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How can I push forward post injury? I’m always worried about re-injuring myself, but I want to get back to normal.
-Getting Back to Normal
GETTING HURT IS one of the most frustrating things that can happen in the gym. Recovering to get back to 100 percent power might be just as difficult. I’m going through that process now myself. I have a lingering hamstring strain after a long training cycle leading up to running the New York City Marathon last year. My first inkling there was an issue was in August, the race was in November, and now, five months later in March I’m still not back to my normal self. To make matters worse, I tweaked my groin as I was rehabbing the hamstring, so I’m dealing with a pair of leg day issues. My inability to perform my best is driving me up a wall—so this question is near and dear to my heart.
Whether you’re laid up with a serious enough injury that you’re forced to totally shut down to heal or you’re just stuck with a pain that won’t go away when you do certain movements, you’ll have to change up the approach to your workouts. You might have to be cautious when you train that particular body part and avoid positions that could exacerbate the problem area. That’s smart. But what you can’t do is train scared. If you’re so nervous about re-aggravating the spot that you’re having trouble committing to your workouts or only going at half-speed out of fear, it might be a good idea to step back and reassess exactly what you’re doing.
But don’t step back to the place you started, nervous, hurting, and unable to train the way you’d like to when you’re able to get into the gym. Instead, follow this three-step process to reestablish your health—and just as importantly, in this case, your confidence. I’ve taken these steps in my own recovery, and while I’m not back to full strength just yet, I’m in a much better place than I was.
The first thing to consider is if you need help to get yourself back to normal. If you’ve been gutting through pain that doesn’t go away after a few rest days and you’re not already following the guidance of a medical professional, it’s time to visit a doctor or physical therapist to determine what exactly might be wrong—and more importantly, what you can do to heal and work around your problem spot safely.
This took me longer to do than I’d like to admit. I’m stubborn, and I wouldn’t be surprised if many guys reading this would say the same. Even though I was hurting before I ran an entire marathon, I didn’t consider going to get an assessment until months later, when I was still feeling pain when I ran or lifted heavy. What I assumed would be a week-long healing process stretched on and on, and the pain made it difficult to enjoy one of my favorite parts of the day, when I get to train. Don’t be like me and gut through the voice in your head telling you that what you’re doing isn’t working. Listen to your body, then go listen to your PT.
Having expert medical guidance is more important than just giving you an inside track to speed up your timetable to return to full strength. Just take it from my PT: Dr. Cameron Yuen, D.P.T., C.S.C.S. of Bespoke Treatments. “When you get injured, the body finds other ways of moving,” he says. “This new way of moving helps distribute stress away from the injured area but it also increases stress in the areas surrounding the injury.”
This is called compensation, and that can lead to more problems. “If not rehabbed comprehensively, this can lead to re-injury, or injury in an adjacent area,” Yuen says. In my case, the pain in my hamstring was affecting my movement. I had weakness in my hips and glutes, and I struggled with bilateral (single-leg) movements. Soon enough, I injured my groin doing a Bulgarian split squat. I wasn’t able to spot these compensations on my own; it took a visit to Bespoke for an assessment to figure out my issues. Now I’m better equipped to deal with these compensations, and I have help to fix them.
One of the best things you can do is to build up around your injury. Yuen says that building strength and re-conditioning where you’re hurt—and just as importantly, the muscles around it—is essential, and that you can do this using more than just the small pyramid of rehab weights and half-rep exercises. This doesn’t mean that you should recklessly slide underneath a barbell for heavy bench presses if you’re dealing with a shoulder problem; you’ll have to approach the workouts from the perspective of your PT. “Your physical therapist can help you identify the correct isolation exercises that force you to use the correct muscles, and compound exercises to get the muscles to coordinate for efficient movement,” he says.
