By: Justin Parro, M.Sc. Kin, R.Kin
Whether you are an elite athlete training for sport and competition or a recreational exerciser because you know the benefits of a healthy active lifestyle, the vast majority of people in the training world are working through pre-existing injuries and/or restrictive conditions. There are no definitive statistics for this comment since the use of the term “restrictive conditions” can be as broad as to consider someone who cannot achieve full range of motion somewhere throughout their body. This doesn’t necessarily mean that pain is present but it is certainly a common result. Some things to consider:
These are just few questions that many of you reading this will be able to relate to and if you can, you likely fall in the category of pre-existing injury or restrictive conditions. If this is the case then you are in a state that requires repair to your previous healthy condition. This is not to say that you are not a healthy person, but in an ideal training environment the goal should be to perform full range of motion exercises without risking re-injury or even worse, compounding a current injury. This leads us to the very important question: How can we achieve a healthy training state with recovery and injury prevention as the priority?
The first step is to be self-aware and recognize what’s going on physically with your body. For some this is easy. For example you grew up playing hockey and the repetitive strain on your hips from skating has caused you to have tightness and reduced range of motion or perhaps even pain. Maybe this affects your low back, which in turn hinders your ability to pick things up without experiencing discomfort. This again is an example of someone who would find it easy to identify the problem. A less obvious example might come from someone who has worked a desk job for the last 10 years and overall you feel “fine”. In reality you cannot achieve full range of motion in the squat. Since you don’t experience pain you think that’s just normal for you. The truth is that for this particular example you should consider yourself to be in a state of rehab to restore your previous full range of motion, even if you haven’t seen this range of motion since you were a teenager.
To provide a point of reference, US statistics have shown upwards of 7 million sports and recreation related injuries on an annual basis (Conn et al., 2003). If we look at ergonomic and workplace related injuries, according to Statistics Canada there are easily more then half a million workplace injuries reported annually. This doesn’t include the issues that people experience from sitting at a desk all day and other repetitive strain injuries that are not recognized because employees are not taking time away from work due to these injuries.
If you are experiencing pain on a daily basis or during specific activities consult with a health care practitioner (chiropractor, physiotherapist, massage therapist, etc.). They will identify the problem and provide treatment to reduce and eliminate pain. Often they will provide rehabilitative exercises which can be done at home or outside of the clinic. From this point the onus falls on the individual to stay motivated and carry out these exercises. It is far too common for people to think that pain is the norm for you based your your history. Don’t let that be you!
Let’s say you are overall healthy with no history of injury. One of the best things you can do is find an exercise professional who can provide you with a full body movement assessment and identify any deficiencies. If done properly this will lead to an effective plan to rehab to your previous healthy state.
Let’s shift gears to being pain free. This could be post-treatment or this could be someone who never experienced pain but does have restrictions in range of motion. Where should you go from here? The most common thing we see in training is that people go from rehab straight to performance. In this case we’ll consider performance to be your regular training routine. This is when re-injury or restriction become far too common. Often, we see or better yet, we hear people training with restriction and saying something like “I can’t do that and I’ll never be able to again because ‘X’ body part is too tight or gets sore when I move that way”. It’s time to change your mindset! The correct answer is to address the hole in our approach to rehab and training. We need to bridge the gap!
What does it mean to bridge the gap?
If you find yourself in the category above, training is okay but be aware of the changes that need to be made to your programming in the interim. There is no set timeline on this and there’s a strong possibility that you might float in and out of this stage for various reasons. When building your training program, consider these three steps:
There are several critical factors to bridging the gap: keep movements pain free, work to increase functional range, build structural integrity through strength and stability, and create symmetry. This is where an exercise professional with knowledge of human anatomy, biomechanics, and physiology should guide you through this process.
Any movement that you choose to do in training should be pain free. You will find yourself testing the waters at times to know how far along you are from rehab to performance. In order to do this you are working near your threshold and your body is going to give you feedback, so you need to listen. It is not okay to train through pain.
Spend time using the various tools that exist to increase your range of motion and your functionality for training and every day life. Examples include mobility programming that promotes active range control, flexibility programming to help increase your passive range, and soft tissue release. The latter can come from manual therapy or it can be self-guided using tools like bands, lacrosse balls, and other equipment at your gym. Each element has its place. The time you spend on increasing range of motion will partially depend on your restrictions, however it is important not to consume all of your exercise time with this. An effective program addresses your needs in a reasonable amount of time and creates balance among programming elements. This is relevant for the recreational exerciser who likely doesn’t want to spend hours every day on these things and the elite athlete who needs to focus on sport specific training.
Your training should consist of exercises that address your weaknesses (i.e. push/pull, squat/deadlift, etc.), work core strength and build to extremities, and create balance from side to side. Here are some great ways to address the core strength and balance:
This list is not exhaustive and can serve as a starting point for strength and stability. What’s great about these exercises if programmed properly they can be used to increase strength on your compound lifts even if you’re not specifically training those lifts. So, focus on these movements and slowly implement the compound movements like squatting, deadlifting and pressing when your body is ready (no pain, proper range of motion, and unilateral joint stability). If correctly programmed and implemented with intent, the above information will serve as a framework for the bridge from rehab to performance. This is the basic formula to successful training with injury prevention at the forefront.
What Patients Are Saying
I had an amazing foot treatment with Steve yesterday. It left me feeling like I have #newfeet #sharpdressedman" - Darlene