The Two Options You Have When You Are Injured…
Person: “Doctor, my back started to hurt this earlier this week, and hasn’t gotten better. It hurts every time I bend forward.”
Doctor: “Ok, stop bending forward then. I want you to take the next few days off and just relax at home.”
Hmm… that IS one way to go about it. But what if there is a better way? What do you think the downside is of stopping your activities?
When you are injured, the activities you were doing before can be painful, whether it is deadlifting or washing the dishes doesn’t really matter.
To manage your injury, you essentially have two options….
Option 1: Decrease your activity level
The idea here is that you decrease your activities to a level that doesn’t cause pain.
This is a viable option for some injuries, but it is never a permanent solution. If you decrease your activity too much for too long, you will end up deconditioned, and then you live in a feedback loop where you keep getting worse… Just like this picture:
I recommend that MOST of my patients decrease their stressors for a period of time (but this is only for a few days). Then we get into Option 2…
Option 2: increase your capacity
With this strategy, you work to increase your strength, endurance, and recovery to improve your overall capacity to a level that can handle the stresses of your activity.
Personally, Option 2 sounds like a better solution to me.
The more we can increase your capacity, the larger buffer you have between your demands and your threshold.
In order to use Option 2 though, you need to have a plan. We need a structured, progressive and intentional exercise plan in order to build up this buffer. It can’t be done in a day, and it doesn’t work to just use random exercises with no intention.
Option 2 is a 3 step process.
Step 1: Calm Stuff Down
This often still consists of a period of decreased activity, but it is NOT a permanent strategy. It is only long enough to give us a window to build upon. We also use things like stretching, foam rolling, mobilization, and hands-on therapy during this phase to decrease your pain.
Step 2: Build Back Up
During this phase, the focus is on building strength and endurance around the body parts and systems involved in your activity. This means strength and mobility exercises, with less emphasis on mobility or hands-on treatment.
Step 3: Bridge the Gap
This is the fun part. After your symptoms are under control, we start to work on speed, strength and re-integrating your favourite activities. You like to run? Your rehab plan involved running. You like to ski? Yup, that’s part of the plan. Mountain Biking? You bet we include that.
Here are a couple of the components of Bridging the Gap:
Movement Quality and Capacity: how well do you move in relation to your sport/activity, and do you have enough range of motion for your task
Sport/Activity Specific Cardiovascular and Muscular Endurance: even though you are out of pain doing a simple single-leg squat in the clinic, doesn’t mean you maintain that same quality when you are out of breath
Rate of Force Development: can you generate force quickly enough, as you need it, during your activity?
Recovery: making sure you have the strategies and skills in place you need to recover from the demands of your activity.
This is also one of the most IMPORTANT parts. If all you do is get out of pain, but you don’t continue to improve your movement quality, recovery strategies, and overall capacity, it is extremely common to start sliding backwards, right back to where you started.
The reason I use this framework is that it is not only the most effective method that I have found, it also helps YOU develop the tools you need to keep your pain from coming back.
If you are ready to take control of your pain and get back to doing the things you love, I can help you.
Author: Dr Mark Murdoch, Chiropractor and Co-Founder at Base Camp Chiropractic and Sports Rehab in Vernon, BC.
Mark Murdoch is a Doctor of Chiropractic with a Master’s Degree in Sports Medicine.
Contact: drmurdoch@basecampclinic.com
Instagram: Base.Camp.Doc