Let me start off by saying, I'm not a medical doctor, and the internet isn't in any way a replacement for going to see a real live specialist concerning your health. However, in my relatively young lifting career, I seem to be somewhat injury prone and as such have a lot of experience dealing with my own personal injuries. I have been lucky enough to not experience those muscle tearing away from bone injuries (knock on wood). Unfortunately, I've dealt with all too many of those nagging minor injuries that aren’t really bad enough to stop your training all together but, if left untreated and/or unmanaged, can seriously derail your training for way longer than necessary.
Again, I'm not a medical doctor and all advice and information from this point on is simply my opinions and experiences. Always consult a doctor if you have any questions regarding your health.
Step one: Balance the scale
So it's max effort lower day. You’re in the middle of pulling a massive PR and all of a sudden at the very top of your lift, you feel a twinge in your hamstring and you drop the weight. You definitely pulled something back there and now you’re thinking, “Ahh crap! Now I have to deal with this bull****!”
This is where balancing the scale comes in. Just like when you're training and healthy, you have the amount that you break your body down on one side of the scale and your body's ability to recover from that damage on the other. When your training is going well, your body is able to recover more than you're breaking it down, and the result is adaption in the form of increased strength, size, endurance, or whatever. However, when you experience an injury, the amount your body is broken down increases substantially while your ability to recover remains roughly the same.
What this means is you need to reduce the amount you're breaking down the injured portion of your body by reducing your training volume on movements that use the injured area, increase your body's ability to recover from said damage, or all of the above.
Depending on the severity of the injury and your personal situation (genetics, restoration protocol), you may be able to balance the scale simply by cutting some sets on your accessory work. This might take a few weeks for the injured area to get back to 100 percent, but you can continue to make gains without having to change your training all that much. In this case of the injured hamstring, maybe cut your volume on glute ham raises for a few weeks until your hammy is healed.
With a more serious injury or with a lifter with diminished recovery due to age, disorder, or crappy genetics, you may need to avoid training the injured area all together for some time until it has recovered to the point where you can continue to heal while training with lower volume. Then you can finally return to normal training. Again, in the example of the injured hammy, this might involve avoiding training your hamstrings for a week or two until you can start squatting and pulling with lower volume.
Now that we have a basic strategy for balancing the scale in our favor in the damage department, let's look at some ways of how to balance the scale in our favor in the recovery department.
First, with any injury serious enough to get you thinking about fixing it, the most important thing is to stop the inflammatory process. You want to do this as soon as possible. I’m talking about if you seriously pulled your hamstring on the platform, go find some ice immediately and ice the crap out of it or compress it with a knee wrap or ace bandage until you can get your hands on some ice.
Inflammation is an amazing adaption for survival. If you injure yourself while trying to run from a cheetah, inflammation and scar tissue will help support the injured area and allow you to keep running from said cheetah until you can get away to pass on your genetic information (isn’t evolution great?). However, when you aren't running for your life, inflammation is largely a bad thing. The problem with inflammation is that it prevents the toxin filled blood around the injured area from leaving and it also prevents new and fresh nutrient rich blood from reaching the injury, which would serve to continue the healing process. Also, there’s increasing evidence coming out showing that inflammation is at the core of a lot of our health problems.
So the first goal is to neutralize inflammation and stop further injury to the area. The former can be achieved by means of compression or ice while the latter involves some self-control in not doing those glute ham raises verse monster minis after you felt a pop in your hamstring.
Once the inflammation has gone down (this can take anywhere from a day or two to a week or more, depending on the severity of the injury) and the pain is no longer sharp, you can start the recovery process. One of the major problems with tendon and non-muscle belly injuries is that they don’t tend to get a lot of blood flow. The problem with this is that the stuff our body needs to repair itself is all carried by blood. So if you have an injured tendon that isn't getting enough blood, it isn't healing optimally and will take longer to heal than necessary.
This is where we “blow up” the injured area and then ice it. This continuously flushes in new blood to the injured area, picking up toxins and bad stuff, and then the ice forces the blood away, carrying away the waste materials that might inhibit healing. This step is different for everyone. The key here is to find the right amount of work where you aren't reinjuring the area but simply using it through a full range of motion and increasing blood flow. This can be accomplished through a number of ways.
One of the easiest ways to do this is a microwavable heating pack paired with a good gel icepack. Simply microwave your heat pack, apply for 5–10 minutes, switch to the icepack, apply for 5–10 minutes, and repeat for up to an hour.
