As a physical therapist who specializes in treating athletes, I’ve seen many types of sports injuries. I try to hear their WHOLE story and dissect where it could have gone wrong. Over time I noticed that certain themes came out of every story and I condensed them all here in this blog in hopes that you don’t experience an injury in the future.
Before I get on with the list, I want to explain a rehab and training concept known as the SAID principle. SAID is an acronym that stands for “Specific Adaptation to Imposed Demands.” What this basically means is that your body adapts to what you do most.
If you use it, you improve it; if you don’t use it, you lose it.
Picture the sprinters with huge tree trunk thighs built for generating explosive power. Even when those sprinters age, they seem to maintain those girthy thighs. If you can visualize a long distance runner, they are usually leaner because all their muscles have adapted over time to be built for endurance.
Injuries happen because of tissue failure, meaning that they haven’t been built up to handling the load it’s going through. The SAID principle helps us understand why injuries happen and can help us minimize injury in the future. My first point is about doing too much too soon. Weekend warriors are frequent clients of mine because they work a regular job during the weekdays, and go hard on the weekends to try to make up for lack of activity during the week. New year’s resolutioners also help our business thrive because if you get out of shape and quickly try to get back into it, you are vulnerable for an injury. You may be mentally prepared and motivated, but physically your body is not ready.
1) Doing too much too soon
Remember the first leg day back to the weight room or the time you started playing pick-up basketball again after a hiatus. The first week could be rough, but soon your body starts to adapt.
One of the most common causes of injury with athletes is ramping up too much too soon. Imagine a runner who took a 6 month break following their last marathon; or a weightlifter who took 3 months off during a busy school semester. These types of athletes have a certain mentality and expectation when they perform their sport. They train with a similar intensity and very little patience of gradually progressing to their prior levels correctly.
You body doesn’t care if you benched 345 pounds 3 months ago. You didn’t bench press for a while and now your body allocated its energy in other areas to keep you alive. You’re going to start over and now your max may be 250 pounds.
The good news is that you know your body’s potential. A good rule of thumb is to be patient and however long a time you took off should be the time you give yourself to ease back into your prior levels. So in our example, give yourself 3 months to safely ramping back up to 345.
2) You’re not allowing your body to recover
When you’re in peak fitness, your body is also in peak recovery. The Crossfit Games athletes are so well conditioned that even though it is painful and difficult, they are able to come out there everyday and push their bodies to the limits. An everyday person may need a week to recover from Murph in 110 degree heat!
When getting back to working out after a break, your body isn’t as efficient with recovering. This applies not only physically, but mentally as well. When you 1 rep max and feel exhausted the rest of the day, or when you’ve had a long day of work even though you sit at a desk: this is called neural fatigue.
In the body, pain is your body’s way of warning you that something is off with that area. You may have soreness in that area, and things will be okay, but if you keep going at the same intensity, that area with get injured.
If you’re just getting back to working out or you’ve been consistent for years, you have to provide your body the best environment to recover. This includes trying to limit outside stressors, consuming enough calories and nutrition, and getting enough sleep. There are many people that preach rest and recovery out there. You will find many books, articles, blogs, and podcasts about it. In a nutshell all they really tell you is to find ways to relax, eat enough when you’re hungry, and sleep at least 7 hours a day. Everyone is different; you just gotta find what works for you.
3) Imbalanced programming
Who makes your workouts? Is it you, your personal trainer, or your coach? Injuries can happen from faulty and imbalanced programming, so you have to have a lot of trust in the person creating your workouts for you. Here are three common consequences of poor programs.
- You don’t progress – although this is a travesty, it is safe and doesn’t increase injury risk. If you are not meeting your goals, however, you may benefit from a change in scenery.
- Too much of one thing- lets say this is your workout today:
- Deadlift 5×3
- GHD extensions 15x10s holds
- KB swings 4×20
- Jefferson curls 10x with 3010 tempo
THAT’S A LOT OF POSTERIOR CHAIN. From my experience this can increase the risk of back pain. I’m not trying to create fear. 99% of people will be okay with this workout other than some muscle soreness. The part that we always look at as injury prevention experts is analyzing the risks vs reward. Ultimately this workout will increase the risk and for what? You can easily spread these movements out and program smarter. Plus there’s a strong chance that you will have to use your posterior chain for the exercises tomorrow, but now your lower back is shot! If you notice programming like this, you can just say “no” to it, or scale the hell out of it and train in safer ranges.
