Should You Train When Injured?

A question that I hear a lot in the fitness world is “should I work out when I’m injured?”. I have found that most people fall into one of two categories when an injury occurs — either ignoring the pain and training right through it (bad idea), or stopping training all together until the pain goes away (possibly a good, but generally a bad idea depending on the injury).

injured

In my work as an athletic trainer, I deal with injuries every single day. Injured athletes are the foundation of my job, and many times there is simply not an option to just stop training all together. Whether I’m evaluating a new injury or treating chronic pain, the constant question I get from patients is “So what can I do?”. Working with athletes can be both frustrating and inspiring, because most of them want to train through/play through anything. I have certain athletes who would continue playing a basketball game if one of their legs fell off, if only I would let them. Determination is a wonderful trait, but can also be detrimental if one pushes too much through damaged or injured tissues.

So how do you determine whether you should train/workout when injured? And how do you decide how much is enough, or possibly too much? The broad answer, to which there are of course exceptions, is that an injury should not stop you from doing all physical activity. Barring the extreme (multiple fractures, severe trauma, etc.), there is almost always a way to train around an injury. The key word there is “around”, and the key concept is to learn how to do this safely. That being said, “No Pain, No Gain” is actually the most dangerous concept when it comes to healing from an injury. Damaged tissues need time to heal, and a lot of times they need a little bit of help to create the most optimal healing “environment”.

ankle

You’re not going to be running on this bad boy any time soon! 

If you sprain your ankle, this does not mean that you should be lying around on the couch every day for weeks on end. In fact, after a couple initial days of rest and healing, your body will benefit greatly from movement and healthy blood flow. And the wonderful thing is that this doesn’t mean you have to stick to just upper body exercises (or lower body exercises, in the case of an upper body injury). Research has proven time and time again that when you have a unilateral extremity injury (ankle sprain, broken wrist, etc.), that training the opposite side can produce training effects on the injured side. It’s called Cross-Eductation, and to me it’s just more proof that the human body is pretty darn amazing. It has to do with neural pathways and the connection between the brain and your muscles. I won’t get too far into detail in this post, but can do that later on if people would like!

F1.medium

[Source]. In this study (click the link to read details), patients who trained their right arm while the left arm was in a cast showed just about equal strength after being immobilized for three weeks, compared to the significant loss of strength displayed by those who didn’t train the right side.

Yes, you can (and should) train the opposite side in order to see progress in the injured side. Many people won’t do this for fear of getting “lop sided”, but with a little careful planning and execution, that won’t be the case. True, you should not train one side of your body for months on end, but unilateral training while healing will help to keep you stronger all over, not just on the healthy side. There have even been studies which show that visualization exercises can slow muscle atrophy in an injured limb, and that just blows my mind. The human brain and nervous system is an amazing thing, no?

Think of it this way: If you sustain an injury, once it is healed you can either start back at square one because you have stopped training altogether, or you can start somewhere in the middle because you’ve kept up your fitness throughout your healing process. Even if you are not able to do any heavy strength training or high impact activity, doing something while recovering from an injury is almost always better than doing nothing. At the very least, mobility work (foam rolling, stretching, range of motion) can help keep your muscles and tissues healthy while the injured site heals. If you sprain your ankle and then simply stop moving for a couple of weeks, you’re going to have more problems than just your ankle when you start up again. Your muscles and fascia are going to be tight and immobile, leading to poor movement quality and possibly another injury. Doesn’t sound too wonderful, does it?

So what should you do after you sustain an injury? Well, the first thing you should do is get checked out by a medical professional. But if you get the okay to keep exercising, there are certain steps you can take to keep the rest of your body healthy in the meantime:

1. Start with mobility work. Foam roll daily, general stretching, maybe even some yoga poses (those that don’t aggravate your injury). Keeping your body mobile is the most important thing for tissue; without movement, muscles, tendons and fascia can become shortened and fibrotic. As said earlier, this can lead to further injury once your workouts ramp up again. Take care of your body and it will take care of you.

2. Train away from the injury. If you have a lower body injury, ease back into things with an upper body workout. If you have a back or torso injury and you have been told that it’s safe to exercise, start with something low impact like a recumbent bike, swimming, or just walking daily. Add in isolation extremity exercises such as bicep curls, lateral raises, calf raises, and other smaller lifts.

