Don’t Rush Back

If you follow sports at all, you know who Lebron James is.  He is likely one of the most athletic and skilled sports figures of all time and has been for over 15 years.  One of the major factors in his long career is that even with among the highest amounts of minutes played in the NBA, he gets injured very rarely.  In fact, in 15 years the longest he had been out due to injury (until recently) was two weeks due to a sore back.

Recently he experienced what has been called a strained groin muscle. This is a common injury for many of us, but especially sports participants who have to do high velocity movement like basketball, hockey and football.  He’s been out of playing or even practicing for 4 weeks and it has just been reported that he will be out likely at least another two.  Suggested recovery time for an injury of this nature is 6-8 weeks so this is right on track.

My point is that this individual has access to the best rehabilitative care in the world.  He has trainers, physios, any therapeutic thing he wants all day every day.  He has access to literally the best of the best.  Yet still he takes a long time to heal from an injury.

Rushing back from hurting yourself is something I see a lot in my practice.  Typically someone hurts themselves and then does about half of what they need to in order to return to their activity and then gets really surprised when the injury either recurs (and is usually much worse) or they hurt something else that is linked to the original injury.

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The typical timeline requires rest, therapy and then slow easing back into movement and activity.  It depends on the severity of the injury obviously, but if one of the most athletic people on the planet still needs 6 weeks to recover from a strain with access to the best therapy in the world, a regular participant has no business returning to activity having done basic physiotherapy and resting for a couple of weeks.

Here are some typical timelines for injuries I see often in my practice (according to the Mayo clinic):

Sprained hamstring:  Grade 1 is 3-4 weeks, Grade 2 is 6-8 weeks.

Herniated Disc in the back:   6 weeks.

Rotator cuff surgery:  4 to 6 months.

ACL surgery in the knee:  6 to 9 months.

Concussion: Anywhere from 2-9 months depending on the severity.

This is also taking into consideration that you are doing all of the things you need to do in order to heal the injury.  Now, I get to help these people after they have completed physiotherapy which usually makes my part of the job much easier – if they have done what they needed to do in physio.

The best way you can help yourself to make sure this doesn’t happen again is:

  • Find a competent therapist (not a cookie cutter hook you up to the machine and walk away therapist).
  • Do your exercises daily (they exist for a reason – you can also do your own homework easily for modifications or progressions).
  • Figure out your new limitations (often after surgery scar tissue will not allow the same range of motion or strength through a range of motion).
  • Find out why it happened in the first place (was it a fluke accident like a fall, or an overuse injury).
  • Strengthen the supporting muscles around the joint as much as possible (this needs to be done with proper progressions and regressions)
  • Re-establish range and proper movement before re-entering the activity (ie don’t rush back – the whole point of this article).

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The injury recovery process can be frustrating to active people but unfortunately, the one thing I can tell you after dealing with hundreds of them over the years is:  if you try to rush, you’ll make it worse.  After all, if elite athletes need to take the time, so do you.  If you take the time now to make things fully better, you’ll be able to enjoy your activity longer and hopefully never have the injury get worse or recur.

If you need any more details or are interested in exploring further, feel free to reach out to me via email at strengthrehabottawa@gmail.com.  I’m happy to help!

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Keys to Injury Prevention

My whole business is focused on getting people back to strength after suffering an injury.  Many times when dealing with a new client it would be great if that injury never happened in the first place.  It sounds a bit counter intuitive, but if there were people out there actively trying to work towards NOT hurting themselves it would make my life a lot easier.

So when we look at the basic causes of an injury, it can be boiled down into a few main factors I see constantly.  I would like to address these one by one with the hope that it will allow some of you who might be on your way there (or are quite injury prone) to prevent any recurrence of what you have already done, or also maybe not have an injury happen in the first place.

What does your tissue need in order to be at its peak performance when you shove a bunch of forces through it?  It needs to be able to generate (and sometimes sustain) tension across a wide range of motion so that the tissue that is that last line of defense to prevent injury isn’t adversely affected.

