Jill Miller, who is the inventor of a program called Yoga Tune Up, recently revealed on her blog about a month ago that she needs a total hip replacement. At the age of 45. Now, she has been absolutely instrumental in helping many, many people discover a modality that can really help irritated tissue and brought it to the main stream. The story, however is what I want to bring your attention to today.
What was telling about her first blog post, which you can find HERE (and I’ll link to the second part HERE) is that she felt nagging pain not only for most of her life but for the past seven years. Until recently she didn’t bother to have it looked at because she was worried about surgery for personal reasons. That’s fine.
This is one of the most respected and knowledgeable (from an anatomy standpoint) body teachers IN THE WORLD and even she ignored her symptoms. We all do it, from your fellow office worker to high level athletes who want to keep competing.
“I’m okay, I just need to stretch.” “I’ll start using my therapy ball.” “I’ll take a couple of weeks off from running and everything will be fine.” And then we go back to doing the same thing that caused the problem in the first place and are suddenly surprised when the issue comes back – and worse.
Just this week another client of mine’s husband after almost a year of pain finally decided to go to the doctor and get checked because his knee wouldn’t stop failing and buckling. My prediction is either a torn ACL or a severely torn meniscus (or both). The problem is that he’s been walking around on it for the better part of a year without any treatment or attention, and likely it’s gotten a lot worse. This might mean that something that could have been helped with therapy before might need surgery now.
I’ve said it before and I’ll say it again:
Your body isn’t stupid.
Pain, collapse, restricted range is a signal that something is wrong.
The sooner you figure it out and fix it the better off long term you will be.
If you have water coming into your basement, you figure out where it is coming from and plug the leak. You don’t sit there and wait for it to subside, clean it up and then wait for it to happen again. Mold sets in. The leak might get bigger. Other things can come into play that make a simple leak a catastrophe. Your body is no different.
When your body is subjected to stress, it responds to it. This can result in either stronger muscles, or deterioration and loss of integrity. A large part of my job is finding out the perfect balance between just enough and too much load, stress or torque on joints. You need to consider your body as a whole and what loads it is being subjected to daily, weekly and annually to really figure this out.
And in case you’re wondering, sitting is a load. Driving is a load. Weight training is a load. Yoga is a load. I remember when I sat through the Yoga Tune Up course (I did not certify because I have no desire to be a yoga instructor) and a room full of body practitioners looked at me like I had two heads when I suggested that yoga poses – especially extreme ones – are still heavy forces through joints. They are, in case you’re wondering. Jill Miller says that herself in her articles. Years ago I wrote a post about why a downward dog is downright dangerous for most people. It’s HERE.
One big fundamental rule I teach my clients is that they should walk out of a workout feeling better – not worse. This means they are far more likely to have had an appropriate level of stimulus and will have a better long-term response. They won’t get worse, they will get better. Isn’t that the whole idea?
The point of this is that nobody is invulnerable to the rules of the body, even people who have spent their whole life practicing something that is supposedly therapeutic. Don’t assume that if you have a problem that things like stretching and pounding yourself with a yoga ball is the answer. It might just make things worse over time. Seek out someone who knows the rules of the body and can identify a proper strategy to bring your body back into balance and stop overloading tissue.
So the next time you work out, try taking a step back. Are you pushing through pain? Have you had a problem for a while and have been ignoring it? Take a really close stock and tell yourself that you should probably get that taken care of before subjecting your body to even more stress.
Because nobody wants a hip replacement at the age of 45. At least I don’t.
Feel free to message me or find me on social media if you have something you would like to identify or a question. Injuries and providing solutions are what I deal with every day.
Any active person has had it happen. You are doing whatever activity you enjoy and suddenly feel a bit of a pull, cramp, sharp pain or something not quite right. Hopefully you’re smart enough to stop what you are doing and not push through the pain to complete whatever you are doing, but maybe not.
