Strategies For Dealing with Injuries
By: Joe Brammer
Around 30 percent of participants in strength training suffer injuries that are serious enough to disrupt training (Kolber et al., 2009. J. of Strength and Cond. Res. 23 (1) : 148-57) Medical statistics show that the rate of injuries in strength training is 1 percent per 200 hours of training.
Here is the breakdown of the most commonly injured body parts.
*30% of Injuries are shoulder injuries
*14 % are arm Injuries
*12 % are knee injuries
*11% are back injuries
(Graves, 2001. Resistance Training for Health and Rehabilitation. Human Kinetics)
The most popular ones are also the ones most commonly blamed for injuries.
- 16% happen during bench press
- 14% happen during shoulder press
- 10% happen during squats
(Eberhardt, 2007.J. of Phys. Ed. And Sport 51 (51): 40-4.).
Here is what most people identify as the cause of the injury
- A poor warm up ( 45% of the time)
- Overestimating one ability (35% of the time)
Let me start by saying I have personally had, dozens of serious injuries, I have broken my kneecap, torn my quad off the bone, tore my MCL, and tendons in my right knee all in one go while I was wrestling. Broke my left ankle twice, broken both hands kickboxing. I had Hernia that was non weight training related. Torn my rotator cuff at least twice bench pressing.
After years of abuse as a pro fighter kicking and hitting people’s bones and constant pain in my ankle, I finally went to the doctor to get it checked out, I discovered I had been walking on a fractured ankle for well over a year. I was in a cast for 3-4 weeks , I got the cast off and my first wrestling practice back one of my training partners shot in on a single leg takedown and by a freak accident my ankle got twisted 360 degree’s and my kneecap broke, quad was torn off the bone and the muscle rolled up like a yo yo on my leg, it looked like my quad disappeared, my MCL, PCL, and LCL were all torn, that took about 2 years to recover from, and it is still not 100% or even 70%.
I don’t tell you all this to scare you but to let you know I have had several injuries and know what it is like to deal with them. I also want you to know that through all my injuries I have never taken more than a single week off of training. Again, I am not saying this to impress you or toot my own horn but to impress upon you that an injury may make you alter your workout but doesn’t necessarily mean you have to completely stop exercising.
Let’s talk about what causes injuries then we’ll talk about how to prevent them, recover from them and work through them.
Injuries can develop insidiously over several training sessions. This occurs because of overuse in conjunction with recovery periods that are either to short or not getting enough rest, food, sleep and nutrients.
Have you ever done bench press or heavy curls and felt like your tendons are about to explode? Tendons have more difficulty recovering than muscles and microdamage occurs during training that can become a problem without proper rest and recovery.
Increasing your muscle strength is much more obvious than increasing your joint strength. For example, weightlifting champions compared to sedentary people have 30% larger quads and are 26% stronger, but cartilage in their knees is only 5% thicker. (Gratzke et al. 2007. American Journal of Sports Medicine 35(8): 1346-53)Their hamstrings are only 11% stronger, and this underscores a huge imbalance between these antagonistic muscle groups. Antagonistic muscle groups are pairs of muscle that as one muscle contracts the other relaxes.
If you also take into consideration that, over time cartilage begins to degenerate more than it is strengthened, you can easily understand the increasing number of injuries.
So, what do you do about it? You don’t want to stop working out with weights because you know how important strength training is for overall health ..here are just some of the benefits of strength training.
- Increases bone density and reduces the risk of osteoporosis
- Helps manage weight
- Increase metabolism and burn more calories.
The #1 Way to prevent injury is to get a proper warm up.
At Elite Edge we do a Dynamic stretch routine before every class to ensure maximum performance and Safety for our clients. Here are the top 5 Reasons
- A proper warmup is first and foremost about injury prevention. If
you are injured you cannot train. If you are injured because of an
improper warmup, this is a training tragedy.
- A proper warmup for metabolic sessions is necessary to burn off
adrenalin and get the body to a steady state of oxygen
consumption. This will make the training session more effective
both in performance and fat burning capability.
