Recovering from an Injury: My Top Tips
If, like myself, you're an avid exerciser, you'll likely have experienced an injury at some point. Even with the best training plan in the world, they can and do happen. Whether that injury be caused during training or your everyday activities of living (that time when you tweak your back getting in the car?), these injuries negatively impact us physically but also psychologically too. Think of the professional athlete who dedicates their life to training to win. They suddenly get injured and have to endure a period of rehabilitation before they can get back to competing. A huge blow.
At the moment, I'm suffering with an inflamed shoulder. It's been niggling for a while and has now go to the stage, probably a pain level 4 on the Lego pain scale, where I am having to avoid many of my favourite exercises.
It's currently coming up to marathon season and as such a time where injury's become more prevalent (and yes it has happened to me when marathon training) so I'm here to share some of my top tips for a smoother recovery and coping with the psychological effects that accompany a period of injury.
Accept the situation and ask for help
Accept that it has happened and work out a plan of action. Don't train through it, you're at risk of making it worse. Don't use Doctor Google to self-diagnose, rather seek help from a clinician who can provide professional advice and a course of action.
You'll likely be prescribed a care plan which may include NSAIDs, heat treatment and rehabilitation exercises or, worst case scenario, surgery. Too often people do not carry out the treatment, especially the exercises. The process may seem laborious, but to get the best results, it really is worth the consistency and patience. If you're willing to put in the effort to get the body of your dreams then put the same level of effort into your rehabilitation. Think of it as part of your training. Trust the process and the results will come sooner.
Work around it and revise your goals
Depending on the severity and site of the injury, you can still train. If you have a broken arm, you can still use your lower limbs. Ok, so it's probably not a sensible idea to barbell squat, but there's always the leg press machine at the gym or body weight versions.
So you can't squat. So what? Do what you can to workaround it and think about a) what you CAN DO and b) set a new goal to help keep you motivated.
Keep Moving & Strength Train
There are three stages of recovery after an injury:
- Inflammatory/ acute stage (0-7 days)
- Proliferation/ sub-acute stage (3 days-3 weeks)
- Re-modelling/ chronic stage (3 weeks-2 years)
Depending on the severity and type of injury, it is important to keep moving. During the remodelling stage, work with a physical therapist who can prescribe rehabilitation exercises at the site of injury. Remaining still will result in a tight scar and may inhibit movement post injury. Weight bearing exercise can help speed up the remodelling process in both bone and soft tissue growth. Continued progressive strength training will then help to prevent future injury.
Physical activity such as walking, swimming and cycling are often the go-to modalities of exercise when injured. Staying consistent will go some way to mitigate any fat gain that may result.
Eat a balanced diet
When injured it can be tempting to adopt a f*** it attidude to your diet and reach for comfort food. Nutrition is a huge influencing factor on the repair and prevention of injuries. Your nutrition should remain goal-focused but with some important considerations to note.
Eating a balanced diet that includes plenty of variety from whole food sources will go a long way to ensure that you have sufficient nutrients in your diet to support the recovery and repair process. These include vitamin d and calcium for bone reformation, and vitamins A and C and zinc, so care to avoid deficiencies is recommended.
Omega 3 fatty acids can aid in reducing inflammation with fish oil specifically aiding muscle protein synthesis (Smith et al 2011).
Don't drop your calories too low
If you are physique conscious, one of the first things you are likely to do when injured is reduce your calories so as not to gain weight because energy expenditure is assumed to be lower.
In actual fact, this may not be the case. Your BMR, or Basal Metabolic Rate, can in fact increase by 20 per cent or above during the initial stages of injury due to inflammation and rapid tissue repair.
Energy expenditure should be considered on a case-by-case basis, depending on activity levels and goals. For example, if you are still training around the injury, then your energy expenditure may not change much, or even increase if you switch training style or modality.
Although it should be accepted that some muscle loss (atrophy) will occur during a time of injury, mitigating it by keeping calories and protein at sufficient levels is a good idea.
Keep protein levels sufficient
Protein is essential for laying down new tissue and to help protect the muscle from atrophy, which occurs when the breakdown of muscle proteins exceed muscle protein synthesis. When injury occurs, generally speaking, the decreased loading of said muscles causes a decrease in anabolism (growth).
To mitigate this this it is recommended that between 1.5g and 2g/Kg of body weight of protein is consumed per day or 40g per meal from predominantly whole food sources.
Since leucine is the most important amino acid when it comes to stimulating muscle protein synthesis, it could be worth supplementing, particularly if you are vegan as there are very few plant-based foods in which it is naturally occuring.
Whilst not essential, there are some supplement strategies that are worth considering, particularly if you want to optimise your recovery or depending on your goals.
If finances allow, HMB can be useful, particularly if you are worried about the loss of muscle when injured, as it has anticatabolic properties, however it is important to note that it does not stimulate muscle protein synthesis. For further information visit examine.com.
Because vitamin D is a common deficiency this can be an extremely useful supplement to take all year round.
Address the root cause of the problem
We often seek to relieve the symptoms of an injury, because it's downright painful and that is the only thing we can focus on at the time.
It may be have occurred as a result of overtraining/ underecovering or it may be from a dysfunction elsewhere in the body.
Addressing the root cause to identify why you incurred the injury or keep getting recurring ones will go a long way to preventing them returning. It is often not at the site of injury but somewhere else in the kinetic chain. The body is an integrated system and, using my shoulder as an example, it may orginate from lower down the body.
A biomechanics screen is one method in which we can identify potential dysfunctions of the nerves, muscles and joints of the body. This followed by a corrective exercise programme can certainly help to prevent future incidences of recurring injury and discomfort when moving.
I can't stress enough the important of sleep. It is paramount to a healthy functioning body and it is the time in which our body repairs itself, physically and mentally. When we sleep many of the hormones associated with injury recovery and prevention have a chance to balance out - Human Growth Hormone (HGH), Grehlin, Leptin and Cortisol.
HGH is responsible for the repair of tissues and lack of sleep may result in insufficient production thus prolonging recovery from injury.
Cortisol, the stress hormone, if consistently high, can result in weight gain, anxiety, depression and higher blood pressure. When we sleep our cortisol levels reduce and keep the potential ill effects at bay.
Leptin and grehlin are the hormones that work together to regulate our appetite. I'm sure you've all, at some point (especially if you have children), had a terrible few nights' sleep and then had the all day munchies? Many people do have trouble managing their weight through injury, so the last thing you want to do is compound the issue by not sleeping properly.
When injured, many people do suffer both pyschogically and physically, so managing your hormones via good sleep is vital to good recovery.
If you usually neglect your sleep and train hard, it is time to address this now, implement a routine so that you get a good night of quality sleep, and continue this for the rest of your life. If you didn't do it before, this could well have been a contributing factor to your injury in the first place, particularly if you train most days.
Yes injuries are physically and psychologically demanding, but should not be used an excuse to give up.
Remember the following:
- Adopt a postive and adaptive mindset
- Seek professional help
- Do the rehab
- Keep moving and adapt training where necessary
- Make good nutrition a priority
- Address the root cause of the problem
- Get plenty of rest, namely sleep
If you'd like help getting through an injury, adapting your training and nutrition plans or like the sound of a Biomechanics screen and corrective exercise programme, I'd love to hear from you.
Thanks for reading,