Spring is traditionally the time we shed our hibernation lifestyles and start to get active. Running, gardening, swimming, outdoor home maintenance all become part of the better-weather lifestyle.
Spring is also the busiest time for physiotherapists, as resuming these normal activities often causes injuries. Unfortunately, the pandemic has raised our risk for injury even if we are just pursuing these normal springtime activities. Before you go out and take back your new freedom, take a moment to rate your risk for injury and think about what you can do to prevent it. Watch our video
Why do I Injure?
There is a science to the prediction of many injuries. It is a formula that tells us that we will injure when the force we meet exceeds the capacity of our body. When I was learning to ski my instructor summed this up with a succinct comment. When it comes to trees you hope to hit a “bender”. His on-the-nose remark summarizes this biomechanical principle. Either the tree bends or your body bends – just ask my husband who has 13 pins in his elbow from a tree-incident!
The same goes for when you lift something that is obviously too heavy. Many workplaces recognize this by limiting lifts to under 50 lb. Heavier weights are a 2 person lift or use a mechanical assist.
These more traumatic causes of injury are relatively straight forward, however the ones that catch us off guard tend to be the more problematic ones. Many of us know to avoid the heavier lift, or to not ski out of control, however we have less awareness of the impact that reductions in the capacity of our body increase our risk for injury. Add to this the effects of the pandemic and we have a perfect storm for increasing our injury risk.
Three factors which predict your risk for injury
The three factors that make the spring of 2021 worse are:
- Weight gain
- Prolonged deconditioning
- Lack of therapy
To help predict your risk, let’s take a look at these factors more deeply. This should help us to understand what may be having an influence on you this spring. At the end of each section I have included a quiz you can take which rates your risk and then summarizes some suggestions on how to manage them.
Risk Factor #1 – Are you injured?
Injuries set us up for reinjury. We know that the biggest predictor of a having back pain is a previous episode of back pain. Statistics tell us that having back pain just one time, puts you at a 78% rate for risk of recurrence.
I find that the biggest cause of this statistic is incomplete therapy. When the pain finally abates, we feel 100% however at this stage in our recovery our strength may only be 40% of what it was before we injured. Injuries weaken us and even when the pain is gone you don’t want to be fooled into thinking you are as strong as you were before the injury. This means that returning to full activity, before you are ready, puts at at risk to re-injure.
This mismatch is one of the most common causes I see of a repeat injury and this year it will be made worse by the lack of therapy. Many people have gone through COVID with injuries that were not addressed or with therapy that was never completed. If this is you, it’s critical to have a plan to avoid further injury – even if you no longer hurt!
How to stay active while injured
Start by taking a page from the training book of athletes. Their strategy for staying active includes selecting exercises and activities with little to no demand on the injured area. Hurt your shoulder – consider cycling or walking, Painful knee – consider swimming arms only.
Need more motivation or guidance? Read John Gray’s, Reg. Kinesiologist’s, two part article on how to return to sport after injury.
Complete your rehab by seeing your therapist to assess whether you need to specifically target the injured area. Specific stretching, strength and coordination exercises are what is usually needed to complete the recovery.
Risk Assessment quiz
- Score 3– If you are still having pain from your injury and you have not started a general exercise program
- Score 2 – If you had an injury in the last year, that no longer hurts but you did not complete targeted therapy.
- Score 1 – If you had no pain or injury in the past year.
Risk Factor #2 – Are you out of shape?
Be honest – how active were you this winter compared to years past? There is no doubt it was harder! The gyms were closed. There was no indoor hockey, indoor tennis or downhill skiing. Unless you made a conscious effort to stay fit you are probably more out of shape in spring 2021 than you were even last year.
Spring is the busiest time for a physiotherapist, as many people typically do less in winter and we decondition. This deconditioning is enough to influence even workplace stats. People doing the same job have more risk of injury in spring than summer and fall.
These injuries are not just because we get more active, it’s also because we think we can do the same in April as we could in October. The truth is that unless we have done something to replace this natural period of inactivity, there will always be a mismatch between the deconditioning of winter hibernation and the sudden strength demands of spring.
Unfortunately, I anticipate this year will be worse, as many of us did not get back to typical levels of activity in the spring and summer of 2020. This means that by spring of 2021 we will have deconditioned for almost 18 months and not the typical 5-6 months of most winters.
Check your Data
To limit your risk take a moment to honestly think about how active you have been since March 2020. Many of us have metrics we can compare to get a solid feel of what has changed.
- Our Smart watch or Smart phone collects our steps data. Use the year-to-date screen to see how your annual step count compares to 2019.
- Consider what you lost i.e. swimming, tennis, and what you replaced it with i.e. on-line classes or increased walking.
If your activity level has gone down then make a plan to increase it incrementally. If you do not have an injury, most people can tolerate 10-15% increments. If you combine injury with lack of fitness you may need to take this down to 5-10% increments.
Consider seeing a Reg. Kinesiologist or certified personal trainer if you need more guidance on managing your return to activity or a fitness assessment to see what level you are really starting at. See a Reg. Physiotherapist or other injury professional if you are recovering from an injury before you increase your fitness.
Risk assessment quiz
- Score 3 – if you have had an exceptionally inactive all winter.
- Score 2 – if you tried to stay active but know you have lost a bit of ground over the winter
- Score 1 – if you have stayed active and fit this winter.
Risk Factor #3 – Weight Gain
Many of us have gained weight in the past year. I hear that COVID 19 can now mean the number of pounds gained during the pandemic. Hopefully you haven’t put on a full 19, but as little as 6 lb. can increase your injury risk when you return to sport, particularly if you have put it on recently.
We all know that it’s easier to lose weight when you are active but it’s best to have a plan to get the weight off with a balance of eating and activities. If you’ve gained weight, resume your activities a bit slower to reduce the influence of these extra LB’s. Consider seeing a weight loss professional as well as working with your exercise/injury professional if you need to combine weight loss with activity or injury management.
Risk assessment quiz
- Score 3 – if you have gained more than 6 lb.
- Score 2 – if you have been active all winter but still gained between 1 and 6 lb.
- Score 1 – if you have not gained weight.
Interpreting the results of your risk for injury assessment
The risk factors discussed in this blog are some of the most common causes of unanticipated injury. The rating is a result of my experience as a therapist as well as what research tells us causes injuries. Here’s some guidance on what I have found works to prevent injuries or recover without re-injuring.
| Score | Risk | Safe Activity level | Should you see a professional? |
| 3-4 | Low | As tolerated. Use effort as your guide. | Professional guidance is always helpful however in this case it may not be essential. If you start your spring activities a bit slower than usual you will usually be fine. |
| 5-6 | Moderate | You should have a plan to gradually increase your activity level. Follow it logically and don’t get carried away by the good weather! |
Before you return to high level activity consider seeking guidance from a Reg. Kinesiologist or Certified Personal trainer If you decide to do this on your own, then try to limit the increases to 10-15% increments and judge your body’s response. Adjust as needed. |
| 7+ | High | Professional guidance is recommended before you get too active. | The higher risk level requires a more complete plan to prevent injury. You should limit increases in activity to 5-10% increments i.e. 5000 steps increase by 250-500 weekly. Have your therapist identify imbalances and develop a plan for targeted stretching and strengthening. Add in a plan for weight loss if needed. |
If you need help with a plan for activity or for your injury please contact us at 416-925-4687 or physio@orthophysio.com
