Thursday, August 29, 2013

Meatheads aren't doctors - Injuries, overuse, and rolling on shit

Should probably put this in a new book, however I've been getting slammed by all sorts of injury questions lately, so I'm just going to address it in this blog post.

First off, the only injuries or pain remedies that someone that has been lifting for a very long time should advise about, are the ones they are rehabbed SUCCESSFULLY.  Even more advisable is that they used the help of a medical professional to achieve this success, and can talk about that.

In other words it should read something like this....

"I had a similar injury, and I worked with my doc/PT/whatever and this is what we did to correct it.  I advise you to get yours seen about like I did."

Nothing annoys me more than a guy asking me about the "grinding and clicking" in his knee that won't allow him to squat.

Go see a fucking doctor.

Or the guy with slipped disks, or pinched nerves in his neck.

Go see a fucking doctor.

"Paul, I contracted leprosy.  I tried your 100 rep curls but my fingers all popped off.  What should I do?"


If it's bone or joint related...or leprosy related, you need to see a medical professional.

Most people don't even understand the difference between a strain, and a sprain for the love of God.

I can offer some insight into a strain, or some tears.  Strains are tears, essentially.  This is muscular.  It's the degree of the strain that generally causes the decision to seek medical help or not.

I have done many of these to many areas, or many varying degrees.  So I can generally write/talk about what I have done to remedy these particular ailments over my training career.  I can even give some timetable/rehab advice on a bicep tendon rupture.  However, I cannot perform surgery on it, even though I've had that surgery TWICE.

I've also never torn any other tendons in my body (well, not completely).  So if you did, don't ask me how to rehab it.  I won't know.

I currently have a partial tear of the quadricep tendon in my left knee.  I did not get online and ask around about what to do.  I went to the doctor to get properly diagnosed.  This is how you are supposed to do things.  Not go around asking powerlifters/bodybuilders/weightlifters how to fix shit DOCTORS get paid to help you fix.

Would you ask an auto mechanic to rid you of the virus on your laptop?

"Hey, both are machines.  Why wouldn't he know?"

Would you ask your ear, nose, and throat doctor to perform open heart surgery?

"Hey they are both surgeons!"

Just because I know about lifting, muscles, and have incurred massive amounts of injuries doesn't mean I know about how to train with/around/fix every injury or problem.  I can talk about what I know, because I've done it to myself, and can talk about what I did to fix it.  However, I don't try to play surgeon or doctor online.

I don't even stay at the Holiday Express that often.

Some dipshits do in fact try to play doctor online, and you should avoid them.  In fact, I'm aware of some young know it all dipshits that constantly try to tell people what they should do to fix every injury they incur, or believe they have an answer for all.  When what they really need to do, is shut the fuck up.  For example, injecting massive amounts of saline into the injuries area so that "more GH will flood the area for healing" might sound cool on paper, however you're still getting advice from a meathead at the end of the day.  Find a medical professional to help you if your injury is serious, and stop asking people online for medical help, if that's not their expertise.  I mean even the ask a nurse can only tell you so much before she says "go find a doctor."

Do you know how many dudes I know that have walked around for months and months and months in pain, because they wouldn't go in to see a doctor?  That all they wanted to do was ask other meatheads on the internet for advice, and hope that one of them had the answer?  So they try everything they hear or read from other meatheads, who also never got their injuries seen about from a medical professional, and then wonder why their injury never gets any better.  Well duh, it's because you've been asking a fucking meathead to fix something that a dude with almost a decade of schooling should be helping you with.

It's akin to that kid asking the owl how many licks it takes to get to the center of a tootsie pop.  Makes no fucking sense.  He should ask him about rehabbing a blown up knee, too........

Hey Mr. Owl, how should I train if I just tore my ACL and Meniscus?

No matter how much we fancy our knowledge of muscles and joints and the ability to come back from injury, we are not doctors or medical professionals.  And like it or not, they know more they we do in regards to these things.  Now, are there some doctors stuck in the middle ages that prescribe penicillin and motrin for everything from Mongolian AIDS to ingrown townails?  Sure.  And the key there is, find another doctor.

