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Dealing with pain and injury, especially the chronic kind, can impact more than just your workouts. Once your day-to-day activity is impaired, then your quality of life starts to significantly decrease.
Here's how to avoid that from happening with the 3 steps I always use in coaching and teaching people how to rehabilitate an injury.
Step 1 - Reassurance & Education
This step defines the mental burden of pain. It typically pushes us to be less active, which creates negative emotions, which leads to further avoidance and fear, which leads to detraining and disability.
Understand that the body can heal from seemingly miraculous things. ACL fibers can reattach. Nerves can regrow. Our bodies are in a constant state of repairing something.
Pain is a perception of a threat, not just a sign of damage, so our perceptions of how "bad" our situation is can affect our recovery process negatively.
Reassure yourself that regardless of how bad your pain or injury is, you can improve and get better. You can get back to doing what you love.
Step 2 - Exercise & Movement
Absolute rest is never the answer when it comes to rehabilitation. Just like when you avoid movement, absolute rest leads to detraining and further disability. That's why the next step here is to introduce movement and exercise.
All injury happens when tolerance is exceeded by the forces being put on the body. Exercise and movement increases this tolerance.
When we do weight bearing exercise, our muscles, bones, and joints adapt to become stronger and more durable in response. So our goal is this stage is to find an "entry point" in training that allows us to receive these adaptations while not irritating the injured tissue.
You may have to get pretty creative here with designing movements and regressing them to a point where they're tolerable, (for example using bodyweight only, assistance, isometrics, etc.) but getting yourself training again is extremely important to the rehabilitation process.
Not only does it help build tolerance, but the increase of blood flow and circulation to the area helps promote healing.
Step 3 - Progression & Expectation Management
Once you re-introduce movement, the goal is to continuously progress it over time.
One of the biggest mistakes people make is trying to do too much too fast, re-irritating the area and setting your rehabilitation back. This is why it's important to set appropriate expectations with your recovery process.
It's always better to undershoot rather than overshoot when it comes to intensity. Yes we want to progress our training with more load, volume, frequency, and intensity, but we need to stay below the threshold that may cause further damage.
You can use a system like RPE (rating of perceived exertion), to autoregulate intensity and account for certain days when you're feeling better than others.
The goal in this stage is to stack small victories in seeing improvements in your symptoms while progressing your training and getting stronger. This helps build both physical and psychological momentum.
The timeline may be different but regardless of the extent of your pain or injury, this process remains the same. Stay patient, focus on finding a way to return to training, and progress appropriately over time while managing your expectations.
To your good health,
Coach Stephen
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