Tuesday, August 4, 2015

Injuries - Training through them, rehab, and prevention

Injuries suck.

Captain obvious quote of the week.

They derail progress and often take a mental toll on you as well.

But there are some things you can do while you are injured to continue to get better, and set the stage so that you come back from said injury in a better position than when you sustained it.

1.  Training around it -

I get questions all the time about injuries, and I think people think I'm being a dick when I tell them, in regards to what movements they can do, that they will have to test it to find out.

No one online can tell you what will hurt, or won't hurt.  So to be honest, I'm not sure why you ask.  I learned at a young age, before the net, that I literally had to go into the gym and test movements to see what hurt and what didn't.

Once I settled in on a number of movements that didn't hurt, I reloaded my training and went with those.  This leads us into point number 2.....

2.  Set new goals - Dwell on what you can do, not what you can't

One of the best things you can do when you cannot continue to go after the goals you were striving for before the injury, is focus on new ones.

After you've made a list of the movements you can do in your injured state, sit down and figure out what goals you'd like to accomplish over the course of your rehabilitation time.

This could be anything from body recomp (maybe it's time to diet?), or to bring up weak bodyparts.  Either way, there's almost no injury so severe that as long as you can physically get inside the gym, that you can't train in some fashion.

Injured a leg?  Grow some big pipes over the next few months.  Focus on increasing your bench.

Now when you can do leg work again, you have bigger arms, or a bigger press to go along with it.

Injured your upperbody?

Do the same for legs.  Grow some big wheels over the next few months.


Get in shape.  Clean up your diet.  Do more conditioning.

There's a million things you can pour your energy into that are still on the table, even in an injured state.  Use that time to improve on another area while you are rehabbing.

3.  Rehab properly -

Speaking of rehabilitation time, this is another area that people consistently screw up on.

One of the things I have learned through years of destroying myself, is that once the pain is gone from the injured area, doesn't mean the rehab is over.

This particular time is when a lot of people injure the same area all over again, because "the pain is gone."  Yes, the pain is gone, however that just means the healing process is only partially complete.  The area itself is still probably not structurally as sound as it was before the injury.

I often think of rehab in two phases.

1.  The healing phase - This is where you do all the things you need to do in order to be pain free again.

2.  The strengthening phase - This is where you slowly strengthen the area back to where it was before, or beyond that.

Where a lot of people go wrong is that they are careful in phase 1 while the area is still painful, and throw caution to the wind in phase 2, once it's not.

Now that the pain is gone, they get in a real hurry to throw weight back on the bar.  Then they typically overload that area far too fast and it "gives way" again.

Back to square one.

Once you are able to train and injured area again, you should have a methodical and well thought out plan for strengthening it back to 100%.  If it took you 12 weeks to get completely pain free from the time it happened, then another 12 week plan may be in order to get back to 100% pre-injury strength ability.

It's better to drag rehab out slowly, and over a long period of time, than to rush it, and find yourself injured all over again.

4.  If it's serious, seek a professional -

If there is one thing that drives me nuts about the net, it's that people will often sustain serious injuries, that may even require surgery, and they sit around on the net asking other people what they should do.

Maybe it's because of the time period I grew up training in that makes this absurd to me.  Or maybe it's because I think common sense should dictate to you, that you don't ask people on the net, who aren't medical professionals, to diagnose your injury.

There are so many things wrong with this I am not sure how people arrive at the conclusion that this is a good idea.

For starters, someone online can't look at your movements in person.  They can't determine if you are having pain because of tightness in a particular area, or because you are weak in some area, etc.

Not only that, as I stated earlier, they can't tell you what is going to hurt.  You will have to test certain movements to see what hurts, and what does not.

If the painful is area is something like "my elbows hurt" then sure, ask around.  However if you sustained a knee, shoulder, hip injury, etc and it's serious, then seek out the help of a professional.

I will give you an example of this -

A lot of guys have strength imbalances in their legs.  One leg can often become more dominant than the other.  When that balance becomes too disproportionate, the lifter will often shift the load in his or her squatting to the dominant side.  They may not even notice it at first.  But over time, they end up developing IT band pain from it.

So what is the first thing they do?

Foam roll the shit out of it.


Because that's what everyone on the net tells them to do.


Because that's what they read somewhere.  That foam rolling your tight IT band was the answer.

How they arrived at this conclusion doesn't make a lot of sense to me.

Not only that, it would take someone seeing you in person to spot this shift in your squatting, or do an assessment that your real problem is an imbalance in your lower body.  In other words, you'd be need to stretch the painful IT band, and then run a program where you restore strength balance between the two legs.

Someone online cannot read an e-mail or message and know that this is what you need.

Muscular rehab injuries aren't a big deal.  But if you have pain while performing a certain movement, someone online probably cannot tell you what the problem is.  Even with a video.  Is it possible they can help?


Is it better to find someone in person who is a professional at this to observe you?  Undoubtedly.

There's nothing wrong with simply asking someone a question online, to get some insight, but if the injury is serious, or chronic, it is best to seek out professional help.

5.  Be introspective - Ask yourself why it happened

If there is another silver lining you can find in getting injured, it's that it may force you to reevaluate your training, technique, and recovery.

One of the reasons I believe that sub-maximal training for the big lifts is superior, is because it allows you to constantly refine your technique.  And proper technique is the number one injury prevention tool.

When you get out of position on a big lift, it means that the joints are now situated so that the transfer of the load is not going to be distributed as equally across the muscle groups involved, as your particular structure allows.

So something has to end up taking up the slack.  And if that "something" is overloaded beyond its capacity to move that load, it's going to go.

