How to get back to your workouts after an injury?

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Many people wonder about when they should get back to their workouts after getting injured. The answer to that question may vary, because it depends on how severe the injury was, the area that’s been affected, the time during which you were deprived from exercising and your overall health.

Both people who exercise frequently and people who don’t are at risk of getting injured. Whether it has to do with excessive loads, bad technique, lack of physical exercise or any other reason, injuries may occur at any time.

When can we be sure the injury is completely healed?

Most people try to get back to their workouts really soon, before the injury is completely healed, and many times they get the same injury again or the one they already had gets worse, which will keep them for working out for a longer period of time.

For example:

 

Let’s suppose you get an injury and you have to lose 2 workout weeks just to stay in a recovery period. In this case, what you need to do it wait until you feel that your injury is healed and, as soon as that happens, you should wait one more week only to guarantee a complete recovery.
If you completed your recovery time, you’ll only lose about 3 workout weeks and you may get back to your workouts, no problem, because the injury is not completely healed. Let’s assume you didn’t wait this additional recovery period (the extra week); you are at risk of getting back to the gym and getting injured again. If that happens, besides worsening your injury, you’ll be prolonging your recovery time, losing another 2 weeks and an extra recovery week. All in all, you end up depriving yourself from exercising for 5 weeks, which means that following your recovery plan as recommended gives you more benefits in the long term.

Picture this: you got an injury in your shoulder that required a 4 week recovery period.
-When you get back to your workouts you should only do one exercise and one set.
-If you do multiple exercises and the shoulder starts hurting on the next day, you won’t know which movement set that pain.
-If you do multiple sets, you won’t know if it was the exercise or the excess of reps, so it’s more complicated to detect the problem and what you should change in your workout.

Try to do one set of one exercise – your choice (bench press, for example), and if the shoulder doesn’t hurt on the next day, that means you can do that exercise, no problem. If on the following workout you chose to include another set of another exercise without having any shoulder pain, that means you can do that movement again.

You should also try to understand what provoked the injury so you can stop ir from happening again and from getting worse.

Tip: When you get back to your workouts, start slowly and with lighter weights. Do it for a few weeks until you get to the level you were at before you had the injury.

What about runners?

In their case, the most frequent type of injury has to do with little cracks in the bones, caused by the excess of impact. On average, it takes about 90 days to fully recover. Still, it is possible to run after 6 – 8 weeks in a controlled way; the most important is to start slowly and to increase the workout volume gradually.

Tips:

1. Be patient. Instead of worrying about the amount of work ahead of you, focus on your workouts and your goals for that week. Define mini-goals each week to get your motivation to stay up at all times.

2. Listen to your body. If you start having symptoms of older injuries or symptoms of new ones, reevaluate your physical condition immediately. That may imply extending the recovery time or it can just mean that it’s an adherence problem.

Almost every street runner has had, has or will have multiple injuries like tendonitis, muscle injuries, articulation weariness, etc…
The problem is, when an injury occurs, the body doesn’t just act in that area.
During the recovery period, the runner changes his/her routine, becoming sedentary and, for that reason, besides healing the affected area, tissue adherences may occur in the area around the injury or even in distant areas.
That makes the athlete feel pain or stiffness in different places when he gets back to his/her workouts or mixed discomfort feelings that can be mistaken for a persistent injury. Truth of the matter is, this is a natural process.
These adherences, also called fibrosis, are nothing but a process caused by multiple factors that may be related to the decrease of the movement between the tissues, the inactivity on the recovery period, micro injuries caused by the return to workouts (late muscle pain) and repetitive daily movements. These efforts may lead to the accumulation of muscle tension, causing the feeling of stiffness or even pain.
Manual therapy may help release the muscles and fasciae (muscle group involved by fibrous tissue) if it’s done by a qualified professional. The difference between manual therapy and massage is that manual therapy aims to improve biomechanics and muscle and fasciae release, sometimes even in a reflex way, by working the opposite muscles. When it comes to the common massage, a sequence of maneuvers that don’t take the biomechanics and the injury into consideration is performed, so most of the time the results are positive, but they can have side-effects and worsen the problem.
That said, if you feel any stiffness or new pain, don’t stress out, go see the healthcare practitioner that has guided you through the whole recovery process, because it might be just and adherence problem.

3. Do not increase distance, frequency (number of runs per week) and the intensity of your runs at the same time. After a crack due to excessive physical stress you need to increase the volume of your workout slowly and allow enough rest to get your bones to adapt. In a specific week, you should take into account one or two workout variables, at most. For the first weeks, it’s better to increase the distance and the frequency of the runs, keeping a moderate intensity. After one or two months following this basic plan, you can start increasing the intensity gradually.

4. In the beginning, you should run every 3 days or so, day on, day off, so that your bones, connective tissue, tendons and muscles adapt to the stress of the run. After that, increase to two days in a row, alternating with 1 day resting.

5. Avoid old running shoes and also avoid increase the volume of the workout quickly.

6. When you can walk fast and with no pain for 1h, you should be able to run for a while. The impact of the run is, most of the times, bigger than the impact when you walk, so the only way you can find out if your body is ready to run is, in fact, trying to run. If you feel persistent pain in the affected area, then that means it’s still not healed enough to run. You should stop immediately and go see a doctor.

References:

Helio Augusto Ferreira Fontes, Voltar a correr depois de um fratura por estresseou outra lesão séria, n/d, translation and adaptation of the original version

Fernando Ribeiro, Como voltar a treinar após uma lesão, 10th of January 2014, translation and adaptation of the original version
Claudio Cotter, Como retornar aos treinos depois de uma lesão, 1st of April 2013, translation and adaptation of the original version
Caitlin Chock, 8 Tips to Make a Strong Comeback to Running After an Injury, n/d, translation and adaptation of the original version

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