3. Train opposite the injury. Let’s go back to the ankle sprain for a minute. If you injure your left ankle, doing things like single legs squats, step ups, glute bridges and single leg leg press on your right side will help immensely. At a certain point of healing, you’ll also be able to start doing these exercises with your left leg again, and because of cross-education, you won’t be starting at square one. Feel funny about going to the gym and only training one side? Honestly, people are too worried about themselves to notice that you haven’t done your single leg squats on your left side as well. Besides, if anyone says anything to you, you can just spout off all of your awesome knowledge about cross-education and blow their mind a little bit.

4. Train the injury. Don’t tackle this one on your own, but at some point (usually sooner rather than later), rehab will be necessary to get you back on track. See a qualified professional to help you through this (athletic trainer, physical therapist), so that you can get back to being the badass that you are!

Long story short? If you’re doing something in your workouts that’s making your injury worse — you’re doing too much. But there’s no reason (unless you’re told by a medical professional) to let all of your hard earned progress go to waste! Training doesn’t have to be all or nothing. Sometimes we have to take some steps backward in order to continue moving forward, and finding that right balance is the key.

The Day I Gave The Universe The Middle Finger

(And it gave it right back to me)

Ready for this one? (It’s a long one, but stay with me here)

As I mentioned last week, months ago I had registered for the Superhero Scramble, an obstacle race being held here in MA. Similar to the Spartan Race and all of the other obstacle races out there, this one was 4 miles of rough terrain, almost all hills, tons of mud, and 21 obstacles. I was a little bit nervous because I had not trained to run 4 miles, but was hoping that my weekly stadium runs would give me a leg up since I knew the course would be hilly.

Then all of a sudden it was Friday, the day before the race. Now I was not only slightly nervous for the length of the run, but I was super excited as well. That is until Friday evening when my racing buddy and friend told me that she had to bail on the race due to a recent injury. They say bad things come in 3s, and if that’s the case, that was definitely bad thing #1. At that time, I definitely considered not going, because I wasn’t sure I wanted to do the race solo, especially since it was an hour away. I quickly decided to stick with it though, for no other reason than I had registered and I like mud, so why not?

Saturday morning rolled around, and I was off for the race. I gathered my things and hit the road… or so I thought. Literally one block from my house, my car’s engine just shut off while I was driving.

Car. Dead. 

Bad thing #2. 

Now, at this point, the race is an hour’s drive away, and there’s no other way to get there than to drive. I really should have realized at the time that this was the Universe’s way of telling me loud and clear that I shouldn’t be doing this race.

It’s as though the Universe grabbed me by the shoulders, shook me a little, looked in my eyes and said “DO NOT GO TO THIS RACE”

And I, in my stubborn determination, looked the universe in the eye, spat in it’s face, flipped it my middle finger and said “I’m racing. Damn it”.

I am a big believer in signs and gut feelings, but I’m also a big believer in finishing something that you’ve started. Guess which one won out on Saturday?

So while Will and his brother were so generous to wait with my car for the tow truck, I hopped into Will’s car and hit the road once again so that I wouldn’t miss my wave. I got pumped up on the way up there, was ready to run, and was pretty proud of myself for sticking with my guns and heading to the race, even though I was solo and without my own car.

Superhero Scramble 1

Here I am, pre-race, all smiley despite the car troubles. 

My wave began and the race was incredible. It truly was 4 miles of up and down hills, through “trails” (that weren’t really trails, rather a course through the woods mapped out by ropes and course markers). We ran through mud puddles knee deep, and at one point I was sliding down a slope so slippery with mud, I was literally sliding down from tree to tree, hoping each time that I would be able to catch the next tree and not go careening down the entire muddy path.

We army crawled through muddy water underneath barbed wire, swung on rings across more muddy water, scaled multiple 10 foot walls, climbed up and down cargo nets, took a 15 foot high “leap of faith” into a deep pool of muddy, cold water, dragged cinder blocks and carried sand bags, among other awesome obstacles. I felt great, I was keeping up a pretty good pace, and quite frankly was dominating most of the obstacles (the rings were a total fail. Into the drink I went!). I was even passing a lot of people who started in the wave in front of me (which took off 30 minutes before my wave). Needless to say, for  a non-runner, I was doing pretty well!