Another major one is simply not warming up properly.  I've seen guys get injured on many occasions because they simply didn't take the time out to get warmed up properly.

I don't understand what is so hard about this.

Here's a simple rule.  Start with the bar.  Just the empty bar.  Perform 50-75 reps with it before you ever add a single weight.  Believe it or not, this can often tell you right away if anything feels slightly "off".

When you add weight for your first set, if things still feel "off" understand this may be your body telling you that things aren't 100% for the day.  And that you may need to play it a bit safe.

But even if you are feeling good, take your time on warming up.  If you plan on working up to 315 for a set of 8 reps in the squat for the day, take your time in working up to that.

Bar x 2 sets of 25
135 x 10
155 x 5
185 x 5
225 x 4
245 x 3
275 x 2
295 x 1
315 x 8

This is a far more efficient, safer, and productive way than the following, which is what I often see...

135 x 10
225 x 8
275 x 5
315 x 8

Not only that, but in the first scenario, you get to prime everything for that heaviest set.  I've often noticed that my body doesn't "get into the groove" with a movement until the 4th, 5th, sometimes 6th set.  Then things start firing wonderfully.

So don't rush the warm ups.  Take your time and be methodical with them.  Use those warm ups to judge how your body is feeling on that day, and to refine your technique.

6.  Be mindful of order of exercise and supplementation/medication -

Believe it or not the order in which you perform movements can set you up for injury as well.

Starting the session off with stretching, for example, is not a good idea.  There's never been any proven data that shows stretching before training has a measurable productive effect.  So why are you doing it?  You should be using a functional warm up to get blood into the muscle as you gain range of motion.  Not using passive tension to prepare for training.

The order of movements will also play a big role potentially keeping you healthy.

It's not a good idea to start off training with movements that put the working muscles in an exaggerated lengthened position.

In other words, movements that put a significant amount of stretch on those muscles.

Incline dumbbell curls, stiff legged deadlifts, triceps french press, flyes, pullovers, etc.

If you aren't starting off your training with a big compound movement, and are doing so with single joint style movements then it's better to pick ones that place an emphasis with the resistance curve being at the top, or finish portion of the movement.

Leg extensions, leg curls, pushdowns, concentration curls, dumbbell side laterals, etc.  These all force a tremendous amount of blood into the area being worked, and don't have a large amount of resistance placed in the range of motion where the muscle is maximally stretch.

Sudafed is something else someone may not think of.  You got a runny nose, you take it, you go train.  Well there can be a bit of dehydration that occurs from taking this, and if you so happen to already be a little dehydrated, you could be setting yourself up for a potential injury if you go into the gym.

I have no idea what all ingredients go into these pre-workout powders either, and the fact is, neither do you.  This is another reason I don't use them.  Because I want to be as smart as possible about everything I'm putting into my body.  Especially before, during, and after training.

6.  Implement injury prevention -

As the saying goes, an ounce of prevention is worth a pound of cure.

So from a high level overstand point, here is some things to consider when trying to make sure you are giving yourself the best chance possible to steer clear of sustaining an injury.

1.  Warm up properly - 

This means both by using a functional warm up, then warming up properly in your set and rep schemes.  It also means not loading the area to be trained by starting with movements that have an exaggerated stretch position.

2.  Make sure you are properly hydrated - 

If you are taking any kind of medication that has the potential to dehydrate you, be aware of that.  Hydrate more than usual, and don't make this a week where you chase weight or rep PR's.

3.  Shore up weak musculature - 

Most lifters are proportionally weak in the rear delts, hamstrings, and upperback.  What do all of these things have in common?  Yeah, they are on the backside of your body.  Make sure you put in an equal amount of work, or even slightly more, to the "can't see" muscles as you do to the "mirror muscles."  For every rep you press, program so that you do at least the same amount of reps for the antagonist in that movement.  For every quad dominant movement, match it with a hamstring dominant movement.

4.  Perfect your technique - 

Perhaps the most important of them all.  If your technique is improper for your leverages, then not only will you limit the degree of progressive resistance you can attain in that movement, but eventually something that gets overloaded due to poor mechanics will incur a significant strain (tear).

One thing that baffles me is that some guys will KNOW that their big movements "don't feel right", yet will still continue to add weight to the bar.  Think about this for a minute.

The lifter KNOWS his technique is improper.  And rather than fix it first, his ego gets in the way of that and he continues to pile on the weight.  This is the definition of "ego training."

If you KNOW that your technique needs to be corrected, you have no business adding weight to the bar until that is fixed.  How do you even reconcile adding weight to the bar in your mind, when you know you aren't technically proficient?

Mind you, I'm not talking about beginners.  I'm talking about guys that have been at this a while and know "shit doesn't feel right" yet still keep pushing and pushing for more maximal PR's.  Does this make sense?

I thought not.

Conclusion - 

Unfortunately, injuries happen.  If you lift long enough it's not about if, but when.  However you can do your best to minimize these issues and of course shorten the length of time you are down and out, if you just have some simple rules in place to do so.

Be smart - stay healthy.  Or, as healthy as possible.

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  1. Hi Paul,

    I've just started the conditioning phase of your book strength life legacy, to lose body fat first.

    In January, I want to begin with lrb 365. So 2016 is already planned.
    What do you recommend me to do in the meantime? I mean what should i do after the conditioning phase?

    I really have no idea

    1. I can't tell you that. You'd have to figure out your top priorities and then go after them for the next few months.

    2. Okay, thanks for answer my question. And you are right, now i think about it, thanks!