Training With Injury
Mariah May, CSCS
Injury, throughout our lives, is inevitable; whether it arises from an accident, surgery, or overuse, there are many potential causes that can manifest slowly or suddenly. Since injuries, big or small, are a fact of life, it is important to know how to bounce back from them.
When Injury Occurs
After an injury, there are two responses mentally that sometimes occur: fight or flight. Some may choose to ignore signs of the injury and simply "push through. While others may be too afraid to engage in any physical activity for an extended period. Striking a balance between these two responses is crucial. Pushing through injuries may potentially cause even more severe damage to develop, while not moving at all can lead to stiffness, muscle atrophy, and joint deterioration. There are various ways you can train and remain active even when injured, helping your body recover and maintain the fitness of the affected areas.
Beginning of Recovery
Right After the Injury
When an injury has just occurred, it can be identified by the inflammation that occurs around the affected area and the accompanying pain. During this time, your body's collagen synthesis decreases. Instead of pushing through during this initial phase of inflammation, you can use the R.I.C.E (rest, ice, compression, and elevation) protocol to aid in reducing inflammation. No active exercises should be done involving the injured area directly.
Nutrition
Well-rounded nutrition is essential during recovery. When injured and experiencing a lack of movement in your regimen, you may undergo muscle loss. Consuming carbohydrates and protein can help mitigate these losses. Despite the reduction in physical activity, your body still requires fuel to facilitate the healing process. In fact, some injuries may necessitate an increase in caloric intake by up to 20% to compensate for the healing process. Just because you're not working at the same intensity as before doesn't mean you should underfeed yourself.
Active Recovery
A great next step is to engage in some active recovery, it allows you to keep moving without risking further tissue damage due to its low intensity. Examples of active recovery include yoga, cycling, swimming, hiking, and walking. By participating in these types of exercises, you can increase blood flow to the damaged tissues, which, when done properly, can promote recovery.
Getting Back Into Training
Listening to Red Flags
When you begin exercising regularly, it is important to pay attention to your body's limitations. Your body may communicate signs of your injury. Some red flags to be aware of while working out include:
Pain in the injured area
Lightheadedness
Nausea
Cramping and extreme tightness in muscles
When these symptoms occur, stop the movement you are doing and make necessary adjustments to the exercise.
Modifying Exercises
Whether you are in the middle of a workout and experiencing pain or know you need to adjust the movements ahead of time, it is important to be aware of the various ways workouts/exercises can be adapted to fit your needs and allow you to stay active. These modifications include:
Shortening the range of motion: This is a great option if you are experiencing pain or discomfort at a particular part of the movement but not throughout the entire range of motion. For example, if you have knee pain and cannot perform a full-depth squat, stopping at parallel or squatting to a box allows you to work the same muscles and engage in the same movement while reducing the risk of further irritation. Just be sure to gradually increase the range of motion back to its normal capability over time, as your body may adapt to the reduced depth, making it harder to return to normal.
Replacing the movement: There are two ways to replace a movement. You can work the same area but switch the exercise or completely shift the muscle group you are targeting. For example, if you experience low back pain, instead of doing kettlebell swings, you can do romanian deadlifts. Both exercises engage the same muscles, but they involve different movement. Alternatively, if your shoulder has recently been injured, you could substitute a shoulder movement with a chest or another upper body exercise.Taking out the shoulder until it is more recovered while still getting in some training.
Lightening the load: Sometimes, all you need to do is decrease the amount of weight you are using. Start with bodyweight exercises, isometric movements, or light resistance bands until you feel confident enough to gradually add more weight. When reintroducing weights into your routine, always start with higher reps and lower weight until you can confidently progress to low reps with higher weight.
Cross Education
When modifying your workout, there are benefits to using unilateral movements or working only one side of the same muscle group that is injured. For example, you can still work the right shoulder even if the left one is injured. While this may seem counterintuitive, there is a phenomenon that occurs under these conditions called cross education. Cross education is when training with unilateral resistance can increase the strength in the other untrained muscle group. These strength gains have been found to range between 8% and 22%. So, instead of abandoning a movement because one limb can't perform it, it may be worthwhile to work one side to reap the benefits that come from cross education.
Injury happens to us all, and while it may be disheartening, it is important to keep moving. This is a huge advantage to training with coaches at Altitude Athletics rather than trying to navigate these issues on your own.
Sources Haff, G., & Triplett, N. T. (2016). Essentials of strength training and conditioning. Fourth edition. Champaign, IL, Human Kinetics.https://www.nata.org/sites/default/files/nutrition-for-injury-recovery-and-rehabilitation.pdf