• Zach

Part 2: I Have an injury. Can I still train?

Welcome back!

Please note that you may be reading this before Part 3 of this topic is released, but it is coming soon!

For this post, we want to address a third common concern that people have regarding weight lifting:

3) “I have a previous injury or nagging pain that makes it impossible for me to lift weights.”

This can be a HUGE barrier for people, especially middle-aged and older folks who are more concerned about little pains becoming permanent injuries than 20-somethings who still think themselves to be invincible.

I want to preface this discussion by stating the obvious: there’s no way to cover every possible injury or nagging pain in one article, which creates the necessity to make very generalized statements instead of discussing specifics.

(And as always, none of the information provided here should be considered medical advice. It is for informational/entertainment purposes only. Always consult your doctor for medical advice or before starting a new exercise or nutrition program)

To start off let me ask you a few questions to get you thinking.

1) Have you been active, working out consistently in any way, since your pain started or the injury occurred?

2) If no, has the pain or injury improved or has it gotten worse?

3) Have you ever considered that lack of activity may actually be making your pain/injury worse rather than making it better?

If you are anything like me, you were told growing up that the blanket cure for basically any pain or injury is rest and ice. But what if that isn’t the right answer?

Have you ever been sore and found that you actually felt better after ACTIVITY than after laying around all day “recovering?” I know I have.

If a week or two or isolating a muscle or joint doesn’t cause a pain to go away (excluding broken bones, torn muscles, and other discontinuity-type injuries) then maybe rest isn’t the right approach. Maybe what you really need is to continue to move through the range of motion that your pain or injury affects.

For example, if you’re having lower back pain it might make sense to move through that range of motion by doing unweighted or even lightly weighted good-mornings.

I’ve had several back “tweaks” during training (or just everyday activities) that I could have blown way out of proportion and self-diagnosed a slipped or herniated disc, “blown-out back,” or some other horrendous condition. I could have determined that it was dangerous for me to do anything with my back and that I had no choice but to completely isolate and rest it until the pain was gone.

And I have done that in the past, usually at the suggestion of someone who had no idea what they were talking about no matter how well-intentioned they may have been.

But what actually helped the most was not rest at all. It was quite the opposite.

Moving through the range of motion that is painful causes two significant things to occur which aid in recovery:

1) It forces more blood into the area, encouraging more rapid removal of any harmful or inflammatory materials that may be present and causing the pain. This is important during the time immediately and soon after your pain, soreness, or perceived “injury” occurs or starts.

2) It stimulates and strengthens the area rather than leading to atrophy through lack of use. How can you honestly expect weaker muscles in and around a painful area to help make the pain go away? This is important in the medium to long range time after the pain/injury first occurs.

For me, the sooner and more frequently I was able to get my body moving through the painful range of motion, the sooner the pain disappeared.

It may seem counterintuitive, but you may be intentionally and stubbornly avoiding the very thing that could fix your problem by isolating and resting a painful area for long periods of time. To get a little bit more specific around a common issue people experience, let’s go over an example.

Image source here (Flickr.com)

Low-back pain or soreness is fairly common in both everyday life and the life of someone who is strength training with barbells. Whether it was from lifting up a box, laundry basket, a kid at home, or squatting or deadlifting heavy, you’ve probably had a “back tweak” at some point.

Ok, so you hurt your back - now what? For the sake of this example, let’s say you felt a twinge of pain during a heavy set of low-bar back squats and the pain continues in the days afterward – but don’t tune out if you don’t strength train. Being as that pain would probably (not always, but probably) be more severe than if you hurt your back picking up a 20-pound box at home, we can apply the same concepts and similar treatment to the lesser-severity pain of picking up the box.

Let’s also assume that the pain is severe enough that you cannot perform a full range of motion low-bar back squat because of it.

Assuming you don’t have any numbness or tingling, your back isn’t bruised/discolored or swollen, and you can physically move through a normal range of motion (no bones are broken or dislocated), the first step would be finding a movement that you CAN do with little to no pain that is similar to the range of motion that causes pain.

For this example, you hurt yourself doing a low-bar back squat. Can you do a slightly higher depth (not going down as low) low-bar back squat without pain at a similar weight as you hurt it at? What about a front squat, hack squat, leg press, or even a deadlift? Try to find a movement that is as similar to the movement that you can’t do as possible, but doesn’t give you so much pain that you can’t handle it.

A little bit of pain is ok for whichever movement you use. Let’s say keep it to a 1 or 2 at most on a pain scale of 1 to 10. This would be a sensation that feels more like what you would describe as discomfort than as pain.

Substitute that new movement for the movement that you can’t do and are trying to recover back to doing (in this case, low-bar back squats). Train the substitute movement as similarly as you can to the original movement.

For example, if you were doing three sets of five, three times per week of low-bar back squats, try to do the same thing at a similar intensity using the substitute movement as long as you aren’t experiencing much or any pain with it (again, keep it to a 1 or 2 on a 1 to 10 pain scale).

At the end of each training session, see how it feels to move through the original movement’s range of motion. If you can get the pain down to a 1 or 2, you can try doing the original movement next training session. Just make sure you start with very light weight and add weight slowly during your warm-up. If the pain ever jumps up above a 2, revert back to a substitute, similar exercise you can do with little to no pain for the rest of your sets for that day.

Another variable you can play with is using supportive equipment. If you normally only use a lifting belt on your heaviest sets, try using a lifting belt on all sets. This will allow you to brace your core a little bit harder and can also serve simply as a mental placebo to decrease your worry of hurting yourself again.

As long as you have patience and are disciplined with working slowly back into the original movement, you should recover fairly quickly with minimal (if any) strength loss through that range of motion.

Image Source Here (Flickr.com)

The same concept can be applied to an injury from picking up a box at home. Can you do unweighted good-mornings? Can you do unweighted good-mornings through a slightly reduced range of motion? Can you do cat/cow extensions and retractions? With low-intensity unweighted movements like these, you can do one to three sets of anywhere between 10 and 30 reps on a daily basis. Muscle and joint pain are usually at their worst in the morning, so I find it best to do these exercises right after you wake up and any time the pain returns to help warm-up and calm down the painful area.

Take it one step at a time and slowly transition to using movements that are more and more similar to the range of motion that you previously couldn’t do because of the pain. For the example of lifting up a box, that might look like this:

Three to four days of cat/cow extensions and retractions

Three days of half-range good-mornings (bending over to about a 45-degree angle)

Two days of three-quarter range good-mornings (bending over to about a 60-degree angle)

Two days of full-range good-mornings (bending over to close to a 90-degree angle at the hips)

Barbell Good-Morning. Don't use a barbell for unweighted good-mornings, but the movement is the same.

Unless something is structurally wrong (broken or dislocated bones or nerve damage) you will always be able to find some version of the movement that created the injury that you can do without significant pain. This is usually your key to full recovery and the original movement being pain-free again.

If you do have any numbness, tingling, broken bones, or dislocations, I hope it is obvious to say you should go see a doctor immediately. What we’re talking about in this discussion are injuries that are not structural discontinuities of bone or nerve.

What do you think? Do you have any experience with pain or injuries and recovery like we’ve discussed here? Share your thoughts below, give it a like, and share this post with someone you know who could benefit from it!

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