Built to Last: Dr. Matt's Guide to Injury Prevention and Sustainable Fitness

Here's something that might surprise you: the two biggest predictors of a long, healthy life aren't your genetics or your diet - they're your cardiovascular fitness and muscle mass. The research is becoming crystal clear on this, and it's revolutionizing how we think about fitness and aging.

Think about that for a second. Your ability to climb a flight of stairs without getting winded and carry your groceries without struggling aren't just quality of life issues - they're literally life-and-death markers of longevity.

Recent studies are showing that:

• Higher muscle mass is associated with better insulin sensitivity, stronger bones, improved cognitive function, and all the other things you'll see in an infographic below.

• Greater cardiovascular fitness correlates with reduced risk of almost every major chronic disease

• The combination of both significantly reduces all-cause mortality

  

  More benefits of just improved muscle mass and strength (I'm biased)

  
  

Yet here's what I see in my practice every day: people letting the fear of injury, gym anxiety, or occasional discomfort keep them from training. They're literally avoiding the very things that could add years to their life because they're afraid of a temporary setback.

I get it. The gym can be intimidating. Training can be uncomfortable. And yes, injuries do happen. But here's the truth: the risks of NOT training far outweigh the risks of training, even if you're not doing everything perfectly.

That's why I wrote this guide. After years of working as both a chiropractor and a fitness coach, I've identified the key factors that lead to gym injuries and, more importantly, how to work around them.

Because here's what you need to understand:

• Most gym injuries are preventable

• Almost all injuries are workable (meaning you can train around them)

• The occasional tweak or strain is part of the process, not a reason to quit

• Smart training isn't about avoiding all discomfort - it's about managing it intelligently

  
  

In this guide, we're going to break down everything you need to know about staying healthy while training hard.

You'll learn:

• The main reasons people get hurt in the gym

• How everything in your body is connected (and why that matters)

• The fundamental movement patterns you need to master

• How to work around pain without losing progress

• The keys to long-term sustainability in your training

  
  

Remember: your body is built to move, to adapt, to get stronger. It's incredibly resilient when given the right stimulus and recovery. Don't let fear of injury rob you of the strength and fitness that could quite literally save your life down the road.

The Sedentary Crisis: Fighting Back Against the Sitting Disease

Let's face reality: we're living in the most sedentary time in human history. The average American spends 9-10 hours per day sitting, and I see the effects of this every single day in my practice. Our bodies weren't designed for this much inactivity, and it's wreaking havoc on our health.

Here's what prolonged sitting does to your body:

• Weakens your gluteal muscles

• Tightens your hip flexors

• Creates forward head posture

• Reduces core stability

• Weakens your upper back

• Decreases overall mobility

• Reduces blood flow and cardiovascular health

But here's the good news: strategic training can help combat these effects.

Let's dive in and learn how to:

Train Smart, Stay Strong, and Build a Body That's Truly Built to Last.

Technique: The Foundation of Safe Training

Poor technique isn't just about looking bad - it directly influences where stress is applied in your body. Think about the squat: shift your weight forward, and you'll dump more stress into your knees. Rock back too far, and your lower back takes the brunt. Neither scenario is ideal.

What I see in my practice all the time is people getting caught up in moving heavy weight without mastering the basics.

Here's what proper coaching should focus on:

- Even distribution of stress across joints

- Movement patterns that respect individual anatomy

- Progressive loading that allows technique to stay solid under heavier weights

Real-World Example:

If you're getting knee pain during squats, we might find you're shifting forward excessively. By learning to distribute weight more evenly and engaging your posterior chain (think glutes and hamstrings), we can often resolve the issue while actually improving performance.

Total Training Volume: Finding Your Sweet Spot

Here's something I tell my clients constantly: your body can only handle so much work before it breaks down. It's like a cup - you can only fill it so full before it overflows. The research backs this up consistently, showing that excessive training volume correlates strongly with injury risk.

The key is finding YOUR optimal volume, which depends on:

- Training age (how long you've been lifting)

- Recovery capacity

- Current stress levels

- Sleep quality

- Nutrition status

Volume Spikes: The Silent Killer

This is huge, folks. One of the fastest ways to get hurt is by suddenly ramping up your training volume. I see this all the time - someone gets motivated, jumps from training 2 days a week to 5, and within a month they're in my office with an overuse injury.