What factors come into play therefore to increase the body’s ability to generate and sustain this tension?

Nervous system engagement

The way muscles fire is part of the autonomic nervous system.  In simple terms, the brain controls muscular movement through firing something called an action potential across a nerve.  This is done in conjunction with the endocrine (hormonal) system.  Therefore, a large part of generating tension in muscles is what we refer to in my world as priming the system.

If you are training for a specific movement, then you should be doing a dynamic warmup to support the main movement that you are trying to practice.  An example would be if you are planning on training explosive power, you would perform something like a jump in order to get the CNS ready for a fast, powerful movement.

What does this mean for the average person who simply doesn’t want to fall down?  Well, a good CNS engagement movement might be as simple as standing on one leg.  It forces the brain and muscular system to adapt to a change in centre of mass and therefore fire muscles in a milder way that will support a larger movement.  There is also a reactionary component that will help the simple movement become more of a reflex than something that must be rehearsed.  In my practice I call this intentional practice.  

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Simple standing can increase CNS potential and “prime” the system.

Blood flow

Any muscle in order to fire properly needs to be hydrated and requires blood to flow through it.  One purpose of a general warm up is to move muscles and increase blood flow, which is also why we move them (dynamic warmup) instead of simply stretching (static warmup).  There are two good supplements to this method.  The first is creating blood flow through pressure or massage to an area.  This can be done simply by massaging an area lightly or using an implement like a stick or foam roller to put pressure across an entire area for increased blood flow.  As a side note, this often also adds a nervous system component to the body.

The second is using isometric contractions.  This means taking muscles through to their end allowable range of motion and contracting them in order to facilitate tension at those end ranges.  Typically, muscles are weakest when they are longest or shortest (with a few exceptions).  I perform these with the help of my ISOPHIT but you can easily do this on your own.

An example of an isometric I use often would be lateral hip movement.  Find a wall, stand sideways to it and lift your leg into the wall and press gently for about 10 seconds.  You will feel a contraction in the hip.  More often than not my clients report after doing this that they are more stable and able to control their movements during the workout.

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An example of a posterior chain isometric on the ISOPHIT.

Control over the range of motion

Ever watched a Cirque de Soleil show or a gymnastic performance?  One thing that any very strong person has master levels of is control over their muscular system.  In my practice, my rule is if you can’t control it, you’re not allowed to do it.  This means that when you first introduce a movement it needs to be practiced at a low rate of speed and focus needs to be made on every portion of the movement.

Any movement can be broken down into component parts, and when dealing with injured tissue often that control aspect is stunted or never existed in the first place.  How you can prevent future injury is to make sure you can perform movements slowly and execute every portion of them.  As I mentioned above, high level gymnasts can perform complex movements incredibly slowly.  Doing things quickly only means that the body often has to cheat in order to achieve a position and if it does this often enough, then it will adapt in that way to work around a weakness.  It’s important for injury prevention to ensure this doesn’t happen.

Use this as your mantra:  Control everything.  Teach your body to move with precision and then when you need it to it will be able to fire properly to prevent the movement you are trying to avoid.

Practice, Practice, Practice

There is a basic principle for any athletic movement called specificity.  It means that whatever you want to be able to do, your training should mimic what is required for that movement.  Want to bench a lot?  You need to bench press and work on the components of a bench press.  Want to be able to jump higher?  Run?  Throw something hard?  These are all things that you need to practice in order to prevent injury while doing the movement.

The one key to this, however, is that most of the practice needs to be sub threshold – or well below the force required for the one individual movement.  You will rarely see high level weightlifters maxing out on lifts.  You will rarely see golfers trying to rip the cover off the ball.  You will see few marathoners running the full marathon distance before a race.  Instead, they work within an allowable range in order to repeat the movement repeatedly without having to worry about the forces involved.

Especially right after an injury, take your loads down to levels far below that which you tell yourself you can tolerate and practice the movements for a while instead.  Make sure they are perfect before trying to ramp up and you will see that you will be able to return to proper form faster and without risk.