I understand that lots of people have had bad experiences with the medical community and doctors, however if you plan on lifting for a long time, it behooves you to find a doctor that knows about lifting, sports, etc and has a good relationship with capable PT's and such.  When I fuck shit up now, I don't go asking online.  I either follow my own rehab protocol, or I go to my doctor; or my awesome orthopedic surgeon; or my awesome PT.  Who all know each other, know me, and know their shit.

Then I don't have to ask other meatheads how to rehab something, when they can't look at me and diagnose the issue.

A few years ago, I had an IT band issue that just would not clear up.  So I did what all of us meatheads do.  I looked online, talked to people, foam rolled (more on that in a minute), did the stretches, etc everything.

It never got any better.  Eventually I saw my doctor and he referred me to a (my current) physical therapist.  In a few weeks I was pain free.  This was after months and months of listening to meatheads and doing shit I was reading about online.

The problem wasn't the leg that was in pain, actually.  It was my other leg that was causing the issue.  The one that wasn't having pain.  Once it was fixed, my pain started to subside, and eventually I was squatting again.  Pain free.

Fact is, I had been making the condition worse through all of the advice I was getting online, and reading about.  The PT was able to look at how I moved, and in three minutes knew what my problem was.  Wow.  Eureka!  I slapped myself in the fucking forehead and said "I coulda had a V8!"

And no, don't fucking ask what it was because the fact is, what my particular problem was, may not be yours, and may not be what you need.

What can we offer as meatheads?

Now, I'm just as guilty as the next guy in terms of handing out advice in terms of handling injuries, if asked.  HOWEVER, not if I have not HAD THEM.  I don't like to speak on something if I have not had experience with it/experienced it, and I also add in the caveat that they should still see a doctor, or medical professional.  

I do feel as though there are definitely some solid guidelines out there that we as meatheads can follow, in order to save a few bucks, and at least try before we do head off to seek the advice of a medical professional.

Here are the steps I generally take to rehab something on my own.

1.  If it happened suddenly, like a pop in the adductor during squats, I will try to rehab it.  Sudden injuries that are ONLY muscular related, I will generally rehab on my own.  

2.  Use the movement I got injured on to rehab it with, AFTER I can do so fairly pain free.  

3.  Use an isolation movement after that, that makes the muscle perform it's primary function.  

That's it.

For example, when I tore my adductor I squatted (light) because I tore it squatting, and I used the good girl machine because that is the primary function of the adductor muscles.  To adduct the thigh towards the knee.  I remember watching one guy do all sorts of crazy movements to rehab the same injury.  It took him months and months to get back to "normal".  It took me a few weeks.  Why?  Because I use the above protocol.

The Rock used the same machine to come back from a torn adductor.  His own words.  No fancy fucking movements required

That's my entire "philosophy" about "home rehab".  If you apply these, you don't need to ask me what to do about that "torn hamstring" or whatever.  If the above protocol doesn't fix it, I go see a doctor.  That's what I do.  That's my advice regarding ALL problems of this nature.

Overuse injuries - 

These tend to be the ones meatheads have the most issues with.  Mainly because, in the beginning the pain from overuse comes and goes.  So they think it may not be a big deal.  Then it worsens, and the "asking around" process begins.

"A few months ago I had this ache in my (whatever).  I didn't pay much attention to it because it would come and go.  Now every time I (insert compound movement here) it hurts really bad.  I'm not sure what happened, or what I should do.  Anyone ever experience this?"  

Now every meathead chimes in and offers advice on how to fix it.  Which is nice of them of course.  However overuse injuries generally exist because of flawed mechanics or muscular imbalances that generally can't be addressed online.  Often times, not in person by a meathead because they aren't trained to look at mechanics a certain way, or look at certain movement patterns.  

This is why it's important to have a PT or sports medicine person in your life that knows their shit, that you can trust.

If you have a chronic injury or overuse injury that is keeping you on the sidelines, find a medical professional that can help you.  Don't dial the "ask a meathead" hotline.  

Foam Rollers, PVC pipes, and Lacrosse ballz - 

I swear to God foam rollers can cure cancer now.  It's got to be close, if they can't.  At least a partial cure.

That and mobility work.  You know....stretching.

"Hold this position."

You know, the shit your fat PE teacher taught you in gym class.

Apparently these cure fucking all.  The real reason that you have Hep-C is because your mobility work is shit.  Your inability to bring your Crossfitting girlfriend to climax via cunnilingus is really due to lack of tongue mobility.

Ok, so this one could potentially be true.

