Pain-Free Lifting: How to Protect Your Joints in Strength Training

Written By Dr. Ben Stokes

Strength training is one of the best things you can do for your body. It helps you build muscle, strengthen bones, boost metabolism, protect your joints, and it’s safe for most people when the program and technique are right. But, without proper form or recovery, lifting can do the opposite and cause pain or long-term damage. As a Doctor of Physical Therapy, I often see patients who love to lift but start developing shoulder, knee, or back pain. The good news? Most of these issues are preventable with the right approach.(1)

Below is a simple, science-backed guide to keep your joints happy while you get stronger!

How Strength Training Affects Your Joints

Your joints are designed to handle load, but only when muscles, tendons, and ligaments work together. When technique or mobility is off, that stress shifts to areas that aren’t meant to carry it. Research shows that proper resistance training improves joint health by increasing cartilage nutrition, enhancing tendon strength, and improving coordination between muscles – which helps spread the load safely. Poor muscle control or weakness, on the other hand, is tied to extra joint stress and degeneration, which can cause stiffness. Proper resistance training can actually improve your flexibility just as well as stretching.(1-4) In other words, when done correctly, lifting doesn’t “wear down” your joints - it actually helps protect them.

Common Mistakes That Irritate Joints

Even experienced lifters can develop bad habits that lead to discomfort or injury. Here are a few of the most common mistakes I see:

  • Only training prime movers (your big muscles). Skipping stabilizers (like the rotator cuff, scapular muscles, core, and hips) leaves joints less protected.(6,7)

  • Not focusing on technique can cause movement deficits such as valgus knee collapse on landings/squats and sloppy shoulder/scapular control with upper body exercises. Both are linked with higher injury risk.(5,7)

  • No plan (or the wrong plan). Programs that don’t follow gradual progression make aches more likely. The American College of Sports Medicine (ACSM) recommends small, steady load increases (about 2–10%), depending on the lift and training status.(2)

  • Progressing volume and/or weight faster than your joints can adapt. That mismatch can raise injury risk.(10,11)

  • Ignoring pain and just pushing through instead of addressing the cause.

Your pain-free lifting plan (step-by-step)

  • Warm up 5–10 minutes.

    • Dynamic warm-ups improve blood flow, mobility, and muscle activation. A 5–10 minute warm-up prepares your joints for load.

      • Use easy cardio plus 1–2 light sets of your first lift. Add 1–2 simple landing or balance drills on lower-body days to “teach” good knee alignment. Neuromuscular prep like this reduces risky knee mechanics.(5,6)

  • Own your technique.

    • Good form should always come before heavy weight. If you can’t maintain proper alignment, reduce the load. Having a skilled professional assess your movement patterns can help you find weak spots before they cause problems.

      • Squat/hinge: knees track over toes; spine neutral; push through mid-foot/heel.

      • Push/press: ribs down; don’t shrug early; finish with controlled shoulder blade (scapular) motion. Good scapular control and rotator-cuff strength are modifiable shoulder-injury risk factors.(7)

  • Respect tendon rules.

    • Tendons like consistent, progressive loading. For painful tendons (like Achilles), research shows that both heavy-slow resistance and classic eccentrics work well; heavy-slow may feel more satisfying early on, but long-term results are similar.(8)

    • If you’re in a rehab phase, a pain-monitoring approach that allows continued activity within sensible limits did not worsen outcomes in Achilles tendinopathy.(9) Work with your PT to set your personal “allowable pain” range.

  • Progress gradually.

    • Most lifters do best by increasing 2–10% at a time, based on the lift and how you’re feeling.2 Keep reps in reserve (RIR) or use a rate of perceived exertion (RPE) target, so effort climbs slowly week to week. This respects how muscle and tendon adapt over time.(10,11)

  • Build your “joint armor.”

    • Add 1–2 sets of accessories after your main lifts:

      • Shoulder: external rotations, scaption raises, serratus punches(7)

      • Knee/hip: clamshells, lateral band walks, single-leg balance variations(5)

      • Core: plank progressions, anti-rotation presses(6)

  • Recover on purpose.