Tied for first in terms of increasing blood flow and promoting recovery is self-massage or, in this case, self-myofascial release. That’s right boys and girls. Break out your foam rollers. It's time to get busy. When an injury occurs, your body will send scar tissue to the injury holding the muscle together, allowing it to still function (keep running from the hungry cheetah). This is all well and good except scar tissue is less flexible and weaker, leaving you open to re-injury and frustration. Using a foam roller or a tennis ball for those hard to reach places, you can actually help break up that scar tissue, allowing for healthy normal flexible tissue to grow in its place. I’m not going to explain how to foam roll here. If you don’t know, you should know, and if you still don’t know, google it. All the foam rolling principles apply to the tennis ball.
The foam rolling is actually a form of stretching, but maintaining flexibility and pliability of your tissues is key to avoiding injury again. Often injured areas will heal tighter than before, and this inflexibility can lead to another injury as well as muscle imbalances that can mess your whole body up.
The key to recovery here is consistency. If you're consistently fighting inflammation while promoting fresh blood circulation to the area and preventing new scar tissue from forming by foam rolling, you’re going to see improvement, unless of course your issue isn't soft tissue related. Then maybe it's time to go to a doctor and get an MRI.
Once you have fully healed, it’s time to start the strengthening portion of your rehabilitation. Often, injuries occur from muscle imbalances and weaknesses. That’s why it's important to train everything because, in my opinion, the best way to prevent injury is through increased strength. I learned this lesson the hard way after neglecting my quads and developing a nasty case of quadriceps tendonitis on both legs, throwing a serious wrench in my training that could have been avoided by more quad training to keep my tendons strong. In terms of this, you’re in the right spot, as elitefts™ is the place to be on the internet for getting stronger.
So now that we’ve dealt with the injury, how can we hopefully prevent injuries like this from happening again? Here are some things I’ve found paramount for staying injury free.
A good dynamic warm up
The importance of the dynamic warm up is largely underplayed in today’s fitness industry. Always keep in mind (to quote a recent elitefts™ article), “Cold taffy breaks; warm taffy does not.”
The Diesel Crew have a great upper body and lower body warm up on YouTube and I highly advise taking a look at it and just outright copying it. If not, take the pieces you like and roll with it. My favorite dynamic warm-up stuff is foam rolling, leg swings, and hip abduction verse bands. After those, I look like I’ve jumped in a pool and am ready to start working up. If you aren't warming up properly, you’re doing yourself a disservice.
Sleeves are your friend
This point goes hand in hand with the above point. Getting warm and staying warm is key. For someone with elbow or knee issues, simple neoprene sleeves can help keep the warmth in, keeping the joint lubricated and flexible and leading to pain-free training. I now rock the knee sleeves and they really help my knees stay toasty. I highly recommend them for anyone who’s ever had beat up knees, elbows, or even shoulders. Pliability is key to avoid injury.
Flexibility—It isn't just for girls anymore
A big part of avoiding injury is being flexible enough for whatever activity you’re going to engage in. As a powerlifter, your flexibility needs are going to be way less than that of a gymnast, but you still need some flexibility. If you can’t break parallel with less than four plates, you’ve got some serious tightness issues that are going to land you in the dog house one day or another. For those of you with back pain, tight hip flexors can pull your pelvis out of alignment, causing a serious amount of back pain.
Having enough flexibility in your chosen activity will help you stay injury free and that again is why the dynamic warm up is important. It will increase your flexibility for the task at hand, helping to prevent injury while also not diminishing muscle tension like static stretches do (this is bad for weight lifting; muscle tension is part of how you lift heavy things).
Static stretching should only be used if you are symptomatic. For instance, if you're having back pain and find your psoas is as tight as all hell, you need to static stretch it regularly to decrease the muscle tension, easing the pull on your lower back and relieving your pain.
The importance of decreasing pain
Pain can seriously throw off your rehabilitation process. Pain will prevent you from utilizing the injured area normally. This is good for preventing further injury but can lead to atrophy and weakness that can in turn create more pain. Your body on a chemical level also responds quite negatively to pain, and some evidence has shown that pain may be linked with increased protein breakdown in the area and some other nasty stuff.
One of the best, more natural ways to fight pain is through the use of liniments like blue heat or icy hot. When you're injured, your brain is registering a pain sensation due to tissue damage. By applying something like blue heat, your brain is too busy registering the sensation from the liniment to register the pain signal and therefore not feeling the pain. Pain can be the cause of muscle spasms as well, so minimizing pain is always a good thing. I would experiment with some liniments and see if they work for you.
That’s all folks. I apologize if you feel like you’ve read a novel, but hopefully some of this information will save some of you some frustration and get you back to training as quick as possible.