I’m probably asked more questions about injuries and rehab than almost anything else. I’m always really hesitant to answer them, because (A) I’m not a doctor and (B) it’s impossible to diagnose anyone online anyway. And I would never want to give anyone advice that might exacerbate their condition.
That said, I understand how frustrating injuries can be. In fact, I think the mental pain of injury is often far worse than the physical. So often, we feel “broken” when we’re injured – but that’s just not the case. Sure, there are times when bodies break: terminal illness, for example. Outside of extreme circumstances, though, we’re extraordinarily resilient. And it’s extraordinarily empowering to be able to see an injury not as being broken, but as having a problem to solve.
That’s a huge part of why I’m grateful for my physical therapist, Dr. Nick Engel. Nick taught me that philosophy, actually, and I’ve learned so much from him that I want to share a little in this guest post. Here, Nick explains why you’re injured.
Why You Are Injured
Every client I see comes to see me because he cannot solve a problem. Most of the time we are injured, our body spontaneously heals. By and large, it boils down to a solution as simple as resting and the pain subsides. For example, a person is a little too ambitious when beginning a new exercise routine and begins to have pain several weeks in to training. He backs off, ices it and eases back to training and, generally has no more problems.
When I see someone, it’s not quite so apparently obvious. Pain came on for an unknown reason and resting has not helped. They’ve been prescribed the steroid pack, potentially had a steroid injection and have now had an MRI and a surgical consult. Desperate for help, he will do anything to avoid surgery. Rather than understanding an MRI report of what tissue is injured, a client must understand why this tissue was injured. I’ve found that making things as simple as possible helps clients best self-manage his condition, heal and avoid future injury.
With so much technical jargon and inconsistent theories on the nature of an injury, clients are understandably confused when I meet them. My goal is to take a complex set of circumstances and make it simple and logical. For every injury, in simplest of terms, my friend and colleague Chris Bever succinctly puts it, “The tissue is overworked and underpaid.” Brilliant. Given a set of circumstances, a tissue can handle X amount of load, and injury occurs when the load supersedes the tissue’s load tolerance.
So then, treatment entails (1) ruling out any underlying issues that might cause a tissue to be unable to handle a normal amount of loading, such as some sort of systemic medical issue, (2) Improving system efficiency, so that a given tissue quality has less stress and becomes more impervious to injury, and (3) reducing training volume to a tissue’s current capacity and then loading it appropriately to increase its resilience.
The real ‘magic’ is in the detective work in understanding these principles, asking the proper questions to discover less obvious contributing factors, observing a client move to discover movement faults and “energy leaks,” relaying it in a client-specific and understandable way, then providing appropriate treatment to address these findings.
How to Use This Information
I harp on it a lot, but the first step is usually awareness. Realizing that “hey, I’m not broken,” allows you to step out of a frustration mindset and into a problem-solving one. It’s easier said than done, and meditation is hugely helpful in developing the necessary patience.
Once you’re in a better headspace, you need to take an inventory of your strengths and weaknesses. Like Nick says, oftentimes it’s hard to determine how exactly you managed to hurt yourself – maybe you wake up with some discomfort, or feel a sharp pain doing something innocuous, like tying your shoes. Other times, the immediate cause of injury is pretty obvious, but the underlying cause of injury isn’t. For example, when I pulled my hamstring last summer, the immediate cause of my injury was deadlifting too heavy, but the real reason I got hurt was that I was taking on too much and running my whole body ragged.
It can be tough to objectively analyze yourself, and that’s when it’s extremely useful to have a knowledgeable coach or other professional (like Nick) who you can rely on for feedback. If you don’t have access to those kinds of resources, don’t be afraid to reach out to friends or training partners for their opinions. While they might not have definitive answers for you, they will at the very least be able to provide another point of view to either balance or reaffirm your own.
Finally: Take. Your. Rehab. Seriously. The last thing you want is to rush back in the game and end up exacerbating what might have been a minor inconvenience.