What to do when you sustain an injury
By Dr Matthew Chircop, 11/16/2016
Well, the first thing to do is to find out what the injury is and what, if anything, you can do to improve your recovery (at least a visit to the doctor). This will almost certainly involve not training the injured part until it has recovered. Once recovered, you might need to visit a physiotherapist to determine if there is either a muscle imbalance or a lack of flexibility that contributed to the injury. If not, then it might be related improper technique when you are performing a particular exercise. In this case, you might want to get advice from a trainer on how to correct this. Sometimes this doesn’t just relate to the execution of the movement, but the sequence in which certain muscles are activated and relaxed during the various phases of the movement.
For example, a herniated disc in the lower back might be related to a lack of hamstring flexibility, overactive or tight hip flexors, or underactive gluteal muscles (in combination with a relative weakness of the back extensors). All of these issues are common in people who spend large amounts of time sitting. The result is a straightening of the normal curvature of the lower back, which increases the tendency of the discs of the lower back to bulge - a perilous position, particularly when performing squats or deadlifts. In this case, rehabilitation would involve avoiding offending exercises (anything requiring forward bending of the spine), avoidance of lifting (which puts a load through the spine and has a tendency to aggravate the bulge), and stretching of the hamstrings and hip flexors. Once the disc has healed (which can take 2-3 months), then commence an overall conditioning program, starting with body weight and gradually adding resistance training as tolerated. The focus of that program might be to improve activation of the gluteal muscles, so that they can take some of the load off the hamstrings, and the lower back extensors – helping the subject to maintain a neutral posture of the lower back (neither straight nor arched – the latter posture can also result in damage to the spine when under heavy load).
Another common example is a torn rotator cuff. Some of the reason for the injury relates to individual anatomy in combination with exercise choice. The shoulder joint consists to the “ball” (or head) of the arm bone (humerus) held up against the “socket” of the shoulder blade (scapula) by 4 small muscles (with their corresponding tendons – collectively referred to as the rotator cuff). The socket and rotator cuff is further enveloped by bony projections (from the scapula) and ligaments, which effectively restrict the mobility of the shoulder joint. For some people, the space between those rotator cuff and the bony projections is smaller than for others. Such people are prone to wearing or fraying of the rotator cuff during certain exercises (e.g. upright rows, wide grip bench presses). For some people, poor form contributes to increase wearing of these tendons (e.g. performing presses with the shoulder blades pushed forward and/or raised, instead of pulled back and down). For others, this is the result of poor programming, whereby exercises that fatigue the rotator cuff are performed early in a session, placing the shoulder in peril during later exercises. Some people might also have relative weakness of the rotator cuff muscles. In some individuals there is a lack of flexibility, with the chest muscles being relatively overdeveloped and tighter than the muscles which pull the scapula back and down (the trapezius and rhomboid muscles). Whatever the predisposing cause, rehabilitation involves gentle unloaded movement of the shoulder joint throughout its range (to prevent “frozen” shoulder), followed by stretches, and rotator cuff muscle strengthening (once the injury has settled). Once training resumes, there needs to be attention to exercise form and appropriate programming - to prevent early fatiguing of the rotator cuff muscles during exercise sessions (e.g. by performing rowing movements on a separate day to pressing movements), substituting certain exercises for others (e.g. overhead press instead of upright row), modifying the form of certain exercises (e.g. narrow grip bench presses instead of wide grip bench presses), and correcting any imbalances (e.g. by increasing strength of rowing movements). If not, the injury has a high likelihood of recurring, and leading to arthritis and pain of the shoulder joint later in life.
The other common injuries are overuse injuries like “tennis elbow”, “golfer’s elbow”, and Achilles tendonitis. Sometimes these are caused by too rapid a progression in your training, whereby the main muscles for a particular exercise are getting stronger faster than your forearm (e.g. chin up or hammer curl). In over cases, this relates to sudden changes in activity levels – e.g. when people start to walk significantly more than usual (plus or minus some inflexibility of the calf muscles because of prolonged sitting) then Achilles tendonitis can result. Rest and stretches fixes these problems. Once the pain has settled (weeks or months later), and once the flexibility has improved, consider dedicated strength training for the lagging parts and reducing the training load otherwise (either resistance, frequency, duration, repetitions or combinations thereof).
Well, that covers the training aspects of managing some common injuries. What about nutrition?
As always, an adequate intake of micronutrients, especially vitamin C, is essential for rapid repair. Vitamin C is required to “crosslink” collagen, which contributes significantly to the tensile strength of soft tissues (like tendons and ligaments). Amino acids (found in protein) are also essential structural components of collagen and the active (movement-generating) fibres within muscle cells. Energy is also required. As such, you might want to consider either reducing your calorie deficit or else eliminating it entirely.
This depends on the severity of the injury, the rate of progress of your healing, and how much weight you have to lose (the more weight you have to lose, the less concerned you need to be about eliminating calorie deficits to promote healing).
Our personalised meal plans can help keep you on track with your body transformation whilst sustaining an injury.
Provided in tasty recipes that you enjoy.
Provided in tasty recipes that you enjoy.