Smart Progress Example:

Instead of jumping from 3 sets of squats to 10 sets overnight, try:

- Week 1-2: 3 sets

- Week 3-4: 4 sets

- Week 5-6: 5 sets

And so on. Your body adapts much better to gradual changes.

Training Background: Experience Matters

Here's an interesting stat: lifters with less than a year of experience are significantly more likely to get injured. This makes sense when you think about it - they haven't built up the foundational strength, movement patterns, and body awareness that experienced lifters have.

If you're new to training, remember:

- Focus on technique before weight

- Progress slower than you think you should

- Build a base of general fitness before specializing

Previous Injuries and Individual Differences

This is something I deal with daily in my practice - everyone's body is different, and previous injuries create unique considerations. Two people can do the exact same program, and one might get knee pain while the other develops back issues.

The key is understanding your body's history and adapting accordingly:

- Strengthen previously injured areas gradually

- Pay extra attention to form on exercises that stress old injury sites

- Don't ignore minor aches that persist

Fundamental Movement Patterns: The Building Blocks of Training

Listen up, because this is absolutely crucial to understand - whether you're trying to build muscle, get stronger, or just move better, everything comes down to six fundamental movement patterns. I can't tell you how many times I've seen people in my practice who've gotten hurt because their program ignored one or more of these patterns.

Let's break them down:

1. The Squat Pattern

This is more than just barbell squats. It's any movement where you're lowering your body by bending at the hips and knees while keeping your torso relatively upright.

Examples include:

• Air squats

• Front squats

• Goblet squats

• Box squats

Why it's crucial:

This pattern is essential for everything from picking up your kids to getting out of a chair. Plus, it's one of the best ways to build lower body strength and maintain hip mobility.

2. The Hinge Pattern

Think of this as bending forward from the hips while maintaining a neutral spine. This is probably the most important pattern to master for protecting your back.

Examples:

• Deadlifts

• Kettlebell swings

• Romanian deadlifts

• Good mornings

Why it's crucial:

This is how you properly lift things off the ground. Master this, and you'll dramatically reduce your risk of back injuries.

3. The Lunge Pattern

Any single-leg movement where one leg steps away from your center of mass.

Examples:

• Forward lunges

• Reverse lunges

• Walking lunges

• Split squats

Why it's crucial:

Life happens on one leg at a time (walking, running, climbing stairs). Plus, unilateral training helps identify and fix imbalances.

4. The Push Pattern

This includes both horizontal and vertical pushing movements.

Examples:

• Push-ups

• Bench press

• Overhead press

• Dips

Why it's crucial:

Pushing strength is essential for everything from putting groceries away to maintaining shoulder health.

5. The Pull Pattern

Again, both horizontal and vertical pulling movements.

Examples:

• Pull-ups/chin-ups

• Rows

• Face pulls

• Lat pulldowns

Why it's crucial:

In our desk-bound world, pulling movements are essential for maintaining good posture and shoulder health. Plus, a strong back is your insurance policy against injury.

6. The Carry Pattern

Simply picking up something heavy and walking with it.

Examples:

• Farmer's walks

• Suitcase carries

• Waiter's walks

• Overhead carries

Why it's crucial:

This might be the most functional movement of all - how often do you need to carry groceries, luggage, or other objects?

Program Design Principles:

Here's how I structure programs around these patterns:

1. Include All Patterns Weekly

   • Minimum 2-3 times per pattern per week

   • Vary the exercises within each pattern

   • Balance pushing and pulling volumes

2. Progress Systematically

   • Master bodyweight versions first

   • Add load only when form is solid

   • Vary intensity and volume, not just weight

3. Consider Movement Quality

   • Each pattern should be pain-free

   • Focus on control throughout the range of motion

   • Pay attention to end-range strength

     
     

Common Mistakes to Avoid:

• Overemphasizing some patterns while neglecting others (looking at you, bench press-only folks)

• Jumping to advanced variations before mastering basics

• Not maintaining balance between opposing patterns (push/pull ratio)

• Ignoring carries (seriously, these are game-changers)

Remember:

A well-rounded program hits all these patterns consistently. If you're missing any of these in your training, you're leaving gains on the table and potentially setting yourself up for problems down the road.