- A proper warmup can be used to increase heart rate and blood
flow to and the temperature of the muscles. This increase in blood
flow and temperature will lead to improved strength and power
- A proper warmup can be used to increase flexibility. Our
Warmup uses specific stretches to improve areas of range of
motion that are commonly limited in most people.
- A proper warmup gives you an opportunity to focus on the
upcoming workout and set the tone for the session. The warmup is
the buffer between your life in and outside of training.
Recovery is not simply taking a long enough time between muscle groups to allow recovery. It is not simply taking a day off. Recovery must be viewed with much more respect. Recovery can be an important part of the process just like sleeping and eating right, just like meal prep it is an active procedure that requires attention. Some active options for recovery are
- Proper Nutrition
Some of the best recovery techniques I have used in the past are icing and hydrotherapy. I always ice any body part that is troublesome several times per day until the problem subsides. I like to use a plastic bag filled with ice and water, wrapped in another bag to prevent leaking. I put the ice on the area of concern for about 20 minutes and then move it to another area while that area re heats, I usually repeat this for 60-90 minutes.
A cold bath is a great form of post workout recovery as well if you have the option. This is a gut check though depending on how much of your body you can submerge in the icy water. 50 degrees is usually tolerable, 5-10 minutes is usually my limit, but some people can stay in longer. Stay in as long as you can. Contrast this with a hot bath or hot shower to get the circulation flowing. Repeat this a few times and finish with the hot water. You can do this with a shower or bath.
Massage is great but not everyone has the time and money to make that happen. But the good news is that self-massage is free, and you don’t have to do anything special just massage your muscles in the direction back towards your heart. This returns the blood flow and relaxes the muscles; many athletes swear by this.
Stretching or Yoga.
Muhammed Ali said that he stretched after every workout and that was the key to his longevity. Personally, I always did a lot of stretching and coincidentally most of my injuries occurred during periods where I was not stretching properly for long periods of time, I justified cutting the stretching from my routines because I was saving time. Now that I have had some pretty serious injury’s I have learned my lesson and gone back to basics and do a dynamic stretch before every session and a static stretch after each session.
Yoga was a big part of my recovery after my major injuries. But yoga is not just stretching out after a workout, it is the connection of the mind and body through exercise, meditation and breathing techniques. I used to think yoga was just for mediation and stretching and didn’t build strength, I found out none of that was true.
We all know how important sleep is and we all know we want more of it. But I don’t think we realize how important getting a good night’s sleep is to every aspect of our lives and staying healthy. Several books could and have been written about proper sleep so I won’t go into it too much but getting a good night’s sleep will help recovery, prevention and performance among many others.
You can use certain nutritional supplements to accelerate cartilage reconstruction and lubrication. In one study, high level athletes with knee problems took one of the following each day for 28 days.
- A Placebo
- 5 grams of glucosamine
Recovery of range of motion in the thigh was 40% faster with the glucosamine than with the placebo (Ostojic et al., 2007 . Research in Sports Medicine 15(2): 113-24
Decompression techniques were developed by professional football teams to quickly get injured players back on their feet, treatment involves decompressing the painful joint.
A basic way to decompress is to hang from a pull up bar at the end of a workout. A lot of people have had a great deal of success with this technique. So why not apply this to all of your joints?
You must use decompression as soon as possible after a training session. Joint traction relieves some of the pressure on the joint, thus promoting blood flow and recovery. This technique should be done carefully. Don’t try to use jerky movements or external force, you must use gravity.
At night, people are three-eighths to three-fourths of an inch shorter than in the morning. Gravity will compress your discs, squeezing out the fluid enclosed in them. Think of your discs like sponges: When they are squeezed the fluid comes out. They fill up again at night when the pressure is removed because you are laying down sleeping.
A lot of weight training exercises and life in general compress your spine, I recommend hanging from a pullup bar for at least 30 seconds after every workout, do this 3-5 sets of 30 seconds.
When you hang upside down from a pull up bar, you are not just decompressing the spine. The wrist, elbow, and shoulder joints are also decompressed and experiencing the same regenerative benefits. This technique is called inversion.
