Physio Corner: How's Your Form?

26th March

You hear the f-word everywhere at Gymbox. Form. Whether you obsess over it or have stuck it on the back burner for future you to worry about, there’s plenty of us that could do with a bit of expert advice. Matt Ramsdale from Capital Physio is a regular fixture down at Gymbox Farringdon, providing treatment and support to help our members get the best from their workouts. Today he sheds some light on the matter of form, as he explains what not to do and why it’s worth our time.

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Whenever you complete an exercise, whether it’s benchpress, squats or deadlifts, there is always an emphasis on getting the correct form. I’m sure many gym-goers have spent hours on YouTube watching videos of the correct form for exercises and then try and copy it the next day. Because surely if you don’t perform an exercise with this perfect form it won’t work the muscles properly or you can cause an injury, right? This blog will look to discuss exercise form, from a physiotherapist’s point of view, looking at injuries related to form, ‘good form’ itself and whether with some activities, form may not be as important as first thought.

Firstly it is important to clarify what ‘form’ is. Form is a specific way of performing a movement, likely a strengthening exercise, in order to prevent injury and get positive gains (strength). Form covers a wide range of aspects, from range of movement, starting posture, hand position, spinal position… the list goes on. There is a lot to think about, making it very tricky to get the ‘perfect form’. Although with every exercise there is often an ideal form, I feel that this should be a guide for people rather than a must to copy exactly. Everyone is made up differently – obviously! Therefore for some, having the ideal squat form is difficult due to joint mobility, tissue elasticity, coordination etc. Can they still perform the exercise? Absolutely. Will it look exactly like the person you saw on Instagram? Maybe not. But it doesn’t mean the exercise is not working your quads or glutes.

Range of movement is a very important aspect of form, you can get set in a perfect position with heavy weights, but if you’re not exercising through range then you may not be getting the results you want. Limiting range during an exercise could have several implications. Firstly, by not completing an exercise through range, you may not fully using the intended muscle by working stabilising muscles instead. At the same time, you may not be activating the stabilising muscles and just working one muscle group rather than multiple.

Another issue with reducing range during exercises is that this may limit range of movement at a joint otherwise. If a muscle or muscle group are repeatedly exercised in a reduced range, this may have an impact on the range of movement seen at the joint in day-to-day life, as the muscles are not used to being stretched through range. An example of this would be bench press with a bar bell. A repetition of bench press, through range from extended arms down to your chest has more benefits than if you completed a repetition with quarter or half range.

Firstly, a full range press will not only work your pec major but will involve your deltoids, triceps and biceps. In restricted range these stabilisers may not work as hard. At the same time, not completing a full rep towards the chest may have an impact on pec tightness, causing a more protracted posture and having an effect on shoulder range of movement. For most people, most importantly, working through range can have better improvements in strength, as you would likely be completing more controlled, longer repetitions.

Away from building strength and muscle, the most important reason most people look to correct form is to prevent injuries. Injuries that occur during exercise usually are down to a number of reasons rather than a single one. Usually a mix of fatigue, excessive weight or load, form, flexibility and weakness contribute to an injury, injuries are rarely caused by just one of these factors. The chances of injuring yourself whilst working out just because of poor form is unlikely, but this definitely contributes, especially if the poor form is repeated.

Poor form can cause injuries in a number or ways; first of all poor form could be one area of your body trying to compensate for a weaker area when the load is too heavy. An example of this would be the lat pulldown- you may see people starting upright and then as they pull down they arch backwards (lumbar extension) and lean to move the weight, often this will be due to weight being too high. As you arch backwards you are using your lumbar spine (low back) to pull the weights rather than your lats or other shoulder/back muscles. Repeatedly loading your back in this position could have a negative effect and you potentially could sustain an injury to a muscle or your spine in your lower back.

Another form-related issue that could lead to an injury is when a particular joint is being forced into an unnatural position and therefore have an increased load as a result. An example of this would be a squat or single leg squat. Some people find it hard to squat or single leg squat without their knees dropping inwards (medial drop). This is often due to a weakness higher up in the hips or an issue with control around the knee. If the squat is also weighted with this medial drop then there would be a massively increased stress on the inside of the knee. This could have an impact on knee stability, as well as potentially worsening or causing an injury to ligaments or cartilage in the knee. It is important with any exercise, as well as researching the correct form, to make sure you are completing the exercise in a similar manner. You can do this by using a mirror for exercises, use a friend to film or get the help of a PT or physio to help with form. It is also important to safely increase weights as this increase in load could have a detrimental effect on joints.

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A current, fairly controversial, ‘hot topic’ within physiotherapy is related to lifting and the back. For years everyone has been told that you must lift with a straight back and bend the knees;that bending your back would definitely lead to a back injury, likely a disc injury. It has been argued that lifting technique doesn’t actually make a difference to the incidence of injury. The first argument is that it is impossible to keep a completely neutral spine anyway when lifting something. You will always have to go into a degree of flexion.

A study by Kingma et al. found that lifting an object in the traditional (squat) technique caused 4% less load through the tissues than the stoop technique (bent back) indicating that this classic technique of lifting isn’t too different from the forbidden kind. So to relate this to exercise we can take the dead lift, arguably the hardest exercise which truly tests a person’s strength. The ideal form is with bent legs, neutral spine with your head up, lifting the bar straight up and then back down, making sure you definitely don’t bend your back!

Even with the pictures and videos where it is explicitly advised to not flex your back, there is still some spinal flexion, it’s hard not to when you’re picking something up off the floor. This, for most people, is an unreasonable position to get into, hip mobility, hamstring tightness and shorter limbs are just a few reasons why some people may not be able to perform the ‘perfect deadlift’. If you look at the greatest deadlift of all time, Eddie Hall’s 500kg deadlift in 2016, he performs this with some spinal flexion- would you tell him that his form is a little off? I wouldn’t!

My advice for deadlifts would be to perform them how you feel comfortable, if you are able to keep a neutral spine and feel comfortable with this then that’s fine. If you have to stoop slightly and lift with a slightly flexed spine do that instead. Just performing one exercise slightly differently from the norm won’t suddenly mean your back will fall apart. The back is the one of the strongest areas of your body and needs a certain degree of load to stay strong.

Overall from this blog I hope the takeaway is that yes form is a good thing, it can prevent injury and improve strength. However it should not be the be all and end all of exercising. If you deviate slightly from the ‘perfect form’ you can still build muscle and you won’t necessarily get injured, everyone is different and one form definitely cannot be generalised for every body!

Capital Physio treatment rooms are located in our Farringdon & Holborn branches, get booked in now

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