Joint-By-Joint: Why Everything's Connected

Here's something I see constantly in my practice - someone comes in with knee pain, but the real problem starts at their hips or ankles. This concept is called regional interdependence, and understanding it is absolutely crucial for both preventing and rehabbing injuries.

Think about your body as a chain of joints, each with a primary need:

• Feet: Stability

• Ankles: Mobility

• Knees: Stability

• Hips: Mobility

• Lumbar Spine: Stability

• Thoracic Spine: Mobility

• Scapula: Stability

• Shoulders: Mobility

  
  

  When one area isn't doing its job, the joints above and below have to compensate. This is where problems start.

Real-World Example:

Let's say you have limited ankle mobility. When you squat, instead of your ankles bending properly, your feet might collapse inward (pronation) to get depth. This creates a chain reaction:

• Knees track inward

• Hips internally rotate

• Your butt winks and your lower back compensates.

  
  

Next thing you know, you've got knee pain or a pissed-off lower back - but the real problem started at the ankles.

Training Priorities: Building Resilience for Modern Life

Based on our understanding of how joints work together and the challenges of modern living, here's how I prioritize training with my clients:

1. Master the Fundamentals

   • Breathing mechanics and core control

   • Basic movement patterns (squat, hinge, lunge, push, pull, carry)

   • Focus on quality before adding complexity

2. Build Your Foundation

   • Posterior Chain Strength (your "anti-sitting insurance policy")

     • Smart deadlift variations scaled to your level

     • Hip thrusts and bridges

     • Romanian deadlifts and hamstring work

   • Core Stability (not just crunches)

     • Planks and variations

     • Dead bugs and bird dogs

     • Pallof presses

   • Upper Back Strength

     • Face pulls and band pull-aparts

     • Row variations

     • YTWLs for shoulder health

3. Address Mobility and Stability

   • Targeted mobility for mobile joints (ankles, hips, thoracic spine)

     • Hip CARs and 90/90 stretches

     • Thoracic mobility work

     • Ankle mobility drills

   • Strategically reinforce stable joints (feet, knees, lower back)

     • Shoulder blade stability work

     • Knee alignment work

     • Core brace/control exercises, technique utilization

4. Daily Movement Habits

   • Move every 30-45 minutes

   • Morning mobility routine (5-10 minutes)

   • Quick office breaks:

     • Hip flexor stretches

     • Doorway Pec stretch

     • Office Chair Lat Stretch

     • Some quick foam-rolling

     • Band pull-aparts

     • Bodyweight squats

5. Progressive Loading

   • Master bodyweight before adding load

   • Focus on movement quality overweight

   • Build volume gradually

   • Maintain balance between movement patterns

Key Principle:

Every training decision should consider both performance goals AND lifestyle demands. We're not just training for strength – we're building resilience against modern sedentary habits.

Remember: Mobility without control is dysfunction waiting to happen. Your goal is to build a body that's both strong AND adaptable to daily demands.

Pain: Understanding It, Not Fearing It

Let me tell you something I tell my patients every single day: pain doesn't always equal damage. This is huge to understand. As both a chiropractor and someone who trains hard, I've learned that some discomfort is part of the process - the key is knowing how to interpret it and respond appropriately.

The Pain Scale: A Practical Approach

Here's my general rule of thumb:

• 0-3/10 pain: Generally safe to train through with modifications

• 4-6/10 pain: Time to make significant modifications

• 7+/10 pain: Stop and reassess

But remember, these are guidelines, not hard rules. Context matters.