Is a more advanced version of decompression where you hang upside down by your feet from a pull up bar. I don’t recommend this unless you are very comfortable with it and have a pad below you, along with a spotter. Inversion, or placing your head down low and your feet up high, decompresses the spine and reduces lumbar pain ( Leslie et al. 2009. Journal of Science and Medicine in Sport 12s:S11. Lymphatic circulation is accelerated because of natural drainage, and this is particularly noticeable after a thigh workout ( Cerniglia et al. 2007 . Clinical Physiology 27 (4): 249)
The first few times you try inversion you will feel as if your face and eyes are filling with blood. Heart rate, blood pressure, and intra ocular pressure all increase. This is a sign your body is not used to being upside down. Because of that you should do the following.
- Get used to inversion slowly over time, until these symptoms disappear.
- Do not use inversion if you are not in good health
- Wait a few minutes after a serious training session before attempting inversion
If you hang by your feet, then the ankle, knee, and hip joints are better decompressed, which gives you a few hours head start on your recovery. Use inversion after a lower body workout if you feel comfortable with it and have the right bar to hang from.
The Fetal Position
This is a great technique that is great to help ensure that hanging from your feet you can decompress all the joints in your upper and lower body.
When hanging from the bar by your feet instead of releasing your hands, keep your grip on the pull up bar. This “fetal” position will decompress all the joints that suffered abuse during your training session.
When you have your feet and hands on the bar your head is not so low, and you will not feel as much pain in your head. Additionally, because your arms are still holding onto the pull up bar, you will stretch the supraspinatus and the infraspinatus, two muscles that are very heavily used in strength training. Stretching them in this manner will prevent spasms and pain and accelerate recovery.
Decompression machines like we have at our Waukee Gym are great for reducing back pain as well. Remember the greater the spine is compressed the greater the risk of pain.
Working through Injuries
If you are involved in sports and fitness, you must face two facts. You will get injured and you will have to deal with the pain. It is not if it is a matter of when. Injury is not the problem it is how you respond to it.
There is a lesson to be learned in each injury, why did it happen, how did it happen and how can you prevent it from happening again. There are strategies for how to react to an injury that you can implement to work around that injury and move forward.
All too often I see a client suffer an injury and take many months off from training. I don’t think any injury should result in this. I have seen some people break a hand or finger and take weeks off of training. Through injury we can always focus on a different area of our body, your nutrition, work on specific techniques, or even work on reading about training and learning new ways to prevent injury.
Injury is a negative experience but in every injury is a lesson to be learned. We can learn not only how to prevent them by learning the cause but also, we learn about our ability to face adversity or at least get around it.
Sometimes an injury can be a brick wall for people, they totally stop, or they keep trying to go through it and make it worse. Sometimes you have to sidestep it and move around it by altering your training or removing certain things all together. You must work around your injury’s so you can heal up and keep moving forward.
When you get injured don’t focus on what you can’t do, focus on what you can do!
Getting injured due to hard training is acceptable, getting injured because of carelessness, improper warm up or laziness is not. Proper training, proper form and technique, and proper nutrition are the best ways to prevent injuries from happening.
Injury prevention should be top of mind in each training session. Making progress, keeping old injuries at bay and preventing new injuries must take precedence in your training. Do not fall into the trap of trying to compete with your training partners and trying to lift more than others, this is one of the things I see again and again that leads to injury. Drop your ego at the door focus on building muscle not trying to lift more than someone else. When ego gets involved with lifting invariably the form goes out the window in favor of simply moving more weight. This is very short sighted and should be avoided at all costs.
Here is a Ten Step Plan for Dealing with Injury
- Accept that the injury has occurred and don’t stop training completely.
- Identify what caused the injury and never let it happen again
- Learn all you can about how to rehab the injury and what happened.
- Use all methods available to you to rehab it.
- Be consistent with your rehab efforts.
- Determine what you can do to work around the injury.
- Focus on areas of improvement while you are recovering.
- Do not try to push through it and re injure the area.
- Create a list of what the injury is trying to tell you.
- Learn the lesson for the future.
You can view each injury as a problem or a challenge. A problem is something you have; a challenge is something you can overcome. Next time you get injured take on the challenge, go around the brick wall and learn more about training and yourself as a result.