Then the inflammatory feeling starts kicking in. Your tissue will feel full, there may be lingering low level pain or sometimes acute high level pain when you move. Sometimes you can’t move without your body telling you not to through a jolt of pain. Often this is a bit indicator of the severity of whatever injury has happened.
So you realize that this is beyond a simple pull, mild strain or simple fatigue. You’ve done something that may require intervention and some sort of attention. You’ve injured yourself.
First things first: if you have acute high level pain and can’t move a limb or joint please GO TO A HOSPITAL. You will wait a while because musculo-skeletal injuries aren’t triaged as a priority but at least you will likely get some imaging immediately. There may also be things going on underneath the surface you have no idea about so better safe than sorry.
If that’s not the case, what is your next step. Well, there is a simple routine that you should follow, and it can be done in this order:
This is what you do immediately. The biggest thing to do with any injury is STOP MOVING IT. Don’t stretch it right away, don’t think that you can “push through the pain”. You will make things worse. Stop what you’re doing. Your body is very intelligent and is already doing what it needs to in order to start fixing things. Give it a chance and don’t make things worse.
Don’t ignore pain. Pain is a signal saying “QUIT IT”. Your body is literally telling you to stop what you’re doing just like taking your hand off a hot stove. Once you have stopped moving, the next step is…
Some questions to ask yourself:
- Is the pain acute with movement or does it come and go, for example it stiffens up during sleep or is painful at different times of day?
- Is my strength compromised for certain movements, ie can I not pick something up, reach over my head or extend my leg without a problem?
- Is there soft tissue damage? Swelling is one thing, but bruising typically means a much more severe trauma that requires attention faster.
The more you have information, the easier the next step will be because you can figure out which practitioner to see first and not waste your time. Have a soft tissue problem? Massage might be best? A serious joint issue? Maybe an osteopath or chiropractor (more on this later in the article). Arming yourself with answers and figuring things out on your own can be valuable in not wasting your time. That leads us to…
This does NOT mean going to someone like me and asking them what it is, because I have no authority to diagnose anything even with my years of experience. What is does mean is going to someone with the words Doctor in front of their name and ideally getting some testing and/or imaging. I always tell my clients to push for imaging because ultrasound and x-ray can reveal things simple testing cannot. If MRIs were more easily accessible that would be my default for many things. For those of you in Canada, remember that some provinces (ie Quebec for those of us in Ottawa) do allow paid MRI’s – you just have to pay for it.
As much as I appreciate the access to General Practitioners or walk in clinics, regular MD’s have little to no experience with bone and joint injuries and often will suggest exactly what I just said anyway, so don’t waste your time. And if a GP does give you a “maybe it’s this” diagnosis please get it confirmed by someone with experience and ideally imaging as I said.
Be proactive – once you have a diagnosis, learn everything about it that you can. It will not only educate you on what the injury is, hopefully it will make you realize WHY it happened and how to prevent it in the future. Often during my initial consultation I have found that clients have never had their injury properly explained to them by anyone and have no idea what happened to them and why. Knowing the why is very important for any recovery model. And that allows me to discuss…
After you have a diagnosis, depending where you get it the first suggestion is always physiotherapy. It’s covered under benefits, didn’t you know? The only problem is that there are lots of other ways to treat an injury and in my experience physio yields the worst results overall for my clients and others I have spoken to. If I was going to suggest the order you should look into things and why, here’s my list. Again, not to knock any practitioners – there are lots of good and bad ones out there – this is simply my experience in dealing with all of them frequently.
#1: Osteopath. These people frequently have had experience in another modality and decided to move into osteopathy. From an assessment and treatment perspective the results from these practitioners seems to be consistent, and they don’t ask to see patients frequently.
#2: Massage Therapist. With the disclaimer that this is for soft tissue injuries only, a good massage therapist can help with things like scar tissue, blood flow to improve tissue and relieving stiffness and immobility. This should be included with any recovery plan.