When to Train Through It

If you're experiencing mild discomfort (3/10 or less):

• Movement actually improves the pain

• Pain subsides quickly after warming up

• No sharp or shooting sensations

• Pain doesn't worsen during or after training

• No significant change in movement patterns

  
  

Getting Creative with Modifications

Here's where many people go wrong - they completely avoid training when dealing with minor pain. Instead, try these approaches:

1. Modify the Range of Motion

   • Find your "pain-free range"

   • Work within that range

   • Gradually expand it as symptoms improve

2. Adjust the Load

   • Reduce weight but maintain quality movement

   • Sometimes going heavier with better form actually feels better

   • Use different loading tools (bands, machines vs. free weights)

3. Change the Tempo

   • Slow down the eccentric (weight lowering) phase

   • Pause reps to maintain control

   • Eliminate momentum

4. Alternative Exercises

   • Same movement pattern, different variation

   • Example: If back squats hurt, try:

     • Box squats

     • Goblet squats

     • Split squats

     • Belt squats

Real World Example:

Let's say your shoulder is bothering you during bench press. Instead of skipping all pressing movements, you could:

• Try floor press to reduce range of motion

• Switch to neutral grip dumbbell press

• Incorporate more push-ups

• Focus on unilateral work

• Experiment with different machines for similar movement patterns 

When to Be Concerned

Red flags that indicate you should seek professional help:

• Pain that consistently increases during activity

• Pain that's sharper than 3/10

• Pain accompanied by numbness or tingling

• Significant weakness

• Pain that doesn't improve with rest

• Night pain that affects sleep

• Pain accompanied by swelling or redness

The Mental Game

This is crucial: don't catastrophize minor pain. I see it all the time - someone feels a twinge and immediately assumes the worst.

Remember:

• Pain is information, not a death sentence

• Your body is incredibly resilient

• Most issues are temporary and manageable

• Stay positive and solution-focused

My Clinical Approach

When patients come to me with training-related pain, here's what we do:

1. Identify the irritating movements

2. Find modifications that allow continued training

3. Address any contributing factors (mobility, stability, technique)

4. Create a plan to gradually return to normal training

5. Implement preventive measures for the future

Remember:

The goal isn't to never experience discomfort - that's unrealistic if you're training hard. The goal is to respond intelligently to pain when it occurs and use it as feedback to improve your training.

Here are some concepts to prioritize to minimize the chance of random pains in general:

Priority Training Areas for the Modern Human

• Posterior Chain Strengthening

  • Smart Deadlift variations (scaled to your expertise)

  • Hip thrusts

  • Hamstring isolation

  • Romanian deadlifts

Think of this as your "anti-sitting" insurance policy.

• Core Stability Work

  • Planks and their variations

  • Dead bugs

  • Bird dogs

  • Pallof presses

Your core needs to be trained for stability, not just crunches.

• Upper Back Strengthening

  • Face pulls

  • Band pull-aparts

  • Rows (all variations)

  • YTWLs

Combat that forward shoulder position with these movements.

• Hip Mobility Work

  • 90/90 stretches

  • Couch stretch

  • Hip CARs (Controlled Articular Rotations)

Tight hips lead to back pain - period.

Daily Habits to Combat Sitting

Beyond structured training, here are my top tips for minimizing the damage:

1. Set a timer to move every 30-45 minutes

2. Consider a standing desk (but don't stand all day either)

3. Take walking meetings when possible

4. Do 5-10 minutes of mobility work first thing in the morning

5. Perform "micro-workouts" throughout the day (quick sets of basic movements)

   
   

The 5-Minute MicroBreak

Here's a quick routine you can right in the office if you bring your own small foam roller:

5-minute MicroBreak

Remember: sitting isn't just about comfort - it's actively working against your fitness goals. Every hour spent sitting is essentially undoing some of your hard work in the gym. That's why a well-designed training program needs to account for our modern lifestyle and actively work to counteract it.

When we look at the fundamental movement patterns and injury prevention strategies we're about to discuss, keep in mind that many of them are even more crucial because of our sedentary lifestyle. We're not just training for performance - we're training to restore our bodies to how they should naturally function.

