30/12/2022
Pain and rehab.
Whether it's a full injury, or just daily muscular aches and pains, the same basic approach applies.
After recently posting about Andy, who's recovered from two injuries (one of them very severe) in the past year, I thought I'd cover the basics that we've used in his rehab during personal training sessions to help anyone else dealing with injury.
- Rest the affected area to the appropriate degree.
If it's serious enough to land you in A&E then you'll most likely need full rest for at least a few weeks (and will be under medical supervision for this). For more minor ailments, you may only need a few days rest.
- Once the pain has reduced considerably (a few days for minor injuries; a few weeks for more severe ones), then begin with very gently moving the affected area.
Little and often, not giving it a work out or trying to push it, just keeping the area from seizing up (newly forming scar tissue can keep the area permanently tight if it's laid down on an immobile area). Stop if the pain increases, or becomes anything more than very, very mild.
- When simply moving the body part causes no pain (and no sooner; this will take weeks, if not months!), begin exercises that provide more of a challenge to the muscles (eg light resistance/strength exercise).
This is where 3 factors become very important:
1 - Perform exercises that begin pain free, and allow you to perform high reps (eg 15 - 20) before feeling any pain. Stop once you feel pain.
There are different takes on how much pain is acceptable. Commonly, 3/10 on a pain scale is what's given as a cut off. I err on the side of caution, and have clients stop once they feel any pain. The important thing is to be consistent - always stop at the same level of pain. No pushing harder from one session to the next.
Tip for selecting exercises - Google will usually show you all of the basic motions that a joint can perform, and the corresponding exercises for it.
However, each injury is unique. There will be a certain motion, in a certain position, that feels worse than others. Performing this action, for 15 - 20 reps, stopping when it hurts, will be the most beneficial.
To take Andy as an example, he found that reaching up and across to take something from a shelf was the most painful position for his shoulder.
While also working on the standard, text book shoulder exercises, we made this shelf grabbing motion into an exercise, gradually adding weight over the weeks, keeping the reps high and the pain at the same low level.
2 - Make your progress monitorable.
Did you do 15 reps before feeling any pain last session? Then the goal this time is to perform 1 or 2 reps more before feeling any pain. (This is why it's important that you always stop at the same level of pain, so that you can see if you genuinely are improving, or just getting better at pushing through the pain).
3 - Allow time for recovery.
In the previous stage, when just looking to keep the area moving, your body could be used every day or two (depending on how it felt).
Now, you're stressing your body with exercise. This causes slight damage. Don't worry, this is what we want. It will stimulate the injured area to grow back better and stronger.
However, THIS TAKES TIME. For lighter work, 3 days is a safe bet. If you've strayed into more strenuous exercise, around a week is best. If you've over done it, base it on the level of pain, and return to where you were in the rehab cycle when it last felt like this, slowly building back up.
Injuries can persist, very stubbornly, if not treated correctly. Don't let something minor drag on for years by trying to rush the rehab. Prepare yourself for a boring, but necessary, few weeks/months ahead, and take the time to come back properly.
If you've got an injury, or ongoing muscular pain, personal training with professional guidance could help you, just like it's helped Andy and numerous other clients.
It's the time of year when slots start filling up fast, so get in touch now if you're interested in getting £5 off your first 5 sessions. Hurry, availability soon starts dropping!
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