Saturday, October 19, 2013

Weight Lifting with Injuries and Pain

My friend and fellow Venus- Rhonda

I have gotten injured myself and coached others though new or existing injuries. They are a fact most of us with deal with at some point in time. What I see is a lack of information on how new and existing injuries should be addressed. Most people that I see with injuries fall into two camps- too conservative or too harsh. You need to find moderate ground when dealing with aches and pains.

What to do about new injuries


1) Most doctors and therapists allow from 3 days up to a week before they actually want to see you to treat the injury. (I am talking run of the mill sprains and strains here not broken parts, or wounds.) If you tweak something during a workout or while moving around, you should apply heat/cold and wait to see if the body will rectify it without intervention. After 3 days, if the injury is getting worse or not improving- go ahead and schedule an appointment. Better safe than sorry.

I had some tendonitus last year in my foot, I wrapped it up in an ACE bandage for a week or more. Running was out of the question for that week, but squats and lunges were fine. All upper and core work were fine. I still taught my gym class. I just worked around the injury.


2) Generally, 1-2 rest days are in order. (That does not meet you need to eat like there is no tomorrow either, it is not a nutritional rest haha!)

3) You can workout despite the injury. I find that most people are overly cautious here, they would rather just rest until they are healed up. An ankle sprain for example, can take weeks to fully heal up, which could set you back a bit. You should work around the injury.


My friend Rhonda, for example, broke a bone in the top of her foot recently in a random accident just walking, on uneven surfaces which required surgery to correct. Rhonda will be in a walking boot for 5 weeks (out for a total of 8 weeks probably). She has still been going to the gym on her normal schedule in a boot to keep her upper body from regressing. Rhonda can keep up with all of her upper body work. She has found many workarounds for her lower body too- she found she is still able to do leg extensions, leg presses, hamstring curls, and wall squats just fine. 


4) Pain should be your indicator. If it hurts, stop. Pops, crackles, grinding are actually all just fine as long as there is no pain. If it hurts though, it is not okay to do whatever you were doing.




What to do about existing injuries


1) I would try to strengthen the injury through lifting before I went to a therapist. It is very likely that most of the exercises they will have you do are what you do anyway in a good lifting routine (Venus Index is one of those, I highly recommend it) The only thing the therapist might give you that is new are some additional stretches, form modification, or work arounds. Generally, most people who are experienced at the gym will already know these things, if you do not, then going to the therapist would be a good idea.

My friend Stephanie has an existing shoulder injury from her youth. She can do lots of upper body work, but some things hurt while others do not. She can do a shoulder press no problem, but not push ups and tricep dips as well for example. Lateral raises are also very challenging for her. She works around the issue and we try to sub out similar exercises for the area. She finally went to a physical therapist this year after dealing with it for most of her life. She was surprised to see what most of the work they had her doing was exactly what she was doing during her lifting workouts with VI. They did teach her some new stretches and band work that she has now incorporated into her routine. But it only took a few sessions with the therapist to learn those, she is now doing her therapy on her own. Stephanie has now improved her strength in her shoulder and is using weight (8's and 10's for lateral raises) as she is able.


2) Existing injuries are often exaserbated by muscle imbalances from avoiding the use of the limb/joint. You should do an additional set on the weaker side until balance is restored. DXA scans are the gold standard to ID imbalances- you should do progressive scans until balance is evident.


John Barban, creator of the Venus Index, also has some shoulder issues from pervious injuries. When he got a DXA scan recently, his musculature imbalance from left to right in his upper body was significant. For the next 8 weeks, he did an additional set of the weak side of anything that targeting his back/shoulder area. He then went back for a DXA and he had brought up the weaker side enough to shift the balance to neutral.

3) If you are new to lifting- do not be surprised if existing pains go away over time. Sometimes painful knees or backs are due to the lack of musculature and/or overloading. As you lose weight and get stronger from your workout routine, these aches and pains generally go away. I have seen it with backs and knees time and again. So keep trying the movement each session, if it hurts work around it, but one day you might just be able to do the movement with good form and no pain!

These are just some ideas to go off of. I am not a licensed health care provider- your treatment should always be in conjunction with a physician's care. The good news is that the setback is just temporary. Any muscle that shrinks during your healing time will respond quickly; you will be back to where you started much more quickly than the amount of time that it took you to get there initially.