Primum Non Nocere: A commentary on avoidable injuries and safe resistance training techniques

Objectives: Recently attention has been brought to potentially unsafe training methods within the practice of resistance training. Thus purpose of this commentary is to highlight the importance of the moral injunction Primum non nocere, and of weighing risks to rewards of training methods, for those providing resistance training recommendations and practitioners of it as a training approach. Design & Methods: Narrative review Results: It appears that many popular resistance training methods that make use of either explosive movements or unstable platforms with heavy external loading may present an increased risk of injury. In addition they may not offer any greater improvements to measures of health and fitness above safer alternatives that utilise more controlled repetition durations and avoid use of unstable platforms. Indeed, as resistance type and load may not be as important for determining strength or hypertrophic adaptations as previously thought, nor does there appear to be much supporting evidence for the transfer of balance skills developed using unstable platforms to other movement skills, the necessity of such unsafe practices appears further questionable. Conclusions: It is recommended that persons wishing to engage in resistance training for the purposes of health and fitness whilst reducing risk of injury should utilise a controlled repetition duration that maintains muscular tension and avoid use of unstable platforms. Indeed, practices involving use of lower external loads, or even the absence of external loads such as bodyweight training or isometric co-contraction, may also be effective and may pose an even lower risk of injury.