 

In summary, these four keys are necessary to reduce and prevent injuries to pretty much anyone.  The good thing is that they are simple to apply and take very little time added to any workout that you might do.  These are things that become gospel to my clients who are looking to recover from a previous injury and prevent future ones.  My goal is to always make sure that injury doesn’t happen again.

Feel free to let me know if you have any specific questions about any of these points and as always, I’m happy to help any of you with injury recovery.  Good luck with your training and rehabilitation!

Let your Personality Guide your Fitness

Over the years I’ve dealt with probably several hundred people and helped guide them towards their fitness goals.  What many people don’t know is that my background is in psychology, and I’m fascinated with how people think.

One aspect of goal setting that many people forget about when it comes to creating a goal is really digging deep into their personality type.  We all have different aspects to our personality depending on several factors.  These personality traits can either set you up for success in life or take away from it because you’ll always feel like you’re forcing a square peg into a round hole if you don’t.

As an example, three years ago I was offered an office job temporarily during the federal election.  I found quickly after a couple of weeks that sitting at a desk all day in an office environment made me want to dig my eyes out of my head with a rusty fork.  The work was easy for me, but I much prefer being on my feet, teaching and coaching different situations and people and having a fluid schedule.  This is just part of who I am.  The temporary job just reinforced it to me.

As an aside, I’ve never understood people who are miserable at their jobs just to take a paycheck home.  If you don’t like your situation, just change it – it’s not as hard as you think.  But I digress…

So how does this apply to fitness?  There’s a few ways you can analyze your personality and make it work for you fitness wise as well.  Here’s a couple of key questions to ask yourself when it comes to creating a strategy towards fitness:

Are you a Group Person or an Individual? 

What sports did you play as a kid?  Were you a hockey or basketball star or did you prefer golf or racquet sports?  Most people are either team sports oriented or individual sport oriented.  Someone who is team sport oriented likes meshing with and depending on other people to perform their activity.  An individual person might be part of a team still, but prefer that their performance relies on their own effort and skill.

This tends to also work in adulthood.  Individual sport people usually will prefer the same environment.   This might mean you join a running group, golf with a couple of others, play a racquet sport or cycle alone.  Team sport people will be more likely to join a league or team for things that require multiple people.

Let’s translate that to the gym.  An individual person likely would prefer something like simply lifting weights alone – even at home.  They don’t have to have another person relying on them to get things done.  A team person would likely prefer showing up to a yoga class with a bunch of people they know or doing anything with a bunch of others.

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Can you Focus or are you a Multi-Tasker? 

Some people can sit down and complete a grueling task that takes all day and enjoy it, checking off a list one thing at a time.  Others (like me) prefer constant changes and stimulation and can have several projects on the go at the same time.

The former person will prefer to walk into a gym with a defined plan.  Something to follow and check off parts as they go and likely not adjust it.  The latter will be more of a type that will adjust a plan on the fly if they have one, or try different types of classes in the same week for variety even if they might not be guiding towards anything specific.

A focused person would set one or two goals in a year and work diligently towards them like a marathon or a large event like a tournament or championship.  A multi-tasker might have ten goals and only accomplish five of them and be fine with that.

Your most successful champion athletes are typically the focused ones who can work on one goal for long periods of time and follow a plan – but it’s okay to admit that you aren’t that type of person.  If you find that you can’t follow a focused plan for more than a couple of months, admit that to yourself and find a way to tweak things so that you are working on a couple of things at once.  Triathletes are excellent multi-taskers (which is probably why I liked it too!).

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Do you Want to Show Off or are you Self-Fulfilled? 

This is where I might get criticized a bit but hear me out.  We all have a certain amount of narcissism within us.  Some more than others.  When you are digging deep you really need to ask yourself if you’re doing the event to be able to brag to your friends or show off to others, or simply for accomplishing a goal and feeling good about it yourself.

