Lifting weights is safer than you think

It is widely accepted that lifting weights is incredibly beneficial for us, and yet social media is inundated with fitness professionals telling us how not to get hurt. And while many medical professionals seem almost excited to tell us never to deadlift again, no one ever tells us how we are supposed to pick our groceries up off the ground. There is endless fear mongering in the fitness industry, and most of it comes from well-meaning individuals who do not truly understand the actual risks of resistance training. With misinformation abounding, let’s clear the air on what the evidence says, and why we really should not be afraid to lift. 

It is well understood how important exercise is for our health, but it bears repeating; exercise is the most potent longevity drug we have. Adding in one to two hours of resistance training alone shows a 20% reduction in all cause mortality in any given year, otherwise known as dying from anything. Combine that with some aerobic training, and your chance of not dying increases to 40%. There is even evidence that grip strength, as a proxy for the overall strength of your body, is a more powerful predictor of your overall health risk than your blood pressure. And while exercise can profoundly impact our health, the data is clear on its safety. The best estimation we have on injury rates in resistance training comes from Serafim et al, which saw .24 to 1 injury per every 1000 hours of resistance training. By the highest end of this estimation, if you trained 3 times a week, you might expect to experience injury every 6 and a half years! Compare that to running, which actually has an injury rate of between 2.5 and 33 injuries per every 1000 hours, and resistance training is clearly the safer activity. 

So why then is there such a pervasive belief that lifting weights is dangerous? For one, we often conflate injury with pain. At a fundamental level, pain is a normal part of the human experience. Everyone will experience pain at some point, but we tend to pathologize the experience, assuming that every time we experience pain it indicates something that needs fixing. But pain is multifactorial, meaning, there is likely more than one reason why you might experience pain at any given time. An evidenced based physical therapist should be a major part of your healthcare team, as they can help you navigate what your aches and pains mean, and what they don’t mean. 

But it pays to be negative, and there are countless people in this industry who make a living selling a negative, fragile view of the human body. It is much more profitable to sell a black and white solution than to approach a complicated situation with nuance. So many on social media make a living off of ‘fixing’ peoples’ pain, who have absolutely no qualifications to do so. These people are charlatans who should be exposed for what they are. Tell me again how your tib raises are going to fix my back pain. 

So while pain is a normal experience, many of us lack the tools to adequately navigate these experiences. We get fed a message of fragility and negativity, which is much more powerful due to a psychological phenomenon called the negativity bias. This general bias towards negativity is a well documented phenomena, in which we have a higher propensity to remember and learn from negative information and experiences compared to positive ones,  and everyone can remember the story of the first time we hurt ourselves. I remember so clearly the pop I felt in the outside of my right foot when I was 12, as I turned to push the push the ground away in the suicide sprint I ran that morning. And we love to tell these stories to our friends. I don’t often remember the thousands of reps of snatches or clean and jerks I performed successfully, but I have a vivid memory of the rep I attempted at 225# in which I tore the UCL in my right elbow, effectively ending my olympic weightlifting career. We sensationalize the rep in which we hurt ourselves, but forget the thousands of reps we completed beforehand safely. 

In addition to the way our brains are wired to fixate on negative experiences, negative expectations can be a self fulfilling cycle. Most of us are familiar with the placebo effect, i.e. the benefit that we get from partaking in an activity that we believe is good for us, but few understand just how powerful it is. It has massive implications in our life in areas like the results we see from physical treatment from acupuncture, to the way our bodies respond to weight loss protocols. In a landmark meta-analysis done in 2017, sham surgery was found to be as effective as actual surgery in reducing pain and disability, with the authors citing the placebo effect as the major reason why. In the placebo effect, positive expectations lead to real physiological positive outcomes, but in the nocebo effect, the opposite happens. Nocebo has been studied less than placebo, due to ethical considerations, but its effects are just as powerful. When everyone in your life is telling you that deadlifts are bad for your back, the second we feel a strain in our back during an intense lift, we are more likely to view that as negative, and potentially lead to a pain experience. In this way, our negative expectations essentially become self fulfilling.

Getting hurt and being in pain is inevitable as a human. Frankly, it would be impossible to live a life free of pain and injury, and to attempt to do so would be to deny ourselves the sort of life actually worth living. But these negative experiences have an outsized impact on our conception of risk, and alongside the barrage of constant negative messaging creates a negative self fulfilling cycle. But the real risk of injury in resistance training is exceptionally low, especially when we compare it to the potential benefits. Charlatans want to convince you that you are fragile, and we are more likely to believe them. But when that bias leads us down the path of expecting the worst to happen, it inevitably does. As we age we tend to view lifting weights as too ‘risky,’ however, when we look at the data, the real risk is in not exercising.