    • Sleep 7–9 hours, spread hard sessions 48–72 hours apart for the same muscle group, and rotate intensities. This helps tendons catch up to muscles.(10,11)

Quick self-check list

  • Does your knee cave inward on squats or landings? Practice mini-landings and slow eccentrics, focusing on knees over toes.(5,6)

  • Shoulders ache with presses? Add 2–3 sets of light cuff work and scapular control drills after lifting for at least 4–6 weeks.(7)

  • Feel “tight” after lifting? Keep training - resistance work can increase range of motion when done correctly.(3)

When to see a Doctor of Physical Therapy (DPT)

  • Sharp or worsening joint pain that lingers >5 days

  • Night pain, locking, giving way, or swelling

  • Numbness/tingling or pain that limits daily tasks

  • A tendon that’s stayed sore for weeks despite easy training

A DPT can assess movement, load tolerance, muscle imbalances, and tissue irritability; build a plan that respects how your muscles and tendons adapt; and progress you safely back to heavy training.(1,2,10,11)

At Tualatin Valley Physical Therapy, we specialize in helping athletes and active adults move better, lift safer, and perform stronger. Pain-free lifting isn’t about avoiding challenges, it’s about moving well, building smart, and respecting your body’s limits. Protect your joints, train with purpose, and your strength will last a lifetime.

References

  1. Fragala MS, Cadore EL, Dorgo S, et al. Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association. J Strength Cond Res. 2019;33(8):2019-2052. doi:10.1519/JSC.0000000000003230

  2. Ratamess NA, Alvar BA, Evetoch TK, et al. Progression Models in Resistance Training for Healthy Adults. Med Sci Sports Exerc. 2009;41(3):687-708. doi:10.1249/MSS.0b013e3181915670.

  3. Alizadeh S, Daneshjoo A, Zahiri A, et al. Resistance Training Induces Improvements in Range of Motion: A Systematic Review and Meta-analysis. Sports Med. 2023;53(3):707-722. doi:10.1007/s40279-022-01804-x.

  4. Herzog W, Longino D, Clark A. The role of muscles in joint adaptation and degeneration. Langenbecks Arch Surg. 2003;388:305-315. doi:10.1007/s00423-003-0402-6.

  5. Zebis MK, Andersen LL, Brandt M, et al. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: A randomized controlled trial. Br J Sports Med. 2016;50(9):552-557. doi:10.1136/bjsports-2015-094776.

  6. Jeong J, Choi DH, Shin CS. Core Strength Training Can Alter Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury. Am J Sports Med. 2021;49(1):183-192. doi:10.1177/0363546520972990.

  7. Hoppe MW, Baumgart C, Polglaze T, Freiwald J. Risk factors and prevention strategies for shoulder injuries in overhead sports: an updated systematic review. J Exp Orthop. 2022;9(1):78. doi:10.1186/s40634-022-00493-9.

  8. Beyer R, Kongsgaard M, Hougs Kjær B, Øhlenschlæger T, Kjær M, Magnusson SP. Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial. Am J Sports Med. 2015;43(7):1704-1711. doi:10.1177/0363546515584760.

  9. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Continued sports activity using a pain-monitoring model during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. Am J Sports Med. 2007;35(6):897-906. doi:10.1177/0363546506298279.

  10. Brumitt J, Cuddeford T. Current Concepts of Muscle and Tendon Adaptation to Strength and Conditioning. Int J Sports Phys Ther. 2015;10(6):748-759. PMCID: PMC4637912.

  11. Mersmann F, Bohm S, Arampatzis A. Imbalances in the development of muscle and tendon as risk factor for tendinopathies in youth athletes: current evidence and concepts of prevention. Front Physiol. 2017;8:987. doi:10.3389/fphys.2017.00987. PMCID: PMC5717808.

Dr. Ben Stokes

Hello, I’m Dr. Ben Stokes, a proud native Oregonian with a deep passion for helping others thrive. Born and raised in Hillsboro, I’ve embraced the Pacific Northwest lifestyle (think multiple rain jackets and no umbrellas). I graduated from Century High School in 2008 and then earned my BS in Kinesiology from Oregon State University, where my fascination with human movement and rehabilitation began.

Before pursuing a career in physical therapy, I worked as a specialized personal trainer focusing on rehabilitative exercises. A pivotal moment in my life came when my father was diagnosed with ALS, which was before I even thought about being a PT. Witnessing how dedicated rehabilitative care enabled him to participate in our cherished family dinners inspired me to pursue a career in physical therapy. With that driving force, I earned my doctorate at George Washington University and then returned to the Pacific Northwest, where my heart has always belonged.

My approach to physical therapy is rooted in learning from the best. I have trained under both chiropractors and experienced physical therapists, embracing diverse treatment methods to ensure the best outcomes for my patients. I’m dedicated to passing on the hope and healing I witnessed in my own family to as many people as possible.

Outside of the clinic, I enjoy solving puzzles, playing games, exploring hiking trails, and discovering local festivals and events. I’m thrilled to bring my expertise and genuine care back to our community at Tualatin Valley Physical Therapy, where your journey to lasting health and improved function begins.

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The Benefits of Working with a Doctor of Physical Therapy