#3: Chiropractic – Again, with the disclaimer that this does NOT mean back cracking or neck cracking. A good chiropractor who knows other treatment protocols like ART or myofasical release, or even relieving nerve entrapment are usually your best bet.
The thing with chiropractors is that a lot of them are salespeople who try to lock you into long term treatment plans where you see them three times a week – please don’t fall for this and if it is suggested, find another practitioner. This generally doesn’t have any interest in your recovery, it has interest in your wallet and benefit plan. If you need to see a practitioner three times a week they need to justify it.
#4: Physiotherapy. Again, there are good physios out there. The problem is that in my experience they are few and far between. Look for someone who doesn’t use outdated methods, someone who will actually spend time with you individually (not hook you up to a machine and walk away or leave you with an assistant), and who will progress you session to session properly.
How long does it take for proper recovery? The general rule for serious soft tissue injuries is 6-12 weeks, more serious damage like tendons and ligaments can be up to 3-6 months. Anything requiring surgical intervention can be 6-12 months. This is not carved in stone, but it will give you some perspective in that you need to assume that this is a long term fix and not a temporary thing.
In my opinion surgery should always be a last resort. It is done when there is no other option for restoring tissue. Full tears, severe arthritis, and things like broken joints often carry this load and it is totally necessary. If you have the option, see how well you can get first without it and then see about surgery if all else fails. Realize that if you meet with a surgeon, they are going to likely push for an operation – that’s their job. You have options, consider them all wisely before making a decision that can affect your body for the rest of your life.
As a final note, the number one thing I see that causes injuries to recur is that the person rushed back into exercise and doesn’t do what they need to do to fully recover. This just makes things worse and more often than not will result in a worse injury down the road. Listen to your body and ease back into exercise. Sometimes my clients have to start off ridiculously easy and it drives them crazy, but it takes time for recovery and having a guided path is absolutely essential.
So you’re hurt – there are lots of options for you to pursue and the good news is an injury doesn’t have to be the end of the world. If I told you the laundry list of injuries I’ve had (including a disc herniation and multiple tears in various places) you would be surprised – but I can still move easily and lift heavy things without a problem. Be smart, apply things properly and keep moving forward.
If you liked this article feel free to SHARE it on Facebook and follow me on Twitter @strengthottawa. And of course if you have any questions you can contact me at any time via phone or email. Stay mobile!
Recently a client texted me to ask if she should start taking BCAAs for improved results. This is a typical type of question that I get from clients quite a bit once they start back into the gym after a layoff or even starting out for the first time. Since every person they run into is going to offer some type of tidbit on how to increase results, often I have to be blunt with people, as is my nature.
So I thought I’d share my thoughts on the subject and share basically what I told her and would tell anyone in the same type of situation, and here it is in plain English:
If you aren’t doing the first 90% of what you need to do, don’t worry about the final 10%.
So then you ask: “What’s the first 90%?” of course. And here it is.
Exercising regularly – that means 3-5 times a week depending on schedule for at least 6-12 months without more than a week break due to holiday, illness or injury. Do you have your fitness time prioritized so that regular life doesn’t get in the way? No? Work on that.
Exercising properly – are you getting hurt or sore all the time? Do you know what you’re doing? Are you focusing on the right things ie strength training instead of hours of cardio? Do you track your workouts consistently? No? Consult an expert and work on that. Get a game plan and follow it.
Eating properly – that means within the caloric guidelines for either gaining/losing weight and/or body fat consistently every day. No? Work on that.
Eating for health – meaning real food, not relying on supplements like shakes and powders. Whatever eating profile you decide to go with, just make sure it is healthy – for you. No? Work on that.
Recovering properly – that means are you sleeping, taking rest days and trying to lower outside stress levels so that your body can repair itself. No? Work on that.
Enjoying the process – Life isn’t about suffering unless you’re a Buddhist. If you are forcing yourself to do things it likely isn’t a good choice for you. An example is people who are in a gym when they would much rather be outside or doing an active sport or other activity. Have you found what you enjoy? No? Go find it.
