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!
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.
Every spring brings with it clear roads, nice lush trails and always an explosion of new or reborn runners outside. The year seems bright and shiny and new goals get set, sometimes held over from the year previous. That ½ marathon that didn’t get done last year – this is the one! I’m going to finish my first 10k race in under an hour! I’m going to set a new personal best in May! After coaching endurance athletes for over a decade I’ve pretty much heard all of them before. This applies to those of you who ran regularly last year and haven’t consistently since November (when you finished your last race) too. So I thought I might list off some of the biggest mistakes that I see new or renewed runners make early in season and hopefully it will make sure that a lot of those injuries I end up fixing in the fall don’t happen – at least to you.
1) Start as easy as you need to.
Many beginners start out with a walk/run protocol until they can run continuously for 20 minutes – and you should too. One mistake many beginners make is thinking that they can instantly hop out of their door and run forever without walking. They get 1 kilometer down the road, are gasping for air and their muscles are screaming, limp home and never go out again. I wonder why? This applies to reborn runners as well – sometimes those first few runs are hard on the body and it needs time to adjust and get used to the movement again. Try walk 1 minute, then JOG (not run) 1 minute and repeat for about 10 cycles – this is 20 minutes total, 10 minutes of jogging. This is a good starting point. Start with 3 times a week on non-consecutive days. You will know you are improving when things get easier and then you can progress to 2/1, up to 10/1 and then try for a long continuous run.
Also, it has been proven that aerobic conditioning is incredibly important. The majority of running at the starting stages should be at aerobic pace (meaning at least conversational). This can be very difficult for beginners, so watch your perceived exertion levels!
2) Warm up and Cool Down properly
Just putting your shoes on and going full speed right away is something even experienced runners shouldn’t do. My athletes all start out with mobility movements and drills before starting, then slowly ramp up to their workouts. High level athletes sometimes warm up for over an hour before their main workout starts! This is important for blood flow, getting your brain into movement and making sure all is okay before you start pounding on your joints. At the end of a workout, take some time to walk, evaluate how you feel and don’t just plop yourself down and stop moving right away. Don’t necessarily just stretch, either – often your muscles are too taxed and you are potentially doing yourself more harm than good by stretching immediately afterwards anyway. Treat every workout seriously, because if you want to perform well over time this is an essential habit to have right away.
Historically my athletes all tell me that if they had a crappy run it was because they didn’t warm up or do any movement before they went into their workout. It also significantly increases injury risk.
3) Progress yourself slower than you think you need to.
I can’t stress enough that the majority of overuse injuries I see are caused by their name – overuse. Some days are going to be a lot better than others for running, so ramping up mileage needs to be done weekly with a deload week once in a while (meaning just drop your total mileage by about 20%). There are lots of good plans out there and if the plan calls for 3 miles, don’t suddenly do 5 just because you are feeling great that day. My marathon runners spend months increasing weekly mileage from 50km per week to 70 and many more to 100 – you have to give the body time to adapt to stress under load. I often explain it to people that if you walked into the gym after hardly bench pressing 100 pounds and suddenly tried for 150, likely it wouldn’t go very well and you could easily hurt yourself, right? Running (and any other form of muscular stress) is the same thing. Start with alternating days, then add in a day once you feel capable. 4 days a week is generally plenty for most runners unless you are trying for a very fast time, especially when you add in other components, like…
4) Strength train. Both with resistance and while running.
Huh? How can you strength train while running, you ask? Well, the funny thing is that the body adapts to stress under load. Especially for beginners, getting into the weight room and lifting weights (properly) has been proven to be better for your running efficiency, allow you to recover from workouts faster and severely reduce your risk of injury. Now, this doesn’t necessarily mean bench presses – the strength movements should be tailored to the muscles that you need to be better at running. A good strength coach (and I happen to know an excellent one!) can be your guide here. Strength training while running can be done with things like hill workouts, hard track workouts and even simple drills you can do at the end of a good run. Again, like anything else care has to be taken to do things properly at the start. There are lots of good beginner strength programs out there for endurance athletes.
It also doesn’t require a gym membership. I can outfit a decent home gym for less than $100, so if you need any guidance there or even if you don’t have a lot of space it can definitely be done. In fact, you can get a lot of strength from bodyweight movements alone.
5) Be realistic.
If a person comes to me having never run consistently and tells me they want to run a marathon, I tell them it will take 2 years to do properly and injury free. They usually walk out at that point. So many of us want that big goal without giving our body the time to adapt and get stronger while doing it. If you want to do a ½ marathon (without walking) be prepared to be running up to 50-60km per week. For a 10k it should be at least 30-40 – which requires time, commitment and preparation. Don’t be afraid to downgrade your goal if you find you haven’t put in the training time, you are better off to do that then do the race you set and possibly set yourself back for the future as a result. There are races pretty much every weekend during the summer – they will always be there. Would you rather have a bad experience or a good one? The road is long and if you take your time and do things right the first time, you can enjoy running for years without any issues.
All of this being said, a good coach is invaluable and will give you some perspective. Just please make sure you don’t come to them with a list of goals – pick a top one and have a secondary one, but don’t expect that you will lose 30 pounds while also running a ½ marathon. They are separate things and should be treated as such. If you are interested in exploring either your first race or your twenty-first and are going for a personal best feel free to contact me. I have helped dozens of runners get to that target goal they have been waiting for, whether you are just getting off of the couch or heading towards the Boston Marathon. Feel free to comment, subscribe and follow me on Facebook!