Pause to brag: (**Results just came in, and I came in 95/677 females, 21/151 in my age… Not bad for someone who’s “gone for a run” exactly twice in the last year, eh?**)

And then I got to the last two obstacles. The first of which was my arch nemesis – a free hanging, vertical rope climb that I would guess was 15-20 feet high. As I was waiting in line to complete this obstacle, I saw a couple of women complete it, but many women try very hard but come up short. I really wanted to prove to myself that I could do this, and that all of my pull-up training would be of good use.

spartan_Best_vertical_rope

This is a borrowed picture from the Spartan Race, but this is what it looked like. A straight up, gym-class rope climb… all over a pool of muddy water. 

And you know what? I DOMINATED that rope! I climbed all the way to the top, the only really tough pull was the very last one, and I was so proud of myself. I rode that high as I crawled/swam underneath more barbed wire, and ran down the final hill to the very last obstacle. The very last obstacle that was right in front of the finish line.

It was a rope wall. You know, climb up the rope, using  your feet against the (very slippery) wall, up and over the top and then to the finish line you go. I had been watching people do this all day before my wave, many climbing with ease, many having a lot of trouble, and I also witnessed a few injuries.

Superhero Scramble 2

This is the obstacle. I was on the farthest rope to the right (I am not in this picture).

I thought to myself “I just climbed that other rope. With this one I can use my feet! Piece of cake!Not taking into account the fact that I was starving, my legs were shot and my arms were spent from that victorious rope climb about 2 minutes before. But, since I was feeling on top of the world, I took about 30 seconds to gather myself, and then grabbed a rope and hopped onto the wall. I was doing pretty well, and made it a little over half way up the wall…

…when all of a sudden I lost my grip, my feet slipped off of the slimy wall, and down I crashed. Hard. My right ankle breaking my fall by being jammed in between the hay bails and the bottom of the wall. I felt a crack, let out a very loud F-bomb (I’m sure the spectators standing right next to me appreciated that one), and literally rolled off the hay bail.

Ding Ding Ding! Bad thing #3. 

The pain was searing, the kind of pain that takes your breath away. I was too close to the finish line to not finish though, so there was no way I was going to give up at that point. It took me a good few minutes to get up, but unfortunately had to be helped across the finish line, because putting weight on that ankle was out of the question.

Now here I sit, with a swollen and painful ankle, hardly able to walk, hoping there’s no fracture, and with the hindsight that tells me I really shouldn’t have gone to the race that day. The universe told me so, and I ignored it.  The universe said “Hey shit head, I’ve given you two very clear signs that this is not a good idea, just wait for the 3rd… Muhahaha”

Evil universe. Evil.

Lessons Learned: Listen to the signs. And don’t think you’re Super Woman simply because you just successfully climbed a rope.  And elevate that foot, darn it.

Additional (and more important) Lesson Learned: The people at the Superhero Scramble were amazing. I was helped out by so many people, from the two men who helped me across the finish line, to the two women who helped me get my finishers medal and to the first aid tent, to the woman who spent time going to find my bag at the bag check because I couldn’t move, and the two amazing men who kept me company for almost 2 hours, and then literally carried me to the bus back to the parking lot. The universe may be evil, but people are good, especially those that were at the race on Saturday. Superhero Scramble, thank you for being so awesome on such a shitty day!

And there you have it. The worst day I’ve had in a while, mixed in with a totally awesome race and an amazing group of people. Silver lining?

Do you have any race-day horror stories? 

Putting Lifting on Hold

My title is kind of punny, although I didn’t intend it to be. You’ll find out why as you keep reading…

You see, on Sunday night, I was doing a test run of these mini pecan pies, to test them out for a dinner I’m going to in a couple weeks. As I was blending up the dates with my immersion blender, a horrible, horrible thing happened.

Some of you know where this is going. And don’t worry, there are no gross pictures attached to this post. I’m not that cruel.

