I have previously written a blog post titled “I rolled my ankle, can I put my membership on hold?” that was all about how we react to injuries and how most people will stop training rather than work with their coach and continue to train whilst modifying. In this post I even talked about the way we could modify certain movements in order to be able to still provide an effective session and gave examples for different injuries and situations.
But I’m finding that the mindset of “oh I’ve got an injury so I need to pause” is still super common so I wanted to continue to try and combat it by breaking down injuries one by one and what we do to help our clients work through these types of injuries.
So we’re starting with probably the most common injury, knees. I can think of multiple former clients off the top of my head that I have lost just because they had a single knee injury. They’ve stopped training pretty much altogether because of the injury to this single joint, an injury that in all these cases was already pre-existing when they began training with us. Knee injuries are so prevalent that there is a whole industry of doctors and surgeons that are making pretty successful careers off of just operating on this one joint. So why are knee injuries so common? Well without getting into it too much its a combination of modern lifestyle factors like sitting, being sedentary and a lack of regular movement through a full range of motion. These all lead to the tissues around the knee (the tendons and ligaments) being soft and weak and not able to withstand their daily workload.
I’m not going to go into all the potential causes and types of knee injuries because there are plenty of them. So instead, as we move forward let’s just assume that we have someone who has sustained a knee injury and we need to figure out how to keep training. So first thing when you get a knee injury, whether it has happened all of a sudden (acute) or has been building for a time and you’ve finally decided enough is enough (chronic, the most common), this is what you should do as your initial reaction:
Step 1: Before you do anything else, inform your coach. Tell them about the issue and describe it the best you can. Where is the pain? How often does it hurt? Do certain movements make it hurt? How long has it been bad? This will help you and the coach first establish how serious the issue is and how it will need to be treated going forward. If the issue is serious enough your coach will recommend you see a physio or allied health professional (probably not a GP, they aren’t the best people for this stuff) and they may even be able to refer you to someone they know. Remember, your coach is someone who is active and trains themselves, they’ve had injuries and niggles just like everyone else and they kept training through them so they probably know some good people who can help.
Step 2: Come up with a plan going forward. If the issue was significant enough to go and see a physio or allied health professional then they will give you guidance or advice or what to do going forward. This could be what movements you should and shouldn’t do for the time being and some rehabilitative exercises to do to help restore the area. Hot tip, if your phyiso or doctor recommends that you stop training altogether then they aren’t the right person to be seeing. I’m not going to go into to this too much but the positive benefits of exercise always outweigh the potential risk of injury and there are so many ways to continue to keep moving that stopping should never really be an option and definitely not something that is recommended by a health professional. So, once you and your coach have a come up with a plan (with the help of a physio of needed) you can keep training and put this into action. This plan could be as simple as “Just keep coming in and we will make sure that you modify and scale on the day” to “Okay for the next 4 weeks we aren’t going to do any loaded knee bending so you’re going to do lots of seated movements and get in much more upper body and core work”.
Step 3: KEEP TRAINING. Why do you even train in the first place? To be healthier! So when you have an injury your body as a whole is arguably slightly less healthy so why would you stop doing the one thing that is 100% proven to help make you healthier? When you have an injury you need training now more than ever. The mental side of being injured is often even worse than the physical side as the frustration can really eat away at your motivation. But just stay the course. Don’t give up. Stopping altogether won’t help. It’s just taking the short term route of removing the thing that’s frustrating you but it will catch up to you at some point as a lack of exercise and movement always does.
So, now that we have the steps lets go through some examples:
Example 1: Jimmy has had niggles in his right knee for a while now. He gets pain across the front below the knee cap and it particularly hurts when he gets to just about parallel in a squat. He’s been putting up with it for a while but after having a big weekend in the yard at home and it bothering him all the time and making the yard work more difficult it finally said “stuff it!” to himself and he’s going to do something about it. He goes into the gym the next day at his normal 5am session and talks to his coach about the issue and say that it has been going on for a while. As it’s something that has been persistent for a while his coach says that he should go and see a physio and that for today and the coming weeks until he sees the physio that they will keep him above parallel in squatting movement and change any single leg work to using both legs. Jimmy agrees and follows along with the plan made with his coach and continues to train for the coming weeks. He sees his physio, his physio gives him some exercises to do and tells him to keep training. Which he does and he now still has a great place to do his rehab exercises, at his gym where his coach keeps an eye and helps make sure he’s doing the movements well. It takes a few months of being patient and consistent with the exercises and going back to physio a few times but eventually Jimmy is able to start reintroducing full depth squatting and single leg loaded movements and knee is handling it well.
Example 2: Susan was out in yard playing with dogs last night and after coming inside and sitting down for a while she got back up and had a bit of a limp and her knee was feeling sore on the inside. She didn’t feel anything pop or out of the ordinary whilst out the back but it feels pretty average now. She gets up the next morning and goes to her 9:30am session to train and tells the coach that her knee is feeling pretty sore but is a little better than last night. The coaches says they will keep an eye on it and see how it feels and moves through the warm up and continue to assess from there. As Susan goes through the warm and slowly puts the knee through a full range of motion whilst squatting and stretching she says she can still feel that it’s sore but it also feels as though its stretching and starting to help a little. Her coach helps her to reduce the load for and knee bending movements for that day and after the session her knee actually feels a little better. It gets a bit sore again later at home after cooling down but it is slowly starting to improve. Over the next couple of days it continues to get better gradually until it seems like it was just a random little niggle and that she is mostly in the clear and it’s back to feeling normal by the next week.
I give could give a dozen more examples of all the different variations of knee issues and causes and levels of severity but in the end the result is all the same. Talk to your coach. Work with them and plan ahead. Keep training. It’s simple
I hope this helps even just 1 person to keep training through an injury.
If you need help, you know where to find me.