You're in pain, but still want to workout.
This is what our Boston Physical Therapists hear on a daily basis. We get that. A cranky knee or bum shoulder shouldn't be the end of all your workouts. Although we may try to use some pain as an excuse to just sit on the couch, that's actually the opposite of what we want to do.
I remember back in High School my senior project was to teach the high school soccer players about injury, and the take home message was when you're hurt, use rice. Not like if you dropped your phone in a pond, but R.I.C.E. or, rest ice compress and elevate.
Boy have things changed.
Now the literature has told us that even immediately post injury, the best thing to do is to keep that joint/muscle/tendon etc moving. Movement helps send positive feedback to the brain to speed up recovery, helps keep the surrounding structures strong, and keeps the joint capsule from totally locking up. I know you don't care about any of that, but rather how to take an injury and train around it.
Chances are, you're going to get injured. It sucks, but if you're pushing it in the gym, on the slopes or during a trail run chances are one day you're going to push it a little too far. That's life. Now, how do we continue the training without further exacerbating things?
That's what you're here for. These are the 4 most common injuries I see, and ways to train around them.
Hip Pain While Squatting
This is one of the most common issues I see. Hip pinching at the bottom of your squat can be from a number of different things that we really don't have time to get into (just fix your hip internal rotation.) But, one way we can work around the issue is to take the common issue of lack of ankle dorsiflexion out of the equation. Use this self-assessment if your hips hurt
We can achieve this by elevating the heels instead of squatting from the flat ground. This allows for the lack of ankle range of motion to not be a limiting factor, therefore letting you get deeper into hip flexion without a block.
I also see too many people racking 2 DBs up on their shoulders to do a squat -- let's nip that and change everything you do to the goblet position. This is going to take the lack of range of motion in your upper back out of play and help better turn your core on; sometimes that in itself is an instant fix to hip pinch
THE FIX: Find something 1-3" to elevate your heels on - a change plate or small book that you haven't read in a while works perfectly. From there, nothing changes, do your squat and crush it.
TIP: Still feeling a little pinch? Just go as long as you can until you start to feel it, then go up. Don't move through pain.
Back Pain While Deadlifting
The deadlift is one of the most complex exercises you can do. I could've listed x100 fixes, but I find that since there are so many moving parts to the deadlift the best thing to do is to simply regress. But honestly, it's a crime to call the single leg deadlift a 'regression' from a traditional deadlift. Give them a try and trust me, you're way more gassed after a set than a trap bar deadlift.
A main reason your back probably hurts during a deadlift is because your form sucks, which is a consequence of having too much weight. Regressing to a single leg deadlift immediately solves that problem. Back pain happens due to a compressive load put on the spine - if we go from a 2 leg normal deadlift to a single leg deadlift we reduce that load dramatically. Plus, form wise it's much easier to keep your spine in a good position during a single leg deadlift rather than trap or barbell deadlift.
THE FIX: Simply change your deadlift to a single leg deadlift. Programming-wise, you get the same effect and can load via exertion the same.
TIP: Don't think you're skimping out if you use something to keep you stable. Having a hand against the wall or on a foam roller will keep you in line and balanced, but won't rob you of the training effect for the posterior chain. Also, if you’re a runner and deadlifting you need to read this.
Shoulder Pain While Overhead Pressing
Why people think they can go from sitting at a desk all day long to hucking dumbbells (or barbells, oyy) over their head is beyond me. Often times people think they have good shoulder mobility, but really what's happening is they're faking shoulder movement with spine overcomepnsation.
Try this: go back flush up against a wall with your lower back, upper back, and back of your head as points of contact. From there, raise both your arms up overhead without losing those 3 point.
How far did you get? Not far, huh? That's your actual shoulder range of motion, and where you should be pressing to.
THE FIX: Find a setup where you can still press, but not directly overhead. Ideally, you have a landmine setup.
TIP: You can't force yourself into more shoulder flexion - there are far too many moving pieces. Work on rib cage positioning through breathing, and shoulder internal rotation range of motion to improve shoulder flexion.
Elbow Pain While Bench Pressing
No one should be bench pressing unless you're entering a powerlifting meet. There. I said it.
But seriously, the risk/reward behind a barbell bench press just is not worth it. Due to the barbell, you're wrist, elbows and shoulder are totally fixed in a position that, when done over and over, is not great! Generally what happens on a barbell bench is that since you can't rotate your shoulders on the downward portion of the movement, the elbows have to overcompensate with some unwanted (and highly loaded) rotation.
Ouch.
The best thing to do is is get rid of the barbell and dumbbell press. And, if you're looking for more bang for your buck, a single arm dumbell press will add a core component and a lot more stability to the exercise. Plus, it'll be pain free
THE FIX: Tuck your ego away and get off the barbell bench press. Instead, go to a dumbbell bench press instead.
TIP: Still feeling elbow pain during the press? Click the bench up just a smidge to give some incline on the bench - this is the optimal position for shoulder health.
Training around injuries is one of the most important tools you can have.
Please note, this isn't a blog about how to FIX your injury, but simply how to train around it. Again, these are work arounds for the injuries and not how we fix the root cause. Fixing the root cause is far too specific to the individual, and needs a personalized in person treatment session to fix.
Want to learn more about how to train around your injuries? Want to actually FIX your injuries? Let us help!
Schedule a FREE consultation about your injuries, and how to train around them. We're happy to talk through what your goals are, what injuries you dealing with and some potential solutions to help you move, live and feel better.
Cheers!