I broke my ankle a few years ago.  I was doing some interval runs on the sidewalk.  I went into a sprint and at the part where I traversed from flat-sidewalk to inclined-driveway, I didn't make the proper adjustments and my ankle turned up and inside, towards my groin.  Ankle broken.

My fight coach at the time told me "eh, you should have been stretching more."

Thankfully one of the other instructors was nearby and knew of his love for stretching and piped in, "if you got colon cancer, he'd tell you you weren't stretching your colon enough."

Yes, stretching would have prevented my bones from breaking.  Not.

"But Paul, he might be right because......."

Stop.  To quote Forrest Gump, "that's all I've got to say about that."

Foam rollers are a nice tool, and so is mobility work.  They aren't the fucking be all end all in terms of fixing things, however.  When my above mentioned IT band was killing me, I could roll on a PVC pipe with no pain.  Squatting however, would put me down.

Rolling on something pain free doesn't mean that performing a certain movement is going to be pain free.  I get that lacrosse balls and pvp pipes apparently do everything from cure AIDS to fixing poverty and stopping genocides in Africa, however you still probably want to pursue over avenues of remedy in case they don't cure your ails.

At one point, I was suffering from severe "hip" pain for about a year when I squatted.  Every internet doctor told me how to fix it.

It always consisted of rolling on something.

"Roll on a PVC pipe."

"Roll on the rumble roller."

"Roll on a lacrosse ball."

I might as well have been rolling in dog shit.  I would have gotten the same results, but with much better stories to tell.

"Well, my hip has been hurting when I squat."

"I get that, but why do you smell like dog shit?"

"Been rolling in it."


"Fix this fucking hip."  

Much more entertaining.

I could roll on the rumble roller forever, with no pain.  Squatting however, hurt like a bitch. I did the lacrosse ball (I swear to god the lacrosse ball lovers are like a fucking cult at this point with their love for it) and no dice.

This was a situation my PT couldn't figure out.  Neither could my orthopedic.  Eventually, we put our collective brains together and decided "rest" was an option.

So I just let it rest for a while.  I stopped squatting heavy.  I did shit that didn't hurt, and eventually it stopped bothering me.  It worked.  Resting, that is.

This is why I suggest having a good "team" of medical professionals that know each other, and know what you do.  So that you can all work together to find real treatment outside of finding shit to roll around on.

As far as mobility work goes, it's cool.  To a degree.  One of the things I hate about it is that people often blame the inability to get into and hold a position due to lack of "mobility".

When most often, people can't hold a position of "mobility" because they simply aren't strong enough to do so.  I go to yoga now and again.  I can do all of the very basic yoga stuff pretty well, and was far more flexible than the instructor thought I would be.  I don't really do mobility work, yet I'm still fairly flexible.

I can do press behind the neck with no pain.  I don't have a problem reaching the bar to do deadlifts.  I can put my fingers under my toes and hold that position for pretty much as long as I need to.  I can drop into the bottom of a squat and hold that position too.  

I honestly attribute a lot of this to the fact that I've always done full, or extended ROM movements.  Not fucking partial squats, or cut my ROM short in some way on a movement.  I personally think that people set themselves up for this shit because they try to cut corners on ROM or use improper technical movement.

Generally, a lack of mobility exists for a few reasons......

1.  You aren't strong enough to hold that "mobile" position.
2.  You have a permanent or former injury that won't let you hold a "mobile" position, or has taken mobility away.
3.  You aren't mobile enough to hold said mobile position.

In my experience it's been 1 and 2 more often than 3.  Especially 2.

I'm sure the mobility police will show up to tell me I'm fucking wrong, but seriously, how mobile does one need to be in order to squat, bench, and pull?  Jean Claude Van Damme shouldn't cry in shame at your mobility prowess for you to be able to do some fucking strength exercises.

If you are so tight that you can't perform any of these movements without pain, and you didn't do multiple tours in Nam or fight large wild animals for a living, then life itself is going to be fucking tough.  Getting up and down from a chair is going to be quite the feat for the day.  Wiping your ass after a real mudder is going to haunt you.  Much less trying to move heavy shit.

I've felt, for a while now, that most can get by with the following....