So here’s the thing. I get questions often where the answer is simply – it doesn’t matter unless you’re already doing the above. Do I need BCAAs? Should I do Wendler 5/3/1 or Starting Strength? What about Intermittent Fasting? Or (insert diet name here)? How many reps and sets? How long should I do cardio for?
Too many people focus on the details that aren’t important until the above is in place and consistently followed for a period of time. And as much as other people will moan and say it’s important and other trainers’ heads will explode, let’s the honest and say, the difference is generally negligible. If you’re not doing the things above consistently then you are much better off starting there.
Good luck – and feel free to contact me with any questions.
Over the years, one of my clients’ frequent struggles with weight loss is the concept of a number on a scale. Unfortunately in our society we have been taught that this number means something, when really it is a function of gravity (when you come right down to it). While there are some considerations that need to be taken when you’re dealing with obese people, for those who are within a healthy body weight range the idea of how much they weigh can still be an obsession, and not a healthy one.
I can’t count the amount of times I’ve heard “I just need to lose another five pounds.” No you don’t – you need to get into a smaller pant size or you want to look better at the beach. Or there’s another fundamental reason that you want to be thinner, smaller or have visible abdominals. I want to be more attractive. I want to have people pay more attention to me. Or, on the flipside they want to stop the negative thoughts they have running through their heads constantly about themselves..
The weight on the scale actually has little to do with it. When I’m judging fitness competitors, do you think weight has anything to do with it? One person who is the same height could weigh ten pounds more – and actually look a lot better. I have many friends who are high level performance athletes who don’t think twice about what a scale says – it’s all about how they can do the things they need to do in order to win a race or lift what they need to lift. Runners aren’t classified by weight, they are classified by speed. Fitness models and bikini girls are based on height. Even different clothing manufacturers have different sizes based on demand – you can be a size 4 in one store and a size 8 in another.
Your body changes day to day and month to month. This is a good thing, and it is based on how you move, what you put into it and even how much stress you allow yourself to experience. The good news is that these are all things you can affect easily if you simply make a decision to do so.
So my main point to people who obsess about a number on a scale is simply this: do you walk around with that tattooed on your forehead? Of course, the answer is no. And even if you did, do you really think that the people who care about you would judge you based on that number? I can only imagine a horrible society where if you drifted into the upper range of BMI you would be labelled with a red flag and your coworkers, friends and family would shun you because you are a horrible person. Some people seem to think this is going to happen to them.
This just doesn’t happen. Fundamentally, the only person that really cares about how much you weigh – is you. And you’re insecure about it because at some point in your life you decided that words from someone else or a number on a scale meant more than feeling good about yourself. Or you think that by dropping that number you’re going to look better to yourself and other people. Here’s a news flash – they don’t care. Or at least they shouldn’t, and if they do then you’re probably hanging out with the wrong people.
Your conversation with yourself about that is usually based on what you have been told by other people, some of whom are too stupid to realize that when you were a kid or an adult or they were supposed to care about you they were actually beating you down. I have a very blunt way of dealing with that: forget them. You should always be trying to improve, but in my opinion it should be for your own reasons, not one that another person gave you.
Too much today we focus on what other people think, and in a book by Dale Carnegie I read many years ago he summed it up best: Why are you letting other people decide how you are going to feel? Let’s be happy with who we are and what we have before we allow any type of words (which mean nothing) to affect our daily lives and how we feel about ourselves.
Let’s focus on the right things:
Feeling better every day.
Performing better every day.
Maybe looking better (for yourself, not someone else).
Come from a place of support for yourself.
Every day try to make yourself and the world around you a little bit better.
If you feel like it, take a picture of your scale weight and post it on your forehead for the world to see. Maybe we will start a trend so people will figure out how silly it is that they are defining themselves by a number.