After my premier post here at Target Focus Training, I received a lot of comments, and many of them sounded something like this:
“Charles I love what you’re saying, but I have (insert injury of choice here)… I’m not sure if I can follow your recommendations, so what would you recommend?”
So for all of you who are dealing with injuries (past and/or current), and for those of you who are concerned about avoiding future injury, I’m about to spill my best advice on you right now. I do request one caveat however: as you read the 7 tips below, please make peace with the fact that every injury is different, requiring individualized strategies.
This “primer” on injury management employs a principle-based approach… there’s an old saying that “methods are many, but principles are few.” The take-home lesson is that when you’re dealing with a complicated, multi-faceted problem, falling back on principles is the best way to stay on track. At the end of this post, I’ll make an announcement for those of you who may be interested in more detailed supervision, which may certainly be warranted in some cases.
Now on to the tips.
Over the course of my athletic career, I’ve had my share of injuries, but fortunately, I’ve avoided truly life-altering injuries, and today, at age 52, I can do pretty much anything I want (physically-speaking) without being held back by physical restrictions. Again, part of this is sheer luck, but I also believe that I’ve been very smart with respect to how I handle myself during my workouts, and in everyday “lifestyle” choices and decisions. So with that in hand, let’s get started:
1. If You’re Not Assessing, You’re Just Guessing
In this case, by “assessing,” I really mean “diagnosis.” Now, I’m not saying that if you should run to the doctor for every little thing— far from it. But if you tweaked your knee three weeks ago and it’s still bothering you, you’ve gotta find out what you’re dealing with, and also to develop some baseline data in the event that you have additional problems in the future.
At this point I feel compelled to share a few thoughts about negotiating the medical system here in the US: Very few doctors actually know how to promote health, and I think you’re better off if you don’t have the expectation that they do. What doctors do fairly well however, is fix problems once they’ve already occurred. My personal approach is to consider my health MY responsibility, and then go to the doctor when occasional problems show up (and I’m mostly talking orthopedic issues here by the way, not life-threatening diseases).
Also realize that most doctors will not be terribly enthusiastic about helping a 70-year old solve a low back problem so that he can resume his weight-training program. A doctor’s primary mindset is to minimize risk, but as I’ll explain in tip #3 below, often calculated, intelligent risks must be made to solve certain orthopedic issues.
With all of the above in mind, if you sustain an injury, stop what you’re doing and assess the situation. If you have severe pain and/or other distressing symptoms such as numbing, paralysis, or blood loss (!), yes, call a doctor immediately. However, if you’ve “strained” a muscle, or experience mild to moderate muscle and/or joint pain, again, stop the offending activity that caused it, apply ice to the injury site, and give it a few days to recover. My operational rule of thumb for things like this is that, if the injury seems to be getting noticeably better with each passing day, ride it out. If not, get some professional help and find out whats wrong.
2. Respect The Injury But Do Not Let It Define You
Years ago I worked in a Chiropractic office, where I learned an eye-opening lesson: quite often, people would walk in with disabling low-back pain, and upon reviewing the patient’s x-rays, no mechanical issues could be found. In contrast to this, on more than a few occasions, a patient with no back pain would receive an x-ray for a non-spine-related problem, and amazingly, the doctor would notice significant low-back damage!
The lesson is that there are those among us who have what most people would consider life-altering physical problems, yet these people seem totally unaffected. Other people live in constant pain, despite the fact that extensive diagnostic procedures fail to uncover the underlying cause.
The bottom line for me is that you must acknowledge and respect your physical limitations, but far too many of us give these problems more credit than they deserve. Certainly a balance must be struck here, but I know a competitive lifter who, in his 50’s, with a fused lumbar spine, who squatted over 900 pounds in competition. I know another gentleman in his 40’s who squatted 600 pounds on not one, but two artificial knees. If that were not enough, here’s single-amputee Terry Smith competing in the World Championships in powerlifting:
I guess if I were a doctor, I’d tell you not to take risks. And sometimes that approach is certainly warranted. But I’m not a doctor, and I believe that reward requires risk. My only goal in tip #2 is to keep that thought in mind.
3. Break The Cycle
Take a quick look at the diagram to the left. #1 signifies an injury. Let’s say you tweaked your knee while out on a hike. #2 represents a reduction in activity due to pain from that injury. Staying with our hiking example, you suddenly (and perhaps unconsciously) begin to use less knee flexion/extension as you walk in an effort to protect the painful joint. Now your gait is more straight legged than normal as you move from your hips rather than your knees. This eases the pain, but over time, it creates a new problem — #3: your quadricep muscles (which are responsible for knee health and functioning) begin to atrophy. Which leads to #4: an exacerbation of the original injury due to quadriceps wasting.
Somehow, this cycle must be interrupted, which of course, requires risk. In more serious situations (such as a severely-herniated lumbar disk for example) it’s wise to seek medical assistance. But in less severe situations, you may be able to do it yourself. That’s where the next tip come into play…
4. Boil The Frog
When I was recovering from my second total open synovectomy surgery on my right knee in 1986, I would never have guessed that I’d be squatting weight like this 26 years later:
Tim Larkin comment:
Charles is much too modest to note it… but what you just watched was his recent lifetime PR (personal record) squat of 380# !