Stupidly, without even thinking, I reached into the blade area with my index finger to remove some of the built up date “gunk”… but forgot to unplug it first… and must have pushed the button by accident. Well, you can imagine what may have happened next, and I’ll spare you the gory details. (Side note: I know what ALL of you are thinking — “Why the hell would she stick her finger in near the blade without unplugging it” And believe me I’m asking the same question. I know it was stupid, and I’ve NEVER done that before. I know better. And I most definitely wont be doing it again!)

immersion blender

Luckily, Will was here to act quickly and take good care of me! Needless to say, we spent a few hours that evening in the ER, which was an experience in itself. When all was said and done, I still have my finger, but it’s all stitched up and the entire nail/nail bed had to be removed. I’m now left with a painful open wound, and a big, bulky dressing and splint on my finger for at least 2 weeks.

 (Get the pun in the title now? On hold? heh heh)

And I’ve been instructed by the hand specialist to not sweat for at least the next two weeks. 

I’m a sweater. I sweat a lot. I’m not one of those girls who can go to the gym with my hair down, full make up, and look like a princess after they’re done. (Who are those girls anyway?) It’s hard for me to do ANY type of workout without sweating, so I’m kind of in a bind here. Hell, it’s hard for me to get through a work day without sweating if we’re being totally honest.

(I also just want to add that I know it could be way worse. It’s just a finger, and it’s mostly intact so that’s lovely. It’s more of a pain in the arse at this point)

I’m going to keep this short because typing is a bitch right now.

Here’s the plan: I’m taking this week totally off from the gym…an unplanned deload week I guess. Seeing as just walking around raises my blood pressure enough to make the wound throb and weep (sorry I know thats gross), that will be the extent of my exercise this week. Next week I’ll try to add in some light, non-sweaty, probably bodyweight exercises and see how that goes.

Here’s where YOU all come in! I want you to leave ideas for me in the comments, because theres only so many air squats and light weighted lunges a girl like me can do. Also, I’ll be traveling for work next week (in South Carolina) so theres that.  Give me some creative things to do until I can get back in the weight room, or at least out at the stadium.  Nothing where I have to grip with both hands, and remember — No Sweat!!  We don’t want this finger to be stumpy forever, do we?

Ready Go!

Please share some injury stories of your own — especially those that involve kitchen appliances and/or other household items 🙂 

Easily Frustrated

There is almost nothing that frustrates me more than not being able to complete my workouts due to pain.

I’m not someone who has had a ton of serious injuries; I was always pretty lucky in that department. But lately I’ve had my fair share of nagging aches and pains that have been taking much longer to heal than I would like.

Recently, I’ve had more than a few frustrating moments in the gym, and it’s getting hard to just look on the bright side and think “well, next time will be better”.

My ankle is still bothering me enough to limit my lower body lifts, and a stupid lat strain that I sustained a few weeks ago has started to derail my upper body efforts as well.  At this point, as far as upper body goes, my “pushes” (bench press, push-ups, OH Press, etc) are fine, but almost anything involving a “pull” (row variations, deadlifts) is pretty darn painful. Which, for those of you who have been following along, is a perfect recipe for a shoulder injury.

lats

[Source]

Performing exclusively “pushing” motions without balancing them out with “pulling” motions , especially in the big lifts, is a disaster in the making, with me basically begging for a rotator cuff strain, shoulder impingement, or something equally as obnoxious.

SO WTF.

grumpycat

I am limited in the amount of weight I can squat because of my ankle. I can’t deadlift or row because of my lat strain, so what in the hell am I supposed to do?

Luckily, I am able to do stadium runs, which is an excellent lower body and conditioning workout. And I am riding my bike to work again, which isn’t a ton but is at least some physical activity each day. But these two things don’t make up for the weight room at all. Last week, I had a couple of sub-par lifts, trying to figure out how to work around my injuries and still get a decent workout in. Unfortunately, by doing that, I unintentionally made my lat feel a little bit worse, delaying my progress even further.  Coughing even makes me yelp now.

Oops.

This week, I think I need to sit down and do some serious planning before I hit the weight room. Even if I have to do some lighter lifts, and avoid some of my compound lifts for a week or two, it’s better to do that than to keep delaying the healing process simply due to my own stubbornness, and stupid need to “test” my injuries even though I know better. If I spend this week on some accessory work, mobility work, and conditioning, hopefully within the next couple of weeks I can get back to the compound lifts that I love.