- Ignoring muscle groups – here are classic dominating movements in a “bro split”:
- Bench press
- DB chest press (varying inclines)
- Chest flies
- Shoulder press
- Lat pulldown
- Dips
- Calf raises
If you can visualize someone that works out like this, they are likely deltoid dominant with those bouldering forward shoulders. There is a muscle imbalance happening at the humeral head and the stronger muscles are pulling it up and forward. And while this is not culturally aesthetic, the bigger concern is the possible future issues when muscle imbalances are present (ie. shoulder impingement). A good coach will have a program that will hit both your agonists and your antagonists. You biceps and your triceps. In our example, pecs and anterior delts are balanced by the rotator cuff muscles and the posterior deltoid. The pecs are also balanced by the middle trap and rhomboids. If you notice areas that are being ignored in your programming, bring it up with your coach. Communication is key and most of the time we welcome the feedback because we want to make sure that we are doing everything we can to help meet your training goals.
4) You’re not strong enough yet
This one is simple. You are at a risk for getting injured because you are not strong enough. When your tissue doesn’t have the capacity to withstand a load, it’ll fail. If it doesn’t fail, other areas of your body are overcompensating that now increases your chance of injury in elsewhere. A common movement with a plethora of examples would be the deadlift. If you can’t maintain a hollow position and use your glutes to unhinge and drive the weight up, you may hunch your back to inch the weight up slowly. This is a common way that people tweak their backs with the deadlift. Our tip to you is to drop the weight down 10 percent and perform the movement correctly for 2-3 reps. Build up on your foundations, so you can lift this weight safely in the future and decrease your injury risk.
5) You don’t have the proper stability
Stability is your ability to maintain control of joint movement by the coordination surrounding muscles. When you squat, you don’t fold in half because of your core muscles stabilizing the load while you ascend and descend with the movement.
Stability is often trained when you are performing compound movements; however, if you experience any pain of sorts, your body undergoes a protective response and decreases the activation of the nearby muscles. This is known as muscle inhibition. Since the stability muscle are really small, when they are inhibited, the results are really noticeable. Some common stability muscle groups include the rotator cuff muscles, the glutes, the core muscle group, and the muscles within your feet. Physical therapists are mostly known for addressing the stability muscles because lack of stability can result in injury or could be the result of having pain. You need to regain it if you are going to perform optimally again.
6) You’re lacking mobility
Proper techniques exist because they are the most energy efficient ways to complete a movement. When you lack mobility, you require other joints to increase their mobility so you can get to similar efficiency ranges. If other joints can compensate enough, you then require those stability muscles to compensate for you too. So now all aspects of your anatomy are challenged, thus exponential increase in injury risk.
An example would be the Front squat. People commonly lack the wrist extension to hold heavy loads in a front rack position. With lighter weight the spine can extend more to help you keep the bar more upright. When the weight increases you spine can only compensate for you for so much and eventually your tipping point usually results in you leaning more forward and either straining your back or hyperextending your wrists.
What to do if you suspect an injury
The best thing to do when you suspect an injury is to consult with a medical professional. Since the summer of 2018, physical therapy has been granted direct access in Illinois meaning that you can now see physical therapists directly after sustaining a minor injury. Since the first line of defense with any pain or discomfort is physical therapy, you could just skip a lot of steps and go directly to us.
The most probable things that could happen if you keep an injury to yourself is:
- It will get better
- It lingers for longer than it should
- It will worsen and become serious
- It can reappear with a vengeance in the future
- It can start to cause injuries up and down the kinetic chain
You want your physical therapist to be knowledgeable about your training movements and someone that actually works out. If your symptoms don’t improve within 1-2 weeks, Unbroken Rehab and Athletics is always providing free consultations. Don’t start the new year behind the starting line. You have goals and we will help you meet them. Our main goal is to help you recover as soon as possible, so you can get back to doing the things you love and training pain-free.
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Thank you for reading, and remember…the path to fitness is UNBROKEN