"Exercise is the closest thing there is to a miracle drug, and strength training is one of the best kinds of exercise, practically like magic: more healthy and more efficient than most people realize, and a valuable component of fitness and most injury rehabilitation, but not just for the reasons most patients and professionals think. " -- Paul Ingraham of PainScience.com from "Strength Training for Pain & Injury Rehab"
The quote above was published by the Academy of Royal Medical Colleges in 2015. This fascinating paper gives us a glimpse into the future of medicine (Exercise Applications in Certification In Lifestyle Medicine, Evidence In Motion), and brings up many nuanced thoughts for me, starting with my more critical views on it.
First, it’s important to acknowledge that strength training is not risk free. This quote comes close to claiming that it is perfectly efficient and impervious. Second, conditions like hyper mobility and chronic fatigue are often misdiagnosed and a simplistic outlook concerning exercise can be dangerous to someone with these conditions.
As a co-author in Lifestyle Medicine, I see a big gaping hole between recovering from an injury and having the confidence to succeed with strength training. If you have dealt with injuries, surgical repairs, neuropathies, joint weakness and tightness, then you may have been frustrated by the notion that exercise and weight training can cure your ailments. Perhaps that is because a definitive point when your body begins to feel better rarely exists, let alone a clear process outlining how to get there. Healing can be a long and winding, sometimes confusing, trial and error process that requires looking at and modifying many parts of life. In fact, according to the American College of Lifestyle Medicine, lifestyle medicine is defined as “the use of evidence-based lifestyle therapeutic intervention—including a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection—as a primary modality, delivered by clinicians trained and certified in this specialty, to prevent, treat and often reverse chronic disease."
Here is one of my top pieces of advice for people healing from injury: commit to understanding the foundation that exercise is built on. With that knowledge give yourself the freedom to adapt, develop, and create what works for you specifically. It's like learning to cook rather than following a recipe. Reach out for professional help if you need it. I hope to be the Julia Child of your strength training goals.
One important concept to understand in the healing process is called load management. Instead of thinking of your muscles as weak, think of them as needing stimulation and load management. Load management is a system that smashes old school ideas, including over conditioning and taking the field with a ‘just do it’ and ‘mind over matter’ fitness approach. Instead, load management advocates for simple strength training and baby steps, with the mindset that you aren’t broken.
Load Management has a technical and an academic history in the field of study called strength and conditioning. From my experience with injury rehab for athletes and chronic pain recovery for other people, I believe load management is essential. Being active requires an understanding of your body’s limits and potential. This applies to those who exercise regularly and to those who want to use exercise as a tool for longevity.
Principles of load management that apply to strength training with old injuries:
Maintaining basic fitness levels is always important. If you have a knee injury, it might be time to find a pool, recumbent bike or a seated routine. Think outside of the box. If you can manage physical activity like walking, jogging or a dance class while recovering from a wrist injury, then do that instead of something like yoga that requires weight bearing on your wrists. The minimum for weekly exercise is around 150 minutes per week. This number will change depending on the activity, but maintaining movement is key in any stage of life (WHO, 2020). The missing ingredient for most people though is eating enough protein to maintain the muscle you already have which also gives the body healing power.
When exposing an area of concern or injury to exercise I advise doing it minimally, precisely and carefully. The more precise, the better. If this is not possible for you, you need the help of a trained professional. A physical therapist or a specialist at Impact Your Fitness can support you.
Avoid peaks in load bearing around the weakened joint, muscle or tendon. Don't put too much load into your routine in the early stages, like right after you gain permission from your medical provider for activity. The goal with load management is to ensure you can tolerate an activity before you continue to do it repetitively and possibly injure yourself again. For example, my "walk to run" program for clients involves multiple rounds of thirty seconds jogging pain free before advancing to the next incremental stage.
Maintain work to rest ratios. This is where you must measure load and stress exposure and balance them out with rest. The most well known work to rest ratio is high intensity interval training.
Don’t overdo it. For example, when I’m working with a client during recovery from chronic low back pain, I suggest doing exercises around the area of concern with a decreased range of motion, like deadlifts with 25% less bending. I suggest working within a range that is pain free and using a rest period to examine the body’s response to the work. Learning and practicing how to listen to your body will give you important feedback that you need in order to heal.
Track and record progress. This seems simple because it is. Download our free journaling tips here: https://www.impactyourfitness.net/journalingtips
The specialists at our studio, Impact Your Fitness, help clients every day with building a healthy foundation in fitness. Building a sturdy, productive relationship to exercise can be a challenge to do on your own at first if you don't know how fitness works. Our studio is accepting new clients for personalized work to address old injuries, balance muscle structure and more.
On April 25th, you can sign up for my webinar to dive deeper into this topic and learn how to go from recovering from an injury to better than ever! BYOEG Webinar Registration
Impact Your Fitness provides strategic consultation services to individuals recovering from chronic injuries, sports injury prevention, and programming for specific athletic/life events. Schwartz is the only Master level Muscle Activation Technique specialist in Alexandria. Learn more at impactyourfitness.net.