifter has 3 attempts in each discipline, and the best lifts are added together to get a total weight. External loads up to 4 times the body weight can be lifted in competition settings. There are some variations on equipment depending on the federation an athlete competes in, but broadly speaking the two main divisions are ‘raw’ (classic) and equipped. You can find out more about powerlifting here.

Powerlifting Injury Rate

Despite the massive loads that can be involved with powerlifting, research has shown that the injury rate seems relatively low (1 - 4.4 injuries per 1000 hours trained). This is contrary to a lot of people’s beliefs which equates to high loads to higher rate of injury, a common misconception in a lot of sport and training environments. 

When discussing injury, we can define this as a condition of pain or impairment of bodily function that affected powerlifters’ training. Research by Stromback et al 2018 found that the most common sites of injury were the lumbopelvic region, shoulder and hip. While women experienced injuries more frequently at the neck and thoracic (upper back) region when compared to men, which is something that has not been regularly researched previously. The athletes in the study were asked to report their own thoughts as to the cause of their injuries:

• 23% stated that the injury/injuries were caused by an excessively high training volume and/or intensity

• 6% stated poor technique

• 6% stated poor mobility

• 24% stated other factors. 

While the reasons for injuries occurring are subjective and open to an individual’s own bias and beliefs, it still gives an interesting insight into cause of injury that fall in line with similar thinking and conclusions across sport generally. 

How Can We Prevent Injury? 

As more and more research is developed around injury prevention, there has been a lot of confusion and questioning of the terminology. Injury is no longer thought to be an A + B = C equation and, in actual fact, can be difficult to pin down a single underlying cause of injury. Injury and tissue breakdown is now understood to be multifactorial. However, by flagging issues that may contribute to injury, we can implement strategies looking to reduce these vulnerabilities. 

Below is a list of variables which may affect injury rate, and what can be done to minimise the risk. 

Training and Load Management

Strength training as an intervention is widely used within a range of sports, not only for performance but also to help protect the joints and create greater work capacity. Alongside the research I spoke about above, we can conclude that strength training can be safe and beneficial to a wider population than just powerlifters, strongmen and weightlifters. So how do we then prevent injury if strength training itself is an injury reduction tool for many already?

Much like with other sports and training methods, too much of a good thing can be detrimental. By this I mean rapid increases in your training stress, either a ramp up in volume (sets and reps or training days), return to training (and trying to hit previous training numbers) after a break, or a sudden jump in intensity can all be big contributing factors to tissue breakdown. This is particularly true if alongside this we don’t allow adequate rest and recovery, insufficient dietary intake or inadequate sleep.

So, clearly the first step in trying to prevent or reduce injury is to understand and implement progressive loading alongside adequate recovery strategies and monitoring your response to training and lifestyle stressors that may affect your training. The easy solution is to hire a coach to help construct a programme that follows progressive overload, but that is also able to make adaptations around your needs. There is plenty of literature and content that you can use to put together your own programme, creating more structure. This is all easy enough to write down, but in the real world this is an on-going process of understanding your response to training and when to hype or hold back and a continuous conversation with coaches and peers, discovering the balance between your maximal recoverable volume and minimum effective training dose.

Injury History 

As I said previously, it’s hard to pin point the exact cause of injury and therefore hard to know what interventions are truly preventative. However, research has described previous injury as the greatest risk factor for future injury. This may be down to inadequate rehab and early return to full training or spiking up training too quickly, not improving load tolerance and tissue capacity during rehab by not progressing intensity and even beliefs around the cause of injury. 

Knowing this allows you to adapt your prep/warm up and what accessory exercises you may want to implement into your powerlifting programme. This could be targeting a weakness or mobility issue, aiming to avoid disruption to training time by avoiding re-injury. When constructing your prep/warm up, exercise selection should be looking to both prepare you for the session but will also have a long-term effect when completing this prep consistently. For example, working on hip rotation day to day will have a positive effect on squatting for that session by releasing any acute tightness, but also see long term changes in mobility by consistently targeting hip tightness. This can also be true with shoulder issues where tendons can still be a bit sore following issues such as impingement and tendinopathies. Introducing position specific exercises such as isometrics can prepare the tendon for exercises such as bench press. Reducing tendon soreness, increasing stability and seeing long-term effects through reduced sensitisation at the tendon, and with appropriate progression tendon adaptation/strengthening will occur. 

When including accessory work in light of injury history, exercises that address tissue weakness, sensitive movements, imbalances and stability are required. There are a number of different approaches and exercises that can be brought into your programme. The key thing to remember is that these want to follow the same training principles as your main lifts, ensuring that you are overloading the tissues and the effort and loading should reflect the physical stress and load you are putting on the tissue going into peak weeks and competition. It is worth having a conversation with your Coach/Physio/Sports therapist to discuss ways to target the appropriate tissues. In a lot of scenarios these accessory exercises shouldn’t look dissimilar to exercises during rehab, just that the intensity and volume may be greater. 

Daily screening/base markers/adaptations 

The majority of powerlifters will not have a support team around them day to day to assess and flag any issues. It is therefore beneficial, as an athlete, to incorporate some self-monitoring or daily screening to assess your movement and/or fatigue levels on a given training day to make appropriate changes to your prep and even your programme. 

It has been common practise over the years to have screening as part of an athlete’s pre-season and then at stages in the competitive season. This can help direct focus on particular issues and weaknesses within a programme. Turning your annual screening into more of a daily screening or self-monitoring can be a great tool to not only monitor improvement but also declines in certain individual norms. For instance, if we see a reduction in ankle mobility or shoulder internal rotation over a period of days, this could be a red flag highlighting higher risk of injury. Naturally, this may be as a result of fatigue which is normal but by testing this you are able to include targeted exercises into your warm up to correct the deficit. On the other hand, this could also be a sign of consistently missing out mobility work, onset of illness or overload of structures. 

Alongside this idea of monitoring changes in movement, we can look at how well we have recovered from previous sessions (training wearables can give a lot of info on this) and general fatigue from everyday life (external stressors). We can do this objectively by monitoring things like vertical or horizontal jump, observing if changes are as expected, and subjectively, using rate of perceived exertion (RPE) scales (1-10) for fatigue levels before training and then also intensity of the session. This can give us an indication of training stress (again, training wearables can do this very well) and whether this relates to how you expect to feel at this point or if your scores are higher than predicted. 

By using these methods, taking into account the needs of powerlifting and you as an individual, you are able to combine the information allowing you to be proactive rather than just reactive. Whatever strategy you use to self-screen and monitor, the more you do this, the more you understand what is a normal response for you and what may be a strong indicator of injury risk. 

Summary 

Injury prevention in sport has become a lot less about comparing yourself to a certain model and is rather about understanding your individual needs and responses to both training and external stressors. The above strategies are simple and effective ways reducing injury risk. By implementing these consistently, you can start to understand yourself as an athlete and recognise patterns individual to you, making your overall programme bespoke and not just another online cookie cutter plan.