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Injury recovery requires us to get creative. Most fitness programs will not serve you when you are injured without some measure of adaptation. If you adapt your training to take care of your body through this process facilitates a complete recovery that staves off future issues.
Last week’s post discussed the often-missed need for physical therapy to address the patterns that arise from compensation. This week I’m going to lay out some of the strategies that use to keep my body as healthy, strong, and pain-free as possible while managing injuries.
As I said in my post Injury as a Superpower I have had a lot of experience managing injury—common for people on the hypermobility spectrum. Over the years I have learned to see my injuries, even this current knee explosion, as a part of my training experience. They may not be the pleasant or fun part, but I can’t wish them away by pretending they don’t exist. I need to work with the body I have.
So right now my daily workouts are primarily focused on the things that I know will get my knee moving again and prevent the rest of my body from developing new miseries in the process.
Why One Injury Can Set You Up for Future Injuries
Last weekend I took an amazing workshop on feet from Dr Locatelli Rao in Pasadena. He told us that any time someone comes in the door with pain, ask about all their past injuries. So often these long-ago offenses to our physical system set in motion a series of compensations that leave our basic movement patterns out of balance.
When we are out of balance we may not suffer any consequences for a while. Sometimes pain shows up quickly, but sometimes it takes many years for that old pattern to slowly wear you down or create a situation where one small straw initiates a surprisingly catastrophic result.
Adding to the obfuscation the new pain may not be anywhere near the initial injury. Compensation is a creative process and every body will develop its own coping strategy. A great practitioner like Dr. Loc has a detective’s skill at hunting down the patterns behind pain.
My lab partner in the workshop described his experience of having been bonked in the knee creating some swelling and pain that gradually subsided over time. He is a beast in the gym so he kept on training despite noticing some pain in his lower back. Then one day he leaned over to pick up his gym bag after one last set of heavy back squats and his back spasmed so hard he fell down. It would be easy to miss the connection of the knee bonk to the back spasm, but the back is a direct result of an incomplete knee rehab.
Butthead knows what I’m talking about
Preventing Compensations Before They Settle In
The body is marvelously inventive when it comes to survival. It will do whatever it can to keep you walking, breathing, and looking around no matter what else you have going on. This makes the task of predicting and preventing compensations as much an art as a science.
That said, one of the great gifts of injury is the opportunity to slow down and improve your listening skills, taking the time to learn how your body works and responds. Again, this may not be the fun, sexy part of your fitness life but it will serve you for the rest of your stay in this body.
I am unable to offer specific exercises since this is such an individualized process that I and most practicioners are still unraveling. But here are a few guidelines I use to help me decide what I need to work on:
Identify the big, obvious patterns. Look for the compensations that make themselves immediately apparent through cramps, tightness, spasms, and pain. These are clear areas that need extra strengthening and mobility work.
Avoid the usual approach of doing all your exercises the same on each side. Your sides are different and they need different things. Notice which exercises are really hard for one side and not the other and focus, possibly exclusively, on the side that really needs it.
Don’t overdo it. While we want to keep our bodies as strong as we can, healing is exhausting. Our bodies are already putting massive amounts of energy and resources into patching up, which makes our threshold for over-training much lower than usual. Over-training while injured is a great way to slow healing, worsen imbalances, and even make whole new injuries.
And don’t underdo it either! It is way too easy to forgo training altogether when we aren’t able to work out the way we want. It takes a lot to limp into the gym or get out the mat at home and force your aching carcass through a series of tiny, unsatisfying exercises. It’s hard to find the balance between over- and under-training. It requires both optimism and patience and a rejection of so much of fitness culture to believe that this kind of training is still fitness, and still valuable.
Next week’s post will cover the fitness community that has already invented this wheel and how an under-celebrated group of coaches and educators can provide the leadership that we need to get better at healing and preventing injuries. Fitness culture desperately needs a makeover and these folks know how to do it.
Thank you so much to all of you who emailed to share your stories of injury rehab gone wrong and the long-term effects of incomplete physical therapy (or no physical therapy at all). To everyone out there struggling with pain and insufficient resources you are not alone.
Happy Bendings,
Kristina