So until I can do deadlifts without feeling like a grizzly bear is shredding my right lats, I will avoid them. And to be honest, this is essential for not just my lifting future, but for daily life as well. Lats are one of those muscles that you use in so many normal daily activities, never mind the weight room. I’ve gotten to the point where even opening doors is painful, and pushing through that won’t do me any good at all.

I guess in my old age, even though I seem to be falling apart, I’ve at least gotten a little bit smarter. Silver lining?

Ok, complainy-pants rant is over. If you made it all the way to the end of this post, I applaud you, because there really was no point to this one at all, was there? Now go enjoy your Monday!

pleasegoon

How do you work around injuries in the gym? When you’re hurt, do you tend to avoid the gym all together? What was the last injury that kept you from your usual routine?

The Trouble with Hamstrings

Hamstrings suck.

Well, ok. They don’t really. They’re actually quite wonderful when they’re healthy.

But it is very difficult to do any type of lower body exercise without engaging said muscle group. And when that muscle group is not happy, engaging them can lead to increased pain and other problems.

Do you know how nagging a hamstring injury can be? I’ve had a dull, annoying, “hey listen to me!” feeling in my left hamstrings (specifically the lateral hamstring, my biceps femoris) for the past 3 weeks. After a much needed de-load week last week though, I thought I had given it enough of a rest to be all set.

Not so much.

On Monday, that “hey listen to me!” feeling turned into a “WTF are you DOING to me?!?” kind of feeling. Yep, I really pissed off that hammy when I finished off my lift with some glute-ham raises followed by 5×20 kettlebell swings.

Source

Now, I’m not a complete idiot, so I knew when I was still feeling pain with walking by yesterday (Thursday), that my regularly scheduled deadlift/posterior chain day was going to need a little bit of altering unless I wanted to REALLY do a good job on that hamstring strain.

So here are the switches I made to protect myself from further injury:

Instead of:                                                                                 I did this:

Conventional DLs @ 135 lb                                                        Trap Bar Deadlifts 4×8 @115

Barbell Bulgarian Split Squats 3×8 ea leg @ 85 lb                     Same, only sets of 3 on L leg

Step-Ups w/ 40 lb, 3×8 ea leg                                                    Same

Romanian Dead Lifts 3×8 @ 115 lb                                            Scrap this

SL Roman Dead Lifts w/ 2 16kg KBs, 3×7 ea leg                       Scrap this

SO I did those 3 lifts (the Bulgarian Split Squats were not the best idea, my hammy let me know pretty quick, so that’s why the reps were REALLY low on that leg). And since I wasn’t going to be able to do any interval or hill work, I also added in a few upper body exercises and a little bit of metabolic work so that I could still get a full body workout in. For the metabolic work, I added in 3×10 box jumps onto an 18″ box (which I thought would hurt but were fine!), KB Swings 3×20, and 5×30 seconds on the battling ropes. (LOVE these)

Source

All in all, despite being limited by my hamstrings, I was still able to get in a great full body workout without injuring myself further. While yes, I could have just pushed through the hamstring pain and done my conventional deadlifts anyway, I can guarantee you that I would have ended up in more pain for a longer period of time, and having to modify even more workouts down the road.  I also could have scrapped the whole thing all together, and just given up on today’s lift.

As I see it, modifying the way I did allowed me to still get a great workout in, and also to protect myself enough so that hopefully next week I can beast those deadlifts.  Win, Win*!

*That being said, if you have an injury, talk to a professional who can give you some safe alternatives to your normal program, don’t just go out there all willy nilly and hope for the best!

Now, my final test will be seeing how this hamstring strain holds up today….

WHEN I’M SNOWBOARDING!!!!

WOO HOOOO!!! This is the first (and seeing as it’s already March, probably only) time I’ll be able to get out this season. AND seeing as this is my last full weekend off in a while, I’ve got to make the most of it, right?

I. Am. Pumped.

I’m all fueled up with my overnight oats, and I’m ready to hit the slopes.

Soaked overnight in the end of my Trader Joes PB jar: 1/2 C oats, 1 C almond milk, 1/2 tsp brown sugar, cinnamon.

Added in the morning: Raisins, coconut flakes, 1/2 banana

Yum!

What fun things are you all doing this weekend?Does anyone else have any nagging injuries lately? Do you find it difficult to modify workouts around injuries?