Finding that your return to sport or normal fitness activity after injury is erratic or delayed? You are not alone.
A lot of people can’t shake the “nagging injury” or get past the feeling of being fragile. In Part 1 on this topic I gave you 3 tips that can help you to avoid these pitfalls. Here I would like to go even further to help you get back to being your best.
Tip #4: Don’t train “around” the injury
If you find exercises tedious and boring, recognize that you are no different than anyone else. This is especially true if you are following an exercise program that hasn’t changed in months. Most people have a tendency to start to do only the exercises that they like and leave others alone. However, this bad habit can create large gaps in your program which may lead to an increased risk that your pain will come back.
Fear of pain can also make you avoid strengthening exercises for a previously-injured area. Worry that you will get hurt again holds many people back from performing perfectly safe exercises however this avoidance strategy can limit a full recovery and make you more vulnerable on the playing field. Remember it is safer to do your exercises than returning to play your sport as most resistance exercises stress the body less than the sport itself! Even jogging can create forces in your legs that are close to twice your body weight. Lower body strengthening exercises help to protect the joints against the impact forces created by running, which is why runners are always encouraged to incorporate resistance training into their programs.
When returning to resistance training a good rule to help limit re-injury is to keep increases in workload to 10 percent per week. That means if one week you do 10 push-ups, the next you should try for 11. It may not seem like a lot but once you have several exercises in your workout, it can become a very ambitious goal.
Use the 10% rule to strengthen without injuring
Often after injury I find it even better to keep it lower. I tell my clients not to increase more than 5 percent a week, and I also give them two rules of the game:
- Do not perform any exercise which increases your pain while doing it. If this happens, you are not yet ready for this level and need more time in the previous step.
- Keep increases at or less than 5 percent per week however, if pain is experienced during any part of their exercises, the first rule again applies – back-up to the most recent safe level for another week. For most people, this approach helps keep their progress on track and on a realistic timeline.
Tip #5: Check-in.
It has been said that “failing to plan is planning to fail.” By planning occasional follow-ups with your treating health professional, they can detect small, almost imperceptible changes in your movements habits. In turn, these can indicate possible overloading of tissues which increase your risk of a re-injury. Even athletes at the Olympics use their coaches and therapists to maintain performance and stay healthy throughout the competition, and so should you as you strive to keep your progress consistent and return to sport on schedule.
Checking in will not only stop you backsliding toward a possible injury, but it can also help you keep a positive slope to your progress. You can also use this as an opportunity to change-up your exercises to refresh your mind as well as your body. I’ve noticed that clients who “check-in” each month after discharge from their recovery program tend to stay healthier and play at a higher level than those who decided to go solo. Research supports this strategy as we see that people with knee arthritis do much better by following up once monthly for up to six months after the end of their rehabilitation program, than those who go it alone.
Tip #6: Don’t get cocky.
Overdoing it when you feel good happens more than it should. After the pain has gone and people start to think they can uncork their inner Federer, they find themselves back at the clinic saying that “now they’ve really done it.” Almost always, this happened on a day they were feeling great, having a sense of relief that all is well and now they can finally get back to playing the way they used to. And then they “went for it” – and tumbled like a house of cards.
After injury, many eager players are often not good in controlling themselves when they are near their limit. Holding back is a survival skill that needs to be learned because danger signals from the body are significantly less than in the earlier healing phases. In fact, it’s easier to see steady improvement early in recovery when pain or discomfort sends you constant signals to tell you to slow down. Once the pain fades, learning to listen to the subtle messages from your body is one of the most challenging, and important, parts of returning to sport and fitness after injury.
To help increase your ability to listen to your body, start with controlled exercises or drills that break down movements into digestible pieces that are easy to perform over and over again. Once these have been mastered, combine them to increase the skill level until you are able to perform a variety of techniques in a smooth and consistent pattern. The specific drills and exercises will change based on your sport and performance level, but doing this will help you stick to your game plan when things heat up on the court or field.
With patience and some consideration, you can to return to sport – and perform better than ever – even after a painful injury. Taking a conscientious approach involving appropriate follow-up, referring to your specialists, and learning to listen to your body can help you achieve steady results and shorten the total time spent on the sidelines.
John Gray is a Registered Kinesiologist and Certified Strength and Conditioning Specialist. He has developed athletes from recreational to Olympic levels, and has helped many senior adults to return to their favourite sports after disabling injury or illness.
For more information or to book an appointment, please contact John by email at jgray@orthophysio.com or at 416-925-4687.