Yes, Yuen recommends keeping compound lifts (think squats, deadlifts, heavy rows) in your routine, but that doesn’t mean that you should push yourself beyond your limits. These compound lifts shouldn’t be painful—for example, I can do deadlifts without much issue, but back squats have been more challenging, causing pain and soreness when I do much more than just the bar on my back. With that in mind and with guidance from Yuen, I’ve switched up my focus to front squats, wearing lifting shoes to give myself a better position to work from given my limitations.
Your approach will also depend on your injury. When Men’s Health fitness director Ebenezer Samuel, C.S.C.S. was recovering from an elbow surgery, he still trained hard—but with his arm in a brace, he had no choice but to avoid exercises that forced him to use the injured limb. This made it tough for him to do many compound movements, so his focus instead turned to unilateral work, offset training, and isolation movements. He was able to push himself within his limits while protecting his arm, giving it space to heal.
“Continuing to stay active and push yourself in your training, wherever possible, has a ton of benefit,” says Samuel. “It helps generate increased total-body blood flow, and it can help preserve your hard-earned muscle tissue. And especially when you’re dealing with an injury to a limb, there’s almost always another limb that you can challenge with load.”
This should be your litmus test: Train hard where you can, but if it starts to hurt, stop. “During your rehab, you also want to make sure that you are still training using exercises that maximally stress the healthy areas of the body, while protecting or minimizing unnecessary stress to the injured area,” says Yuen. “Trainees should avoid movements, positions, loads, and speeds that increase pain, and choose pain free options instead.” You might feel discomfort—and again, this is something that you should work through with your PT—but once that becomes pain, you need to step back. If you have trouble determining which is which, get thee back to the PT.
“This is a great chance to really listen to your body,” says Samuel. “You’re injured, so nothing feels quite normal, but if you work closely with your PT, you’ll wind up with a greater understanding of ‘good’ and ‘bad’ discomfort, and exactly how you can work through both.”
You can also think of this period as an opportunity. If you’re concerned about getting hurt taking on the same workouts you were doing pre-injury, why not spend your time and effort elsewhere? If you only strength train and you have an arm injury, for example, maybe this is the time to work on honing your aerobic system on the stationary bike. “Trust me,” says Samuel, “even if your main gym goal has nothing to do with cardio, building a bit of extra engine will still make you better when you go back to hitting the weights.”
You’ll reach a point eventually when you’ll be able to move normally again. Your PT might clear you for general activities without any restrictions, which is great—but then you have to determine what you’re ready for, mentally. Some guys might want to jump right back into their PR-level of training immediately; others, like you, Getting Back to Normal, might be skittish about going even close to all-out again.
You’ll find a good spot by returning to the basics. “Once you enter the post rehab phase, it’s important to build back slowly,” Yuen advises. “The injured area is likely still lagging behind the rest of your body, especially if you have continued training and even though it is no longer painful. Pushing the intensity towards your body’s full ability might be too much for the injury still, so restart training on a base building block integrating the previously injured area.”
I took this approach. After some time off, I restarted my training program in earnest, working with lighter weights, higher reps, and a more generalized routine. I’m slowly getting myself back to where I was—and I know how I’ll be able to gauge my progress. When I was doing front squats during a training session recently, I was feeling good. So I pushed myself to add more weight than I had been working with before and made sure to move through my full, normal range of motion, testing whether or not I’d feel discomfort. I didn’t, and it was liberating.
“The only way to know you’re back to 100 percent is by testing” says Yuen. “Symmetry in range of motion, maximum strength, and movement patterns are all essential. Missing any of these qualities will lead to compensation in another area.”
I’m going to keep working with Yuen, training hard, and finding opportunities to win small victories like my front squat test. I’m not back to 100 percent just yet, but I’m not dreading my workouts, either. Put these ideas into practice, and you’ll be able to get there, too.
Brett Williams, a fitness editor at Men’s Health, is a NASM-CPT certified trainer and former pro football player and tech reporter who splits his workout time between strength and conditioning training, martial arts, and running. You can find his work elsewhere at Mashable, Thrillist, and other outlets.
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