It took time, but here’s how I did it: My first squat sessions were embarrassingly weak. I think I started with 3 sets of 5 reps with my bodyweight only, and with limited depth, which I monitored and controlled (see tip 5 and 7 below) by using a box as a target. My knee reacted poorly at first, rewarding my efforts with pain and swelling. But after 10-12 sessions using the above parameters, the knee began to begrudgingly accept the challenge and my symptoms began to subside. When this happened, I responded by gradually and progressively increasing my depth, an inch at a time, until a reached a “thighs parallel” position that you see in the video above. Once I reached this depth, I gradually and progressively began to increase the challenge by adding weight, first with 25-pound barbell, then a 35, then 45 pounds, and so on.
My successes were interspersed with occasional setbacks by the way — it was very much a “three steps up, one step back” type of a process. But I ultimately succeeded because I applied a method that was harmonious with known laws of “adaptation:” if given a chance, the body’s tissues will positively respond to applied stressors by becoming thicker, stronger, and generally more resistant to the very stresses it is responding to. The key take-home points here are progressive and gradual. There’s no room for ego and instant gratification when it comes to rehabbing injuries.
Footnote: My surgeon (who I owe a great debt of gratitude to) warned me that I’d likely be back every 2 years for clean-up surgeries for my “disease” (which is called synovial osteo-chondromatosis). As I mentioned earlier, my last surgery was in ’86. Again, I’d rather take charge of my own health, and consult the docs when it doesn’t work.
5. Monitor & Document Symptoms
I’d now like to elaborate a bit more on my knee-rehab experiment we were just talking about. In my training journal (if you don’t have one, I’d recommend that you start one), I would keep what I called an “O-Rating” (“O” for “orthopedic”). So for example, in addition to documenting the workout date, the exercise I did, the weight I used, how many sets reps I did, and other factors such as the range of motion used, I’d also notate (on a 1 to 5 scale) how much pain/discomfort I experienced. If/when my pain reached a “3” I’d keep the parameters (weight, sets & reps) constant every workout until my O-Rating was reduced to a 2 or lower. Then I’d increase the challenge again during the next workout.
In other words, document not only the stress you apply, but also your body’s reaction to this stress. Only in this way can you control the rehab process with sufficient precision to get the result you’re after
6. Become Your Own Scientist
Allow me a bit more elaboration on our discussion…
When a scientist is testing a hypothesis, he holds all variables constant, except for one, which is the variable he’s testing the effect of. You need to do the same thing. Here’s a practical example of this concept: when I was rehabbing my knee, my only knee-related exercise was squats. I didn’t do lunges, leg extensions, or step-ups, and I didn’t cycle or run either. I wanted to test the effect of squats on my knee. If I had chosen to perform (for example) squats, leg curls, and calf raises, and my workout kicked up my orthopedic symptoms, I wouldn’t know which exercise to attribute them to.
There are many good or potentially good exercises to choose from, but when in rehab, you’ve got to pick your battles, otherwise you’ll linger in a state of perpetual confusion. Imagine that you’re trying to lose weight, and you go on a low carb diet, start taking a fat-loss supplement, and a new exercise program to boot — how would you know to attribute your results to? Resolving injury issues requires environmental awareness and control.
7. Choose Your Activities Wisely
Finally, an important point on physical activity choices.
For many people, the very exercises or activities that have been chosen to solve problems actually create problems. There are many examples, but I’ll just list a few:
I’m confident that these 7 tips will serve you well in your fitness endeavors. I’d love to see you start applying them for yourself, and please leave a comment if you have a question or would like clarification on any of these points.
Guest Strength & Conditioning columnist
Tim Larkin comment:
I realize in Charles’ first three blog posts he covered a lot of ground. He threw out some concepts and ideas that likely challenged your existing beliefs about fitness; some that were probably difficult for you to wrap your brain around; and others that some of you may just plain disagree with (heck, even Charles and I don’t see eye-to-eye on everything in the fitness world).
But I learned long ago not to ignore anything he says until I’ve tested it myself. He’s changed my mind more than once about some fitness or strength concept I was convinced I had right.
Given that, he promised when we began this little experiment he’d open a bit of time to those of you that would like to explore your situation/goals in a one-on-one environment with him (see his comments about “assessments” above).
And since many of you have asked, I wanted to let you know we’re about to open that opportunity. Understand, his time is limited and it’s not free (he generally averages $250/hr but this varies by situation, and, as we at TFT strive to do, he always over-delivers).
What you’re looking at here is an insider-pass that lets you “cut-in-line” ahead of others waiting to request his coaching and advice because of this special block of time allocated to our TFT family.
In approximately three weeks, Charles will offer two different services to you:
- Program Analysis/Course Correction: After submitting your responses to an in-depth questionnaire, you’ll connect with Charles on a 45-minute phone conversation where he’ll make recommendations and suggestions based on your current training (Initially this option will be reserved for those currently engaged in some type of workout/training regimen — we’ll expand this to other areas later).
- Hands-on training with Charles in Scottsdale, Arizona: Charles suggests staying long enough for 3 training sessions with him, but custom packages can be arranged (This option is available for anyone, regardless of training experience).
I realize this won’t fit everyone initially but let’s see how it works before expanding or tweaking.
And since I personally know, trust and am recommending Charles, TFT will stand behind his work with you. Obviously he can’t wave a hand over your knee and magically make new cartilage appear but it’s rare when he can’t move you up the performance scale (or down the pain spectrum) — or both.
So keep an eye on your e-mail in-box for an announcement about these new offerings. We’re all excited about them.
(If it’s something you’re sure you’d like to know more about, use this link to let us know and we’ll include you in the initial email. You’re not committing to anything; just letting him know you’re interested.)
As I told you before, working with Charles revolutionized my own approach to training, and I’m confident he can do that for you, as well…