Our bodies are actually very simple. They are designed to heal and designed to move. It would be a pretty fundamental design flaw if we didn’t. That is why you need to start viewing injuries, particularly chronic or recurring ones, differently.
Ask yourself – why?
Something is stopping your recovery. And trust me, if it’s been there a while then just resting or just avoiding the troublesome movement, won’t make the difference. The issue will only pop up somewhere else later.
So, if rest isn’t the answer what is? And how can you get rid of injuries for good?
Heal – Mobilise – Strengthen
It’s as simple as that; heal, mobilise, strengthen. In that order! The body needs to work through these phases to get you pain-free, functional and not at risk of future injury.
I’ve tried to cheat the system, my patients try to cheat the system and I definitely see people in the box trying to cheat the system every week. But you can’t cheat it. You can’t successfully strengthen something that is damaged, and you can’t successfully mobilise damaged tissue without it having begun to heal. And trust me, you’ll only get more frustrated with your injury and you’ll just be pushing back the date that you can get back to full training.
Now of course, as with everything, there are gray areas. Yes it’s more than fine to start working on your core to help your back pain even when you’re still in pain. But until it is healed, and well mobilised you’re going to struggle to hit PB’s without injury. Use this formula as your template. Work out what component you’re missing or rushing and you’ll have your answer to getting rid of that injury for good.
So heal – mobilise – strengthen is going to your new mantra whenever you’re trying to recover and get rid of injuries.
This phase is all about letting the tissues, structures and physiology begin to respond to the trauma. Regardless of the injury I always encourage people to think about it like having a cut, or open wound. There is no way that you are going want to poking around in there, putting pressure on it or loading it if it is literally red raw. Let the damage start to heal, start to get that new layer of fresh skin first. It’ is the same with injuries inside the body.
Now, if an injury has been around for a while then it is even more complicated. Again, think of infected cut, regardless of the size of the original injury. It is now been made worse by the infection. This is what can happen with chronic injuries, although you may initially have just strained your hamstring. If you keep just trying to strengthen it, you risk getting inflammation and having secondary issues like tendinitis or bursitis.
So rest, sleep, eat clean, drink plenty of water and avoid anything that causes further damage to the tissues. This could be anything from 3 days to 4 weeks depending on how long the injury has been around. As Crossfitters I think this is the stage we struggle with most. When you have the WOD on the board it is so easy to change your plan to avoid shoulder exercises and just ‘try’ that overhead squat. It is light and only 5 reps per round so what’s the risk? Well we’ve all had it where a cut has been healing and then we’ve knocked the scab off and it is starting to bleed again. That’s what you’re doing to yourself if you head back to training too early. Literally reopening the wound. So of course your recovery is slow and poor.
Be brave, scale the workouts – heal.
Once the tissue has ‘really’ started to heal then move onto mobilistation.
There is such a wealth of information out there, which is also easily accessible that there is no excuse for not know how to do a few mobility exercises per body part. The difficulty is making sure that you also do it outside of the box.
Stiff, tight tissues restrict movement, but they also restrict blood flow and lymph flow. Which are both essential for continued healing and strengthening. Your shoulder issue may well be due to tight pecs – so stretch them out. But there’s another cool way that mobility works.
Muscles work as pairs; think biceps and triceps. Whilst one is contracting the other is lengthening. What’s even more fascinating is that in order to make movement efficient your body actually inhibits the lengthening muscle to make it easier on the one contracting, so that there isn’t a tug of war going on between your muscles. This is called reciprocal inhibition.
Now here’s the geeky bit. Most of us know that we have weak glutes and that this can be the cause for lower back pain or knee pain. So we work our squats, split squats, lunges, glute bridges, GHD you name it. But still get a dodgy knee when we run or back twinge on a heavy squat.
Well – if the activation of one muscle is affected by its opposing muscle, then in is this example it is actually the tight dominant hip flexors that are the issue. They’re constantly working, which is actively inhibiting your glutes. So no matter how hard you work, you’ll get super slow improvements in glute strength.
And this is why you can’t cheat the formula. Mobilise your hips, switch off and inhibit your hip flexors. Then move onto strengthening the glutes. This could either be by mobilising for a few weeks before moving on. Or mobilising at the beginning of a WOD before going on to activate the glutes. Now your glutes can fire well, they’re not being inhibited by tight hip flexors and you can strengthen them to your heart’s delight!
Again, once I have safely got a patient to this point then it is all up to them. Head to the gym, do rehab at home, change movement at work, either way strengthen. You’ve healed the damaged tissues, opened up the joint and connective tissues, addressed any reciprocal inhibition and now the time for setting that new posture or mechanics to stop that injury returning.
The 3 step formula for getting rid of injuries for good is simple: heal – mobilise – strengthen. Have a chat with your coach, sports massage therapist, and work out what stage you’re skipping or rushing. And that will give you the answer as to why that injury keeps coming back.