Making an amazing golf shot brings a good feeling to people – but you’re by yourself, as does making an amazing play on a soccer field so people will cheer for you.  Ask yourself if you don’t care about a trophy but want to have an amazing sense of accomplishment like a long adventure race or a marathon – or if you want to be carried off the field on the shoulders of your team mates or have your picture in a magazine so you can display it all over social media.

Again, how does this translate to the gym?  Maybe someone who wants to show their skills would be a great group fitness instructor.  Or join a Crossfit gym where they can write their accomplishments on a board and have people cheering them on at competitions.  Self-fulfilled people might not even need a gym and be happy just working out at home.

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Ask Yourself These Questions    

This process will go a long way towards making sure that you are doing something that you will continue with in the fitness world.  As we all know, the key to success is one main thing – consistency.  Creating an environment where you will feel your best and keep going constantly will bring you the greatest success with your goals.

Be honest with yourself as well.  It is easy to program things based on what we think others might think of us.  Get over it.  Focus on what you enjoy and really stay true to yourself – and this can apply to many areas of life, not just fitness.

If you have any questions or enjoyed this please like, share and retweet away!  I appreciate any and all feedback and hope that you continue in the best way towards your fitness journey.

Patience Isn’t Just a Virtue When You’re Injured.

Recently because I’m a football fan I’ve been reading about recovery of the quarterback of the Indianapolis Colts.  His name is Andrew Luck and he’s a professional athlete who was the next up and coming superstar in the league.

That is, until he badly tore the labrum in his shoulder and had to have surgery.  The whole thing was mismanaged by his medical staff and it’s a long story, but the point of the whole thing is this:  He did not take a snap last football season and has been out of football for over a year due to rehab.

This is a professional athlete with access to daily physio, the best surgeons in the game and things like stem cell treatments, and he still has not thrown a football in over a year.  A year.  This is a guy who throws a football for a living and he’s not doing it to let his injury recover for a YEAR.

I’ll ask you a simple question:  if he’s taking that long to recover with access to all of those resources, what makes you think that you can recover from an injury any faster?

Typical labrum tear surgery recovery is 3-4 months but can easily stretch into 6-9 months if things aren’t dealt with properly.

Over the years I’ve dealt with hundreds of injuries.  One thing that I really try to get across to my clients is that if you are hurt, you need to give your body time to heal and recover from whatever it is.  This takes TIME.  Usually a period of weeks if not months.  For some reason my Type A people seem to think that if they just baby a problem for a couple of weeks and then go right back into doing whatever they were doing before they will be fine.

Or even worse, they do physio but keep on doing the same activity that caused the injury in the first place and expect to recover.  I had an example of that just last week and when I pointed it out to my client that not stopping the activity meant it would just get worse again she was for some reason completely dumbfounded.

Does this make sense?

The general guidelines for minor injuries is 4-6 weeks.  More severe ones are 6-12 weeks.  Surgery is anywhere from 3-6 months at LEAST depending on the issue.

My main point is this:  we need to exercise patience as a society when it comes to our bodies.

Whether it comes to recovering from an injury, things like weight loss or achieving a goal like running a marathon, you need to exercise patience to succeed.

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Are you acting smart, or making things worse by rushing the process?

Setting a goal for recovery is just like any other goal – there is a timeline and a process involved.  Sometimes it means not moving anything for a couple of weeks.  Sometimes it is moving just a little bit as much as you can as frequently as you can to help the healing process.  It can be frustrating and feel like it’s taking forever.  But you have a long time to achieve whatever it is you’re trying to do.

If you want to be active and healthy for a lifetime, then taking six months to recover from an injury might represent less than 1% of your athletic or active life over a span of fifty years.  You’re not missing anything by taking that time to make sure that whatever happened doesn’t happen again.

Be patient now, be consistent and give it time and you will succeed in your recovery.  Rush back into activity and have a setback or make the situation worse and suddenly a six-week process becomes six months.

If an NFL player can not touch a football for a year, you can wait three months to rehab from surgery.  Don’t think that your body or recovery process is any different.  Patience and consistency wil get you results every time.

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