I work with a lot of injured clients, and the vast majority aren’t from acute traumatic blunt force injuries. That’s right, most of them are coming from an overuse injury, and while most of them will willingly listen when I say to stop doing whatever it is that’s causing the problem, there’s always a small faction out there that JUST……..WON’T……LISTEN.
Disclaimer!!!! Now I’m not picking on any one person out there, because I’m sure there’s about a dozen clients reading this thinking I’m singling them out. Trust me, I’m not, and you’re not alone.
Overuse injuries pretty much describe themselves: You get pain from doing the same thing over and over again and not allowing enough rest between bouts of trying to beat the living hell out of yourself that it winds up breaking down. The more and the harder you beat on it, the faster it breaks down and the longer it takes to heal.
Now the basic thought process is a very simple one: Stop doing the shit that makes the pain worse!!! You would think that would go without saying, right?? But try telling a runner not to run. It usually doesn’t go very well. I mean, I love water running as much as the next person (Re: I want to shave my face with a collection of blades scotch-taped to an electric fan before I would want to do water running), but that’s where cross-training comes in. What it means is that you have something else to do that doesn’t cause you to break out into Celine Dion levels of screaming whenever you do whateverthehell it is that you’re doing that’s causing pain.
I’ve had clients come into me so messed up that they were training 20 times a week, and wondering why they weren’t getting stronger. Seriously. So when I tell them they’re going to cut waaaaaaaaaaay back to just 3 or 4 workouts a week, they have their little crying jag because they think they’ll lose all the fitness they’re currently losing anyway by cutting back, they’ll gain tons of weight because they aren’t burning anything, and the world will shun them like lepers or Oilers fans, but they decide finally that I might know what I’m talking about and start backing off. Wouldn’t you know it?? Within a week or two they usually start feeling better, stronger, and more awesome than ever!!
At that point, they decide to do the obvious thing that everyone would do: They jump right back into their three-a-day workouts at full intensity, thinking the pain is gone, gone, GONE forever!!!!. Ummmmmmmm, NO.
So inevitably, after they feel no pain, the person with the overuse injury will think they’re fully healed, which is a misnomer, because as they feel no pain, it simply means the tissues aren’t currently inflamed enough to trigger the pain receptors in the damaged tissue, not that the tissues are healed. It’s going to take a long time to build up an overuse injury, and the longer a person works with an overused tissue, the longer it’s going to take to get that tissue to fully heal, so getting back into the straining activity too soon will only wind up making the tissue get weak and painful again.
To give you one example, I have a client who was a very competitive runner, triathlete, cross-country skier, and speed walker. Yes, this person competed in all of these things, sometimes multiple races in each in the same year. Of course, she wound up developing tendinitis in her ankles, which made everything very difficult and painful. Of course, she didn’t stop until she wound up having to stop when she broke her ankle in a car accident. Now with the broken ankle, she couldn’t weight bear, which gave the tissues time to recover, but they also atrophied and became weaker and more brittle. As soon as they could weight bear, yup you guessed it: right back to training. Guess what came back?? This time with a vengeance as a full-blown tendinosis. So after trying to run through this pain for two years, she came in to me to design her run program and do a run analysis to help her run better to avoid the pain.
My reaction was a combination of abject horror and, to be quite honest, admiration at her resiliency to avoid giving in to her pain. If she was a midevil witch, she would have survived all the torture tests, and then been burned at the stake for being a witch for surviving all the torture tests. To give you an idea of the type of pain she was probably in, take a look at this picture of WWE former superstar Hacksaw Jim Duggan.
Now imagine you’re a teenager and bringing a special someone home for the first time and that Hacksaw is your dad. He greets your special Suzy wearing his wrestling onezie, and looking like he does here. Now imagine the type of pain you would be in when you went to school the next day, and your special Suzy has told everyone in the school about your dad. That’s the kind of pain she was in on a daily basis: a deep, burning and anger-filled pain.
So I pulled her off ALL of her normal training, and put her on two days of weight training with light balance work per week. She was able to swim twice a week for a MAXIMUM of 3000 meters each. Six months later, she isn’t in any pain, and she can start adding in running once per week, for a total of 5 minutes only. If she has any pain whatsoever the next day, we’re back to square one. Once she can run twice successively with no pain for 5 minutes once a week, she gets to do 5 minutes twice a week, and then up to 10 minutes twice a week, and so on and so on. If she gets even a little sore after a workout, we drop it back two weeks, and make sure we under-cut the threshold for injury based on her current tissue strength.
Now the only people I actually feel bad for are the people who have RSI’s from office jobs, because let’s face it, there’s little chance we’re going to move back towards an industrial revolution level of physical activity in our daily occupations, and we’re pretty much going to become hunched over gnomes who blink in sequence with the refresh rate of the screens. They have to sit there, in a painful position, because that’s their job. If you’re doing the same thing all the time as recreational and you keep getting injured as a result, you’re just not paying attention close enough. Switch up your program, do something different, and in the majority of cases, just take a day or two off. Chillax, read a book, play some Guitar Hero, and let it rest so that it can heal properly.
Most of the time, people are generally good, and will listen to advice as I give it to them, follow directions, and take my warnings as imminent and foreboding, and I find they make the fastest recoveries. The ones who keep pushing it and trying to come back too soon or do too much before they’re ready, they’re the ones who pay the price, and have to keep balancing rehab with performance training. I’d much rather take a week off and rest than take a year off and recover. That’s just simple mathematics, brotha, but hey, what do I know?