Injuries in powerlifting squat, bench press, and deadlift

Summary on a review article looking at powerlifting injuries occuring during performing back squat, bench press, and deadlift.

Who

Powerlifting athletes performing back squat, bench press, and deadlift.

Powerlifting – a sport involbing performing one repetition of maximum load in back squat, bench press and deadlift.

Design

Review of 39 studies (33 case studies/series, 4 retrospective cohort studies, 1 prospective cohort study, 1 meta-analysis). Studies reporting on:

squat = 7 studies
bench press = 30 studies
deadlift = 4 studies

Outcome measures

injuries sustained during squat, bench press and/or deadlift

Main results

Squat-related injuries (5 case reports, 1 case series, 1 retrospective study):
- musculotendinosus raptures:
  - bilateral quadriceps tendon rapture (3 cases, 2 using anabolic steroids), 1 with spiral fracture of tibia and fibula, and 1 with partial ACL tear
  - biceps femoris muscle and tendon
- avulsions of the reflected head of the rectus femoris with a labrum tear
- fractures:
  - talus dome
  - Clay-shoveler’s (affects spinous processes of lower cervical vertebra)
Bench press-related injuries (20 case reports, 7 case series, 1 retrospective study, 1 prospective cohort study, 1 meta-analysis):
- musculotendinosus raptures:
  - pectoralis major (around 100 cases)
  - triceps tendon (4 cases, 3 using anabolic steroids and having pain before the rapture happened)
- weightlifter’s shoulder (1 case; osteolysis of distal clavicle)
- bench presser’s shoulder (5 cases; pecoralis major tendinopathy)
- anterior and posterior dislocation
- fractures:
  - clavicle (1 case)
  - scaphoid (1 case)
  - second rib
  - Salter-Harris type I of the distal radius
deadlift-related injuries (1 case report, 2 case series, 1 retrospective study):
- lower back: lumbosacral injury (4 lifters)
- hamstrings muscle raptures (2 cases)
- pectoralis major rapture (1 case)
- knee meniscus injuries (2 cases)
- avulsion of the anterior superior iliac spine (2 cases)
- acetabular stress fracture (1 case)

Take home message

For a clinician & coach

In powerlifting, the most common injries during squat, bench, and deadlift are: thigh muscles raptures, pectoralis major raptures, and lumbosacral injuries, respectively. Note: some musculotendinous rapture injuries may have been related to the use of anabolic steroids.

For a parent

During performing back squat exercise the most common injury that happened was thigh muscle rapture. Pectoralis major rapture was the most offen injury happening during bench press exercise. During deadlift, lumbosacral injury happened the most.

For an athlete

Original article

Bengtsson V, Berglund L, Aasa U. Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift. BMJ open sport & exercise medicine. 2018 Jul 1;4(1).