Trust me when I say, I’ve been there. I understand the frustration that comes with being injured and not being able to train to your full potential. Being a high level athlete and a physical therapist gives me a unique view, and has allowed me to come up with strategies to overcome injuries in a way that won’t only get you back in the game, but will get you there stronger than ever. So here are my five cents:
1. STOP DOING WHAT HURTS, NO PAIN= MORE GAINS: If you have pain when you squat/deadlift/snatch/press- don’t do that! Just as important as what you DO is what you DON’T DO. We hear this from healthcare professionals all the time, yet we almost always chose to ignore this simple advice. It doesn’t mean don’t do it forever, it just means avoid it for now.
2. TISSUE ADAPTATION TAKES TIME: Injury occurs when LOAD> TISSUE TOLERANCE. Between load and tolerance there’s a margin of safety. If you’re coming back from an injury, that margin of safety is smaller. You need to give your tissues time to adapt by progressively loading them so they are strong enough to withstand the load.
3. HABITUATION: Turn off the pain alarm. Whatever movement is causing you pain, expose yourself progressively to it. For example, if you have back pain when you bend forward, begin with OTHER movements that involve spine flexion like cat/cows, segmental flexion, sitting down in a chair with your head down. The second portion of this point is to begin loading under your CURRENT pain threshold, never above and increase volume and intensity slowly.
4. ISOMETRICS and high rep, low load: There is a big body of evidence that suggests that isometric contractions have an analgesic effect. Stuff like bird dogs, dead bugs, side planks, wall squats, etc. These exercises also increase muscular endurance, which improve stability. I’m talking about 8-10 reps 30-60second hold multiple times per day.
5. MOVEMENT CORRECTION: Sometimes it isn’t as clear cut as simply avoiding a movement. We can do that for a short period of time, but if that doesn’t take care of the issue we need to identify the biomechanical fault and target it with corrective exercises.
-By Dr. Stefanie Cohen, DPT