Recovery: The Missing Link

You don't get stronger in the gym - you get stronger recovering from the gym. This is absolutely crucial to understand. Recovery isn't just about rest days; it's about:

Sleep:

- Aim for 7-9 hours per night

- Establish a consistent sleep schedule

- Create a proper sleep environment (dark, cool, quiet)

Stress Management:

- Monitor your stress levels

- Reduce training volume during high-stress periods

- Consider using heart rate variability (HRV) tracking

Nutrition:

- Eat enough calories to support training

- Get adequate protein (about 1g per pound of desired bodyweight for most lifters)

- Stay hydrated

- Consider supplementation where needed

Psychosocial Factors: The Hidden Influence

This is something that doesn't get talked about enough in fitness. The culture and environment where you train can significantly impact injury risk. If you're in a gym where training through significant pain is celebrated, you're more likely to ignore important warning signs.

Creating a Healthy Training Culture:

- Acknowledge that pain isn't always gain

- Respect recovery needs

- Support proper rehabilitation when needed

- Focus on long-term progress over short-term gains

The Bottom Line

Injuries in the gym are rarely random - they're usually the result of multiple factors coming together. By understanding how your body works as an interconnected system and building your training around fundamental movement patterns, you can significantly reduce your risk of getting hurt while still making great progress.

Think of your fitness journey as an evolution: the goal isn't perfection from day one, but rather continuous improvement. While perfect form is the ideal, the reality is that some movement is better than no movement at all. Every workout is an opportunity to practice and refine your patterns, but remember - progress isn't linear. Some days you'll move beautifully, others you'll struggle with basic patterns. This is normal and expected.

The key is to progress thoughtfully through three stages:

1. First, build the habit of moving regularly - this is your foundation

2. Then, focus on improving how you move

3. Finally, increase the amount of quality movement you can perform

It's like learning a language: first you speak imperfectly but regularly, then you refine your grammar and pronunciation, and eventually you can have longer, more complex conversations with better technique.

Remember: Pain isn't your enemy - it's information. Combined with an understanding of how your body works, you can usually train around discomfort intelligently rather than shutting everything down. By staying mindful of your form, listening to your body's feedback, and making smart modifications when needed, you'll gradually build both competence and confidence. This creates an upward spiral where better movement leads to better results, which enables more consistent training.

The goal isn't to never experience discomfort, and it's definitely not just to train hard. The goal is to train smart, adapt when needed, and stay consistent over the long haul. Some days you'll feel strong, others you'll need to modify - and that's perfectly okay. What matters is showing up, doing what you can, and trusting in the process of gradual improvement.

Want to dive deeper into injury prevention and optimal training?

Element X Personal Transformations

Check out my online coaching program: where we can build you a personalized program that respects these principles while pushing toward your goals.

EXPT Program

For daily tips and insights, follow me on Instagram [@drehealth] where I regularly share movement demonstrations and exercise modifications.

Stay strong, train smart, and keep moving!

-Dr. E

About the Author

Dr. Matt Eichler bridges two crucial worlds in fitness: as both a practicing chiropractor and a fitness coach, he sees firsthand how movement quality impacts everyday life. After helping thousands of patients overcome pain and injury, he noticed a clear pattern - most gym injuries weren't random accidents, but the result of predictable, preventable factors.

This unique perspective shaped his training philosophy: that sustainable fitness isn't about avoiding movement, but about moving intelligently. Through his practice and Element X Personal Transformations (EXPT), Dr. Matt helps people build stronger, more resilient bodies by combining clinical expertise with practical training wisdom.

His approach focuses on meeting you where you are, whether you're dealing with old injuries, just starting your fitness journey, or looking to take your training to the next level - all while keeping the long game in mind. Because as he often tells his clients, "The goal isn't to never experience discomfort - it's to build a body that can handle whatever life throws at it."

When he's not treating patients or coaching clients, Dr. Matt continues expanding his knowledge in pain science, movement mechanics, and performance training, bringing the latest evidence-based practices to his community.

Health Disclaimer: The information provided in this article is for educational and informational purposes only. It is not intended to diagnose, treat, cure, or prevent any health conditions, nor should it be considered a substitute for professional medical advice. Always consult with your doctor or qualified healthcare provider before starting any new health program, making changes to your diet, taking supplements, or if you have questions about your medical condition. Your health decisions should be based on discussions with your healthcare team, not on the content you read online.