Returning to activity after an injury
In my previous blog, I started discussing some tips for rehabilitating an injury. While professional advice can help in this process (and for some injuries, is strongly advisable), many people I speak to have already had their injury assessed, been told that it isn’t anything very serious, and sent away to wait for it to get better. Alternatively, they may have been given some basic exercises that have got them to the stage where they can do their everyday activities; but nothing more physically demanding.
This might leave you at a bit of a loss for how to plan your return to work or sport. If certain movements and activities still cause pain, then what’s the best course of action? Is it better to wait until the pain has gone entirely to avoid doing any more damage? Or should you “work through” the pain?
Here are some of the tips that I often give to clients returning to physical activities after an injury (It should go without saying that this blog is NOT a substitute for individual advice from a professional):
Staying active is often good. With some injuries, it’s important to reduce the amount of stress you’re putting on the painful area. You may need to adjust what you’re doing, and avoid specific activities that aggravate it (and occasionally, an injury will require a period of complete rest in order to heal properly). However, in many cases it’s beneficial to stay active. A good diagnosis and professional advice may be important here!
Distinguish between pain and discomfort. It’s not always easy to tell the difference: as a rough guide, what I mean by "discomfort" is the level you might normally feel during or after an unusually tough gym session. Sometimes a little discomfort is to be expected during the rehabilitation process - trying to avoid it altogether will often make things worse rather than better - but it’s important that it’s manageable and moderate. If, on the other hand, what you’re feeling is intense, sharply painful or reproduces the symptoms that you’ve been getting, then it’s probably time to back off.
Look for the “goldilocks zone”. Many injuries are the result of doing “too much, too soon”. Professional athletes are able to put an incredible amount of strain on their bodies, because they’ve built up to it gradually, and allowed their body to adapt to the training load. Try to do the same without proper preparation, and you’re asking for trouble. This is especially true when coming back from injury. A little stress on the body can be a positive thing, but overdo it and you can easily end up right back where you started. How much is too much? It depends - every person, and every injury is different. Start cautiously, build up the amount and intensity of your training gradually, listen carefully to your body, and adjust!
Take an inventory. Make a list of the specific movements you’re having trouble with (this is handy to take along to a therapist, too, if you’re working with one). If you’re a tennis player, then maybe it’s just one particular stroke that’s still giving you problems. Or, for a weightlifter, it might be any overhead movements. This is useful to refer to, and it will also help you to track any progress you’re making.
Work on an easier movement first. Take the action that’s causing you trouble, and find an easier version that isn’t painful. Maybe slowing it down helps, or reducing the amount of force involved. A judo player could try doing their throw more slowly on a cooperative training partner. Then find a way to build up, step by step, until you can do the full technique. A little discomfort during this process is to be expected, but strong pain that aggravates your symptoms should be avoided. In most cases, the advice is to “work on the edge of the discomfort”. This may be hard to get right on your own, and working with a therapist who understands your sport can pay off. They will also be able to suggest other exercises that will help you build up to sport specific movements.
In the early stages, avoid situations where you’re less in control of your movements. Problems often arise when people go straight back into a game situation after an injury. For a rugby player, mid-tackle is the wrong time to discover that your ankle sprain hasn’t fully recovered yet. Drilling the critical movements in a controlled environment first helps your body to re-adjust to the stresses of your sport, builds confidence and makes it less likely that re-injury will occur. Sport specific drills can be used to re-introduce unpredictability gradually as your recovery progresses.
Focus on your technique. Sometimes injuries can happen because of mistakes in your technique. If you’re stuck with a persistent nagging injury that seems to come back whenever you try to do your activity, then consider booking a few private sessions with a coach to iron out any flaws in your mechanics. It may be a worthwhile investment!