Stop Blaming The Sport And Start Helping The Athlete

I have a bodybuilding client who has thanked me multiple times for my non-judgmental stance toward individuals in their sport. When seeing other healthcare practitioners, including medical doctors, they often don't find the help that they need due to an assumed attitude that their chosen activity is the inherent cause of any health issue; thus, the problem is their own fault.

Let's speak strictly from a pain and injury standpoint. (And I'm firmly putting pharmaceuticals aside from this conversation.) Yes, so we CAN safely assume that bodybuilding and its training style comes with a specific host of injuries and conditions; tendinopathies, back pain, even potentially arthritis. But do you know what other sports also come with their own set of injuries as well, though?

How about soccer, running, gymnastics, skateboarding, and every other physical activity in existence?

It's an easy fact that every activity has its own inherent rate of injury. That rate inevitably starts to climb as the level of sport increases. I recall one of my instructors in school, who worked with many of Canada's national athletes, state, "all high-performance sport is inherently bad for you." It's very true, with the high physical demands of high performance taking an eventual, heavy tole on any body.

Unfortunately, some sports, such as bodybuilding but also including others such as cross-fit or X-Game-type events, hit an unhealthier range before reaching as high of a level. That doesn't excuse medicine from taking a double-standard approach to it, however, treating any one athlete differently because any health issues are "their own fault".

It's not a moral qualm for me. Whether it's a bodybuilder, an ultra marathon-runner, or an extreme skateboarder, I'm well aware that these individuals may be choosing to put their bodies at risk for the activities they love. If they're aware of the risk, not putting themselves in critical danger, and they're not risking the health of anyone else, then it continues to fall in line with my drive to help by helping them to continue their sport, but in AS healthy of a manner as possible.

It's the least I can do. It's not my job to criticize, it's my job to help.

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Can Injury Be A Blessing In Disguise?

It's autumn! The weather is cooling down and the leaves are falling. Time to get out there to rake them up, but, oh wait! You got halfway through and wrenched your back!

Agony ensues, so you check in with your therapist, get your rub down, do the rehab, and feel better. That's all and good, but man, what a waste of time and money that was! It's great that the rehab worked, but don't you just wish that you had never had all of that happen in the first place?

Well, maybe not. Perhaps there was some good that came out this mess.

Consider this; in most cases, there's an underlying condition that contributed to injury or there was a method of prevention had the body been in a different physical shape. There was an existing dysfunction present or there was a healthier state that you could have been in to avoid incident.

While the fact that the injury, well, sucked, the saving grace in the matter is that it has now highlighted areas for improvement. As long as the rehab is taken beyond the realms of getting rid of pain and we can continue to condition the body past recovery and toward prevention, it's possible to come out of the fray being better off than you were even pre-injury.

It's not uncommon for clients to come in for a visit for pain, but after a longer period of discomfort of inability to perform specific movements or functions. After fully rehabbing these individuals and addressing mechanical habits that they had that contributed to their state, they often come back exclaiming how their squat at the gym has gone up in weight, that they no longer wake up in the morning feeling stiff, or how amazing it is that they're now touching their toes for the first time in 30 years!

So yes, injury sucks. Take the silver lining, though, and treat it as an opportunity to improve. We learn from our mistakes and what doesn't kill you gives you a chance to make yourself stronger.

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Staying Involved - The Social Side Of Recovery

When pain or injury hits us, especially when it's severe, it's easy to become disconnected from the world around us.

An example might be of the elderly individual whose back pain has resulted in their inability to go out, see their friends or family, or be involved in their community anymore.

Another might be the athlete with the sprained ACL who hasn't been seen by any of the his friends on the team in months.

It could simply be the person who feels depressed in their month not getting to go to the gym while recovering from their muscle strain.

It's the reality; pain can often prevent us from remaining involved in the activity, communities, and social circles that make us part of who we are. And the tragedy is that this social isolation, as well as the often-prevailing depression and anxiety, are correlated closely to the increase of physical pain! Pain increases, depression worsens, pain increase further, and so on in an unfortunate cycle.

But it doesn't have to be this way! We tend to have an all-or-nothing approach to our activities and involvement, often writing our engagements altogether due to not being able to participate as fully as before. However, this is exactly what leads to that isolation!

Instead, it's crucial to keep individuals in pain involved in the world around them. Whether it's from pain, injury, or illness, we know that greater social support is strongly related to an increased chance of recovery.

With that being said, whether it's you, a friend, or family member, maintaining engagement in social circles is a major factor in recovery. If you're an athlete that sprained your knee, keep coming to practice and involving yourself as much as you can on the sideline. If you're missing out on hitting the trails with your running club, grab coffee with your fellow runners and stay up to date on their going-ons and lives. If your elderly mother hasn't been able to garden or walk with her neighbour, encourage her to have a friend or two to her own home for tea. There's always a way to modify the activity and environment to maintain one's place in the world outside.

Social isolation isn't fun. Add pain to the mix and it can become unbearable. Stay involved, call your friends, and engage in the world rather than let it pass by; you may find that it's what you need to propel yourself back to better health.

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If It Hurts, Don't Do It (Except Do It A Little)

Traditionally, we healthcare practitioners get used to telling clients that if something hurts, then don't do it. Seems pretty obvious.

Exhibit A

However, wait! We've talked about how avoidance of movement out of fear of pain may actually make the problem worse! Let's say that you're wishing to squat, but squatting hurts your hip. Telling you to not squat at all is likely to decondition you even further and prime the nervous system to expect pain when you do attempt the movement again. And thus, the movement does continue to hurt more and more when performed.

As we know, pain and the treatment for pain are primarily nervous system-driven. When certain movements hurt, yes, the tissue may be damaged in the case of acute injury, but the area has also become accustomed to having a lower load tolerance.

With that being said, if you've had long-term wrist pain when squeezing a fist, then retraining both strength and load tolerance will probably see you...squeezing your fist as an exercise. But maybe at 50% rather than 100%.

This is the basis of exercise rehab. The last thing that we therapists want to see is the complete cessation of any particular movements or exercises. Obviously, our job comes in when those movements need to be modified in order to reintroduce load within pain tolerance, and Athletic Therapists are the experts for recognizing when, where, and how those adjustments need to occur to get you better.

So no, when a movement hurts, it's not necessarily a call to stop that movement completely (unless it's absolutely something that the body isn't supposed to do, of course), but adjusting the method and volume of that movement is likely necessary. It's all about re-accustoming the body to the performance that we want it to do.

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