Training through Injuries

By Coach Andrew Clark

This article has been in the pipe work for some time. I’ve been meaning to put together all our thoughts on the subject, but recently, with the sudden growth at our box, the increase in numbers have meant an inevitable increase in the amount of injured people we’ve come across, and I feel that now is the perfect time.

Injuries can be either from an acute trauma (a specific event, such as falling) or a problem that has developed over time, usually unknown to you until it manifests itself as pain. The second type is probably the most common we see at the gym, and this is due to the body not working in the way it was designed to. Over time, the improper function leads to an injury. For example: inadequate glute recruitment is a common problem which causes weak hip extension, which in turn causes an over reliance on the lower back and quads. Or weak/imbalanced rotator cuffs can lead to shoulder injuries.

Poor positioning can also be a factor in injuries. This maybe due to limited muscular and joint range, so the body over compensates somewhere else. These are not the only causes; poor diet, lack of sleep, and stress are other examples that can also impact.

Injuries are common

When we get an injury it can be frustrating. We tend to focus on our own niggles and often aren’t aware of other peoples in the gym. So, it can appear from our own point of view that it always happens to us and nobody else.

But, from my own personal experience, and that which I’ve gained through training hundreds of people over the past 7 years, this simply isn’t the case. Personally, I’ve had problems with my lower back in the past (Kettlebells and CrossFit pretty much fixed that), my neck for the past 10 years (probably not going to go away completely, so have to manage my training around it), my right hip (ongoing, hoping to get this sorted), lower leg pain when running (have got orthotics for this recently, which I’m hoping will help) and other short term injuries. And of all the people that I’ve had the honour of training, I would say that it’s a small, very lucky minority that haven’t had a single injury at some point.

Kelly Starrett, is a highly respected Doctor of Physical Therapy in the US and regularly appears in the CrossFit Journal. In the video “Language to Diagnose” (you’ll need subscription to the Journal to view this), he makes this point by asking the audience at his seminar to put their hands in the air and keep them there if they have a neck problem….or a shoulder problem….or a lower back problem……or a knee problem etc. By the end of the list, every hand in the room is up and he uses this demonstration to show that the assumption that we are normally all in a pain free, perfectly healthy state is false.

He also makes the point that CrossFit is “the most effective way to find flaws and inefficiencies in human movement“ that he’s ever seen. He says in his gym, all his athletes old injuries (twisted ankles at school, scar tissue from operations etc.) and lifestyle impacts (poor posture from desk bound jobs) were being “caught” by the demands of CrossFit. But he celebrates this, as it’s a way to let athletes know what they need to focus on.

James Jowsey, CrossFit 3Ds Movement Expert, has helped CrossFit athletes from all over the UK to improve their performance and recover from injuries. He makes the point in his recent blog (really worth a read) that injury will happen in ANY sport. As a therapist, he’s dealt with people from all types of athletic background – football, martial arts, rugby, CrossFit……. even yoga. And he even makes the point that people who don’t do any exercise and spend all their time at a desk get injured (lower back, shoulder and neck injuries). Speaking to him recently, he said “you show me a marathon runner who hasn’t had a knee, hip or lower back injury…… or a football player who hasn’t hurt himself at some point”.

So, my first point, is: you’re not alone. You’re not unique in your struggles and it’s not abnormal to get injuries.

Keep training

Again, I’ll refer back to Kelly Starrett: “Continuing to CrossFit while you have an acute injury can actually promote healing. You had a surgery on Friday? Take a couple of days off. See you on Monday,” he says. “The key is modifying the program. If a limb is injured, don’t use it. But keep working out. It’s best to train through and around injures. Otherwise, the ghosts of injuries can remain for years and negatively affect athletic performance.

Continuing to work out reinforces tissue and keeps systems intact. The metabolic and anabolic cascade and neurendocrine response lead to increased growth hormone, increased testosterone and increased insulin growth factors—all good things.

