If there is one rule it’s “Do NO harm”. The problem then is that over a long enough period eventually everyone gets hurt. 90% of what I teach is to avoid chronic injury, those of the over-use variety and with enough mental attention to avoid acute injury as well. But we all get hit with the unfortunate and learning to itemize, compartmentalize and progress where available can usually set one up to overcome previous stalls all the while working around the destruction we’ve caused.
Most of us believe that we get injured because we risk in order to achieve great feats and only the fallout of being left exposed to danger has us hurt as a consequence of our charge. The truth is we get injured because we ignore the subtle signals of a lingering injury and our ego drives the nail into the coffin, by not allowing proper recovery. This inevitably ends in a forced rest period where by all means the body will shut you down because its previous signal fell upon deaf ears. Even under circumstances where severe acute injury occurs, I've seen again and again fatigue or lack of recovery lead to accident in and out of the gym that could have been avoided by recovering mental awareness. Very few of us take the moderate road not just to training but to expectations and goal setting. When we take up the torch of self-improvement we generally forget to think about fuel or the future entirely, we are just awed by the luminescence of immediate results and if a little hard work worked, a lot of hard work must surely be the answer. But “hard-work” is even harder to define than to actually do. It is more often than not just doing the thing you’re least likely to do, which is “hard” only for the ego. This added with the chiseling effects of hard training gives us a false sense of hope and compounds the stress while we become psychologically addicted to the effort.
Almost every bit of advice I have/will ever give starts with “It depends”, the situational circumstances guide our training so in this summation we talk speculatively and generally. Identify the cause of the injury. This is probably the most complex step because although we strain our back catching a clean incorrectly, for example the issue probably started way before. Being honest about our technical prowess among other faults is hard to see and usually only available in hindsight. So in doing this it’s easy to pinpoint the straw responsible for breaking the camels back, but we have to work back to why we decided to mutilate the poor animal in the first place, pinpointing our original ambition will uncover some truth about out injury. It is not an easy task to take up the goal of improving ones strength or even endurance, to be told how hard you must work to achieve these things, and in the end have the fortitude to pull the plug when one has had enough to spark the correct signal without burning the whole tower down.
It’s at this time that we categorize the injury at least to ourselves so that we can comprehend the recovery schedule: Acute, Chronic and permanent or temporary, the most basic definitions will give structure to a timeline of expectations. Reality sinks in when something disastrous happens to the point where we all begin to think a little pessimistically. If the injury is bad enough a week or two of healthy depression is normal and expected. The worse the injury and the closer related to required abilities and goals the bigger the slump. Advice at this time is usually along the lines of “keep your head up” or some other useless bullshit. Mine is to let yourself get a little resentful. stew in the anger bath for a bit and hold yourself 100% responsible for your actions. We must grieve our lost abilities as we would the loss of a great friend. Once the fire is good and stoked treat the injury as you would any challenge, which is exactly what repairing an injury is, a challenge. Dedicate time and effort based on value of healing, the truly dedicated will rearrange an entire lifestyle to achieve this. The same can be said of elite athletics. An astounding amount of people claim to want to heal an injury (or complain about it enough to give that impression) but upon the most basic inquiry most have given up post surgery or have lost interest as soon as it becomes “hard”. The hard part to realize is that we all give up fairly easy on most fitness endeavors. It’s hard to see an 18 year old kid squat 320kg and proceed to be motivated to build upon your max of 135kg at the ripe age of 35, but training to build any physical pathway is just relentless signaling and healing and in this way repairing is no different. Depending on the degree of injury, repair is first and foremost, bone, connective tissue and muscular tissue all need time to at least “reconnect” 6 weeks is the standard. after that regaining range of motion is paramount. Then and only IF the proper healing is attained can one start to strengthen the site of and around the injury. This starts slowly and with absolutely NO planned rep/set schedule, the workout needs to be stopped upon proper “satisfaction” and then recovered before anymore stress is added. As far as movements that are good for injury, “it depends”, but a good guideline is something that enforces full range of motion (or as much as possible so as to be measurable progress), is compound and involves multiple joints and most likely has a stability factor to it. If the injury is bad enough and full detachment of ligaments or separation of muscle tissue occurs then cables, bands and assorted equipment may be required.
My first “exercise” after shattering my elbow was to hang the joint out my drivers side car window and let the air resistance assist range of motion, 3X 60 seconds with 5min rest was all I could handle for the first 2 weeks. But I never found a machine that replicated the assistance as well, so I took frequent drives. I let my stubbornness dictate my tolerance for pain, sometimes I over shot what I could recover from, and I prolonged what I could have essentially healed from faster, I took the injury serious enough to rearrange the next year of my goals. I addressed my diet in order to support what needed to occur, having the extra fat on my body drove me mad, but the tolerance to new levels of stress I could enforce on the injury kept my path lit. I was humbled to take up new exercise movements, and to feel ultimate triumph from doing one pushup. I healed in an astoundingly short amount of time, but I will never be 100%. When defining my own injury “permanent” was responsible for defining my goals and a realistic hatred for my mistakes kept me motivated.
People want a definitive answer, which is why the medical field is filled with answers to questions of time that make no sense to an individual that is willing to take care of him/herself, but when addressing the general public advice is given to the lazy the same as it would be to the committed. It’s impossible to denote what the correct thing to do is on such a general subject, but there are universal ideas that are helpful in most situations. Hypertrophy of the smaller supportive musculature is king, especially in injuries revolving around the joints. Eating to restore this type of workload is imperative, but not an excuse to eat like a pig. Smaller/lighter weights can be used for higher reps (once it is time to add resistance). The feeling of pushing the weight is different as in: it is measured, the force output normally associated with strength training turns into a focus of muscular contraction. Filling the muscle belly full of blood has special healing qualities attached to it while preserving the high stress to the connective tissue. Isolation work in these cases may be the only way to achieve the sensation, so a focus on compound movements after is required as to not train imbalances. “Strength training” at this point takes on a new definition, although I still recommend hard training for the rest of the body while isolating the injury. This could even just be power endurance or endurance efforts, realize it might not be the thing you “want” to do or it could just have little to nothing to do with your goals, but the restorative effects of cardiovascular stress cannot be over stated. The healthier and more fit the body is as a whole the faster the recovery time. Moving oxygen through the bloodstream will increase the amount of exposure to nutrients and cell growth. If you are lucky enough to be uninjured at this point in time you can still take inventory and reduce the chances of serious damage in the future. Somethings we will never see coming, but when they hit and the body breaks it is up to you and you alone to restore it as closely as possible to its previous self.