Coming Back from a Sports Injury
A couple of month’s back I was scanning through some newsletters and a particular article caught my attention. It was called “Coming Back from an Injury” by Jeremy Markum.
The article that followed was a concise, well written article that embodies a lot of what I believe in, and a lot of what I endeavour to promote and teach. I thought the article was so good that I asked Jeremy if I could re-print it here. He agreed, and what follows is his complete article. I hope you enjoy it.
It’s almost inevitable that some time or another in your life you’re going to get injured. Especially if you’re living life all out, full tilt, to the max like you should be doing (you only get one go at it).
Even if you have PERFECT form in the gym, masterfully focusing on each and every rep, warming up and stretching before you start, and only using loads you can fully control, it’s bound to happen. More often than not, it happens outside of the weight room. It’s like a cruel joke: you do everything right inside the gym, but then hurt yourself loading groceries, or chopping wood, or playing tennis-something outside your realm of normal daily activity.
That’s what happened to me. I tried playing racquetball without knowing very much about how to play. I thought, “Couldn’t be too hard, you just gotta hit a little blue ball with a racquet-no problem.” No one told me you should keep your elbow locked and your arm fairly straight when you swing. Instead, I attacked that rubber bouncing ball of death with a side-arm, whip-lash, loose wristed, spanking style swing and tore my rotator cuff when I misjudged and hit the wall with my racquet. I heard a little pop, felt a warm tingle, and then winced as the pain set in.
How not to rehab
Now you would think I had sense enough to lay-off of it for awhile. After all, I make my living helping others get in shape and build healthier bodies.
Well, I did, sorta.
I stopped doing certain exercises which seemed to aggravate it, like bench presses and overhead shoulder presses, relying instead on dips, and lateral raises. I also tried icing my shoulder area and rotator cuff after each workout, and I took Ibuprofen from time to time to help alleviate the pain and swelling.
But I was in denial. The shoulder got a little better, but it always fell short of total healing.
Now, fast forward 8 months in time: The rotator cuff is still bothering me, but now, other areas (which are being forced to compensate for a local weakness) are starting to bother me. I have neck pain. My other shoulder is starting to act up. My left arm (the arm opposite the side of the injury) is now stronger than my right on dumbbell curls-and I’m right-handed! (Swelling has started to constrict the nerves which tell my muscles to contract.)
Of course I’d been working out the whole time. I mean, staying in shape is my livelihood. A muscular, lean body is my best advertisement. I had exercise videos to film, modelling shoots to be ready for. But I seemed to forget that if I’m in a hospital bed recovering from surgery; it’s going to be tough to stay in shape.
I finally got the point
Eventually, even the dips began to hurt. And so did the pull-ups. At the rate I was going, I wouldn’t be able to do anything but push-ups, and pretty soon, those would probably start to hurt.
I decided (almost too late), to go see a doctor. No surprise, he diagnosed a minor tear in the teres minor (one of three small muscles comprising the rotator cuff). What was a surprise however, is that all the surrounding muscles that were inflamed with small tears of their own. He explained to me that they had to work overtime in order to stabilize the shoulder joint due to weakness in the injured area. He told me that if I’d have kept training, I would for sure have to have surgery to repair the damage.
Recovering from surgery would take 8 months to a year, and the shoulder would never be the same.
For kicks, I asked him how long it would take to rehab without surgery. He said with the help of a good sports massage therapist and with the proper regimen of stretching and exercises, and total upper-body REST, I might be back in 6-8 weeks. But the total rest part meant NO training for the chest, shoulders, arms, or lats of any kind. You see, everything is connected. You might think you can avoid irritating an injured area by not performing isolation work for that area, but you can’t. Especially the rotator cuff. It contracts in one form or fashion during almost every exercise you can do for the upper body.
I bet if I would have laid off training for just a week or two, right when I injured it, I would have been back in commission. Still, I was lucky to be avoiding the knife at this point. On to what I did to recover.
You might think it takes discipline to work out everyday and stay on a healthy diet. Wrong. It takes a lot more NOT to work out when working out is your favorite source of stress relief, and it’s virtually the only physical activity you get each day (aside from typing in front of a computer all day, but that doesn’t do much).
Nevertheless, you can’t expect a torn muscle to heal by asking it to forcefully contract over and over again. Ice, anti-inflammatories, and careful exercise selection only go so far. The human body is its own best healer, and rest the best medicine when it comes to muscle strains. So my first goal in my rehabilitation was to let the tear heal up completely. Second, I needed a massage therapist to help break up the scar tissue which had been forming and to keep the joint moving freely, and to help realign bunched-up muscle fibers so that the muscle could contract properly and remain in its normal, pliable state. Finally, and only after I got the go ahead from the doctor, I would need to rebuild strength in the injured shoulder and surrounding muscles, and focus on increasing my range of motion (which was severely limited).
It took 7 weeks of complete rest for the doctor to give the go ahead to start training upper body again. During that time I received weekly massages on the injured area (I recommend Active Release Therapy if you can find a practitioner), and I performed a variety of stretches for the injured muscle and the all the surrounding musculature as well (remember, it’s all connected). I also worked on some special exercises designed to eliminate some muscle imbalances which weight lifters can be prone to, and which often develop as a result of minor strains in the rotator cuff.
Take home points
I’m not going to pretend that my situation can be generalized to everyone and every type of injury. But the experience did teach me some things the hard way, and I hope to pass on what I’ve learned in order to save someone else a lot of unneeded pain and wasted time:
1. If you tear a muscle, REST. Completely, until it’s healed. If it’s an upper-body tear, work on your legs (you probably need it), and vice versa.
2. If it’s a bad tear, and there’s bruising and significant pain, see a doctor immediately. Some tears require surgery to repair.
3. Applying ice immediately to the effected area, and routinely during recovery can speed healing. 15 minutes on, 15 minutes off.
4. Be flexible. Stretch your entire body frequently before, but especially after and during your workouts (when stretching is most effective).
5. If you can afford it, enlist the help of a quality sports massage therapist. They can take weeks off your recovery time.
6. When you are cleared to workout again, start light (do lots of reps), and do less volume (less sets) than what you’re accustomed to.
7. Slowly rebuild your strength, but focus on keeping a good range of motion, and remaining flexible. This will prevent future injuries.
8. Compensate for your reduced calorie expenditure in the weight room by performing more cardio work, or some other activity you enjoy that doesn’t involve the injury.