And the psycho-social factors are also important. Athletes should not be isolated from their workout buddies or allowed to give up. They need to get back into action. The last thing most athletes recovering from an acute injury should do is take a month off from CrossFitting.“

Starrett says conventional advice can sometimes be mistaken. “The recovery phase is when athletes need CrossFit most. When it comes to fitness, it’s a case of use it or lose it. Workouts should be modified, not abandoned. Working out increases blood flow and promotes healing. It drives insulin sensitivity, restores proteins and gets the whole system looking for anabolic enzymes. The recovery phase from an acute injury is also a great time to tackle your goat – the stuff you hate to do, but need to do. Injured athletes are still athletes. They need to avoid feeling sorry for themselves and get their butts back into the gym…….and quickly.”

At CrossFit Avon, the athletes who I’ve seen make the best recoveries are those who kept training around their injuries.

So, my second point is this: the last thing you want to do is stop training. We can substitute exercises, scale the movements or completely change the workout if necessary, but keep training.

Don’t give up

Mindset is crucial. No matter what happens to you, you get to decide what message to take from it.

If you’ve had an acute trauma, you can decide to use the recover time to work your other weaknesses and look at it as an opportunity. That may sound hard at the time, but you do literally have the choice to see it how you want to, and why would you want to add negative thinking to the equation?

Realising that you have an imbalance, weakness or postural default is progress. Armed with that knowledge, you can move forward and take some positive action to fix it. I’ve learned more about anatomy, function and biomechanics through my own injuries than through all my other studies. It’s a time when you’re really motivated to educate yourself, because you want to get back to full health ASAP. So, another positive way to think about it is that you’re going through a learning phase, and when you come out the other end, you’ll be better equipped than before.

Treatment Options

There are a lot of different approaches when it comes to treatment, from traditional physios, to chiropractors to other movement experts and therapists.

Some will advocate a lot of stretching, foam rolling and physio balls (Kelly Starrett). Others suggest that these aren’t that useful or are even counter productive in many cases (see James Jowsey article “To foam roll or not to foam roll”). Some focus mainly on the skeletal system (Chiros), others much more on the muscles (physios). You will find a lot of contradiction and confusion if you have much exposure to these different methods.

My own experience leads me to believe that, like most things in life, there is not one ultimate answer, but instead lots of different options that will suit different problems. I’ve seen a lot of different practitioners over the years. Some have helped, others not. But I don’t think the ones that didn’t help are necessarily bad methods, they just didn’t suit my problem at the time, or maybe didn’t suit me.

We can offer you some possible options in terms of things you can try. We have relationships with Physios and Chiros in the local area, who can feed back to us what they think your problem is, and what they suggest you should be focusing on. We have massage therapists who we use and some of the coaching team have had some great results following – a fantastic resource that gives you a daily little video of how to keep supple.

Once you’ve been given some advice as to what to do, you should come to the box early and do whatever additional warming up/ mobilising routine you’ve been instructed to do. Or if you’ve been given stuff to do at home, then do it. You’ve got to be disciplined with the suggestions to see if they’re going to work for you. If you’ve been told to avoid certain movements or scale things down, then follow that advice. Your ego can delay your recovery if you let it. We can guide you as to how to change the WOD to suit your particular situation, but you’ve got to take the responsibility of reminding us each time.

Other really important factors to consider are whether you’re getting enough rest to support your training (good sleep – i.e. 8hrs) and whether you’re eating a good clean diet or one that is leading to inflammation and is compounding the problem.

In summary

CrossFit is a functional fitness training system that is effective at making your body work the way it’s designed to. The movements are natural and are good for you, if modified and scaled to suit your individual abilities. However, it’s demanding, and like any demanding sport there are some risks of injuries. If this happens to you, it’s not a sign that it’s bad for you. It’s a sign post towards weaknesses you have and what you need to focus on.

Be patient and keep positive. Educate yourself and ask for help. We love to see people overcome obstacles and have seen many of our members recover from injuries and come back even better athletes.

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