Injury is most people’s biggest fear with training, or topmost on their list of reasons for why they are afraid of training altogether. It’s not that people are afraid of being in pain; what concerns them is the fear of the unknown. “What just happened?” “What do I do now?” “How long is this going to take to heal?” “How is my life about to be affected by this?” Yet another important pressing thought for many is: “Can I still train?”
As coaches we are fairly unfazed by injuries. We have experienced them, and we have continued training intelligently through them. A good coach will assess their clients and program thoughtfully not only to avoid injuries but also to correct movement limitations or imbalances to help prevent them. Unfortunately, one thing is certain: despite best efforts, injuries are still going to occur. A coach's job is never to diagnose or treat injuries, but to use their experience to arm clients with information to make the best decisions for themselves and to improve their physiology around the injured area. It is always up to the client when to see a physician to diagnose and treat injuries. Hopefully, this will give clients more information for making that decision and for having that conversation with their healthcare provider.
Let’s break common injuries into three easy-to-digest categories to take some of the fear and anxiety out of the picture.
You know this feeling. You bend down to grab something off the floor and BOOM!—you feel your entire lower back seize up unexpectedly. You are assaulted with waves of sharp pain. These involuntary intense muscle contractions typically happen in your lower and upper back, or your neck, though they can happen elsewhere.
This spasm is likely happening for one of two reasons:
- The muscles are trying to protect themselves from muscle strain (tear).
Think of it like your body going into “safe mode.” It is trying to protect itself from further damage. Much of the pain signal being sent is to encourage you to slow down and stop! So listen to your body. This is not the time to push through the pain! (1)
- The muscles can spasm in response to an underlying anatomical problem.
The muscles spasming may be trying to protect you from something more complex like a bulging disc. (1)
Either way, your body is telling you to slow down as you have clearly exceeded your capacity for the day. The common inclination is to stretch, foam roll, massage, poke and prod. Leave - It - Alone! According to Dr. Meyler, some hot and cold remedies along with rest are the more commonly effective ways to take care of spasms such as these. (1)
Suspected tendon issues are probably the most common ailment that coaches work with their clients on. These often painful issues arise from overuse, poor movement mechanics, or training movements that your current physiology cannot support.
Typically tendon issues present themselves in the shoulders and knees, but can also pop up in the elbows, wrists, ankles and hips.
Tendon issues are further broken down into two categories: tendinitis and tendinosis. Most people typically refer to any sort of pain or ailment in their joints as having tendinitis, but the distinction between the two is incredibly important—especially for the coach in understanding how to continue training this person.
Reactive Tendinopathy, AKA “tendinitis,” typically comes on with acute tensile or compressive overload. The pain signal is the body’s attempt at protecting the tissue. (2)
Degenerative Tendinopathy, AKA “tendinosis” – affects primarily older populations, but can be seen in youth and elite athletes with a chronically overloaded tendon. Typically presents with nagging aches and pain over the years. (2)
While these two tendon issues may sound incredibly similar, the distinction in how to proceed with movement is important to help resolve it. For symptoms that present in similarity to tendinitis, the protocol is to rest the area then strategically reintroduce load and volume once the symptoms have dissipated. This means taking a complete break from training the area, or at the very minimum greatly decreasing the load and volume on it.
On the other hand, for people who show symptoms that are more in alignment with tendinosis, the training protocol is completely different. While we want to remove any cyclical/ repetitive movements from the training protocol, loading the area with “heavy & slow resistance training” is an effective way to strengthen the painful tendons.
Still unsure? Answer this question to help create an insight into which type of tendon injury you may be experiencing:
What happens as you warm up?
Does your pain get better or worse? If your pain stays the same or even gets worse as you warm up, this is an indication that is congruent with tendinitis. If your pain begins to feel better and dissipate as you warm up, that is an indication that your issue is more in line with tendinosis.
These are the types of acute injuries that leave little doubt that something potentially serious has occurred. Tendon or ligament ruptures and broken bones typically fall into this category. Seeking immediate medical care for diagnosis and prognosis obviously is strongly encouraged.
This can be the most emotionally difficult type of injury because depending upon the severity, it may take quite some time to completely recover and return to full activity.
This does not mean that the coach no longer has the ability to continue to help you progress or recover from the injury in conjunction with the doctor’s treatment. In fact, working with a coach before, during, and after treatment may be the most important aspect in recovering from traumatic injuries.
In the instance of a traumatic injury where surgery will be required to repair a torn ligament to the knee, good doctors will often recommend strengthening the musculature around the damaged area in preparation for surgery. This can encourage a faster recovery process. Then, once cleared for activity post-surgery, you are very likely to have developed atrophy and muscle imbalances. Working with a coach to help rebuild the strength to correct these imbalances is imperative to prevent further injuries.
For other traumatic injuries, we have had incredible success in continuing progress in body composition and maintaining health by intuitively working around the injury site. Rarely if ever are there injuries that we cannot work around to keep you healthy as you work with your healthcare provider.
Injuries are a part of life, but they shouldn’t stop us from living it. Simply having more information about what is going on can have an immense impact on the effect the injury will have on your mental state. Having a coach is an incredible resource in navigating these parts of your life, but remember: our job is not to diagnose or treat, but to improve physiology by maintaining or improving range of motion and increasing the strength of an affected part of the body. If you feel you want to or need to see a healthcare provider for your injury, no good coach should override that. We do encourage you to advocate for yourself and ask lots of questions to your physio. Our job is to provide you with information, and work in collaboration with your healthcare provider to produce the best and most effective outcome for your injury. To set yourself up for best success, set up a free call with a Professional Coach today!