By Steve Edwards
Last week, we examined dealing with injuries from a preventative perspective: how to avoid getting injured in the first place. This week, in the second part of the series, let's look at what to do when prevention isn't enough and we have to deal with an actual injury.
It's common to see athletes return from being injured better than they were before they got hurt. This is because when you're injured, you're forced to rebuild your body the correct way. Failure to do this could lead to your being handicapped for life. If you rebuild correctly, however, you can easily return from most injuries not only feeling fitter but better able to stave off additional future injuries. Here's a quick guide to how you can come back stronger and faster after you're injured.
Examining your injury
The first thing you need to do is assess your injuries. Let's throw major trauma out of this discussion, because in those situations you need professional healthcare right away. In situations of major trauma, you should follow your doctor's orders until he or she gives you the go-ahead to do things on your own. At this point, you probably still have some physical limitations to consider, but once your doctor releases you, the information I've provided below regarding minor trauma becomes relevant.
Pain is generally associated with an injury, but all pain doesn't mean that you're injured. A fairly common occurrence—especially for people who haven't worked out before—is to confuse standard muscle breakdown for an injury. This may sound absurd, but it's not when you consider how the body becomes stronger. The kind of breakdown we instigate through training is, in fact, a type of injury. The only difference is that it's a targeted breakdown, involving body parts that recover quickly. This is why recovery is such an important subject in fitness training. When you follow a workout program, the overload is progressive, meaning that the amount of breakdown increases over time. But when you overdo it during a workout, you create excessive muscular breakdown, which can feel like an injury.
Most other injuries that don't require immediate medical attention are called soft tissue injuries. These are referred to as sprains, twists, pulls, jams, etc., which are all different types of microtrauma to your ligaments or tendons. These injuries vary in severity. In some cases, you need to see a doctor to assess how serious an injury is—and whether it's something that needs medical attention. Minor cases are often left untreated. Leaving minor injuries untreated is an easy way to help an area turn into a chronic problem.
But whether you're beat up from training or have an injury, your recovery protocol is similar. Although all pain doesn't mean you're injured, all pain should be treated as an injury, because standard recovery for microtrauma in uninjured muscle tissue is similar to that for minor trauma in injured muscle and connective tissue. The only difference should be in how aggressively you go about implementing the treatments listed below. For example, if you know you have muscle breakdown from jumping too high during yesterday's P90X® Plyometrics workout, you can be less diligent about certain protocols, like icing the "injured" region. Ice would still help the injured area recover more quickly, but given that you know it's not a real injury, you can be certain it will heal 100 percent anyway. Incidentally, an after-workout shake like P90X® Results and Recovery Formula™ that enhances quick replenishment can help you figure out whether you're injured, or you just overdid it. A properly timed recovery shake will improve muscle resynthesis so you're less sore.
So essentially there are two types of injuries. Major, which means you need to see a professional ASAP, and minor, which you can (and should) treat yourself. Keep in mind that a minor injury can become major. Therefore, keep a close eye on how your home treatment is progressing. If things continue to get worse, it's always better to get to a doctor—the sooner, the better.
Periodizational training for injuries
As soon as you notice an injury, whether you've twisted your ankle or noticed that a dull ache in your elbow seems to be getting worse, your protocol should be the same. Like an exercise program, an injury treatment program has steps for you to follow and progress through in phases. In most cases, the type of injury doesn't matter because these steps are the same. If your injury isn't so bad that you need to see a doctor, these are the steps you should follow.
Step 1: Post-injury assessment ASAP
When you get injured, your very first step is to assess the injury. Is it bloody, are you disfigured, can you mobilize the area, etc.? Your first step is to address whether or not you need to get to a hospital. If the answer is yes, you want to get there ASAP, because the sooner the treatment is started the easier your recovery period will be.
If there's no doctor on your agenda, your next step is to immobilize the injury. Adding further stress at this point can make the injury worse. So when you've hurt something, the first thing you want to do is to stop moving.
Next, you want to keep the area from becoming inflamed. If you're away from home and you need to keep moving, this can become step one. Taking anti-inflammatory medication like ibuprofen or naproxen sodium should be the first thing you do, unless you have an issue with these medications.
You'll want to ice and elevate the area immediately. Of the two, icing is more effective. Doing both is best. Getting ice on an injury as soon as possible is probably the best way to speed up your recovery. It's amazing how effective keeping an area iced and elevated post-injury are for speeding recovery. By taking the time to do this, even when the injury isn't too severe, you can change something that could become a nagging, chronic problem into something that is gone so fast you forget you were ever injured.
Ice helps with standard exercise recovery, too. If you know you've overdone your workout, immersing the affected areas in ice will greatly speed up your recovery. It's important to keep in mind that icing small areas like your fingers can lead to frostbite, because you don't have enough circulation to melt the ice in those areas. The smaller the area, the shorter the time you should ice it. For fingers, don't exceed 10 minutes or so. For larger areas, like ankles, standard practice is to ice for 20 to 30 minutes. After icing, allow the area to warm up fully before icing again. During the acute stage of an injury, you can ice up to 5 times or so a day. Don't get discouraged if you can't do this. Any icing is much better than none.
Now rest. During the acute stage of this phase, you don't want to do any other exercise. This will cause breakdown that reduces your body's ability to repair the damaged area. The length of this period depends on the injury. For an injured finger, you might be able to move into the second phase the next day. For a larger body part, you might need a few days or more of downtime.
Step 2: Recovery
As soon as you can, you want to get the rest of your body moving again. This helps speed your recovery by reversing the atrophy that begins once you stop movement. What to do during this step varies a lot and is entirely dependent upon the location of your injury. The only constant is that you don't want to stress the injured area at all. Other than that, you can do any physical activity you want.
Step 3: Physical therapy
This is where you target the comeback for your injured area. Visiting a physical therapist can help greatly, because, well, it's his or her job to help you recover. The training you do will generally start with simple manipulations of the injured area. Once these can be done without pain, the intensity begins to increase.
Physical therapy exercises focus on muscular balance. That is, they tend to target both the large prime mover muscles of an area along with the smaller stabilizer muscles. Because you focus on these in combination—which often doesn't happen during sports, or in training programs that are are only based on changing how you look—you'll often return from an injury more balanced than you were prior to the injury. This is why many athletes come back from injuries stronger than they were before.
It's impossible in the scope of this article to explain all the types of exercises you could do for injured areas of your body. There are many references on this subject, including physical therapists. Beachbody now offers a solution as well. Our Total Body Solution™ program covers basic movements you can do for rehab. Keep in mind that you can also do these to help prevent injuries. Total Body Solution also has assessment exercises that will help show you if your body is out of balance.
You know that injuries are really just a part of life, as is how we respond to them. If you follow a regimented protocol, there's really no reason to fear injuries. Like most things in life, they're simply a part of the process of living. How we deal with them can make them worse, or turn them into a positive.
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