  • A hip flexor stretch. - This can be done with split squats.  So you get 2 in 1.
  • A fucking basic hamstring stretch - This can be done with deficit stiff leg deadlifts.  2 in 1.
  • A piriformis stretch. - This can be done at work, in bed, waiting on a bus, wherever.....
  • Band pull aparts and shoulder girdle strengthening - Can be done as part of your bench warm up.

That's training economy.

I'm not saying that us meatheads don't have anything in the way to offer in terms of advice for rehab, or prehab.  I'm also not saying that PVC rolling and lacrosse balls are totally useless.  What I am saying is, you should have your own "rehab philosophy" and your own "I definitely need to get this seen about" philosophy as well.  And not always ask meatheads such as myself how to fix things.  Especially if we've never dealt with them.  We also can't see you in person or watch you squat, pull, press, etc and determine if you have technical issues with movements and that's part of the problem.

You should also limit trying a ton of various remedies because you have no idea if you could be exacerbating the situation by doing so.  Trying 12 different meathead solutions could mean when you do show up to a solid and qualified medical professional, that you have 13 problems now instead of 1.

I am not disparaging meatheads and lifters with this prose.  I am merely pointing out that my own rehab plan is very simple, and limited.  If it needs further input, I seek someone out to give me medical assistance.  I don't ask meatheads how to fix something I don't know how to fix.

If it's a chronic overuse injury, seek help.  If you tore a tendon or ligament, seek help.  If it is knee or shoulder related, seek help.  Those are two very complex joints.

If it's a hamstring pull, or adductor tear, or strain of some sort, have your own rehab protocol in place if you so desire.  However if it lingers, see your medical people.

Or not.  You have options.  You can still go the route of asking us meatheads...."have you ever dealt with..."


  1. Well said Paul. It is no joke having a debilitating injury. Having had 8 surgeries on my shoulders including two partial and one total shoulder replacement in sucks but I certainly wouldn't ask some guy next to me in the gym how to handle it. Seek professional help thats what these people do.

  2. A ton of great information given here! Well worth the time to read and the effort to actually do what it recommends!

  3. Awesome post, especially the overuse injury section. I'm always shocked how many people rest never occurs to! I realised this last xmas after I tried foam rolling for a month for an IT band injury only to have the pain subside after I didn't do anything strenuous for two weeks on holiday.

    I'll still always recommend rolling though, just to see my mates in agony lying on a golf ball.

  4. "This is why I suggest having a good "team" of medical professionals that know each other, and know what you do."

    This just isn't feasible for most people without spending an absolute fortune.

    1. That's bullshit. You find a good primary physician, who works with a good orthopedic and PT. I've never spent a fortune at all.

    2. I agree. If you find the best in any of the fields, he/she can point you to the best in the others.

      And I am with you, I hate the guy that won't go see a doctor because, "this doctor doesn't believe in deep squats." How many doctors do? I can only imagine how many noobs they see with injuries do to CF WODs and shitty form. Of course they would advise against it. But, if I have an injury that needs fixing, I am going to the best and I don't care if he think squatting will give me Cancer of the AIDS.

      Great post, but you know a shit storm is a brewin'

    3. It seems the hard part is finding the right team. Maybe my one experience with PT prior to even lifting scarred me. It was such a waste of time. We're talking doing rows with an elastic band attached to a door frame. Jesus. It actually wasn't until I started lifting that all my aches and pains from sedentary life vanished. Imagine that.

      Now I've had this pestering left hip flexor/sciatica issue for the past few weeks that comes and goes. I can manage it a bit with stretching, mobilizing, and "rolling on shit", but I need to see someone about it. But I look up all these PTs in the area and their sites are all old people rolling on a damn stability ball.

      I guess you just have to keep looking til you find the right people.

  5. "...Your inability to bring your Crossfitting girlfriend to climax via cunnilingus is really due to lack of tongue mobility...."

    Been casually reading for years, never with the slightest urge to comment here. This, however, deserves a tip of the hat - brilliant!

  6. I like to envision that you thought to yourself "I'm just going to write a quick blog on injuries..."

    Good stuff as usual. As an ER nurse people often come to me with their little medical issues and almost every time I will refer them to go to a doctor. Its AMAZING how little you feel confident answering once you have specialized your knowledge to such a degree. I can tell you if you should go get a cast on your arm... But if you have some kind of ear issue or "some weird feeling" in your throat or something... Get your ass to a doctor.