Hey Tribe,
In the last 12-Week Weightlessness Process I had a bit of a mishap that essentially put me in bed for a few straight days. Following that, I needed a few weeks of rehab to get back on my feet. And in that window, I shared with the tribe my thoughts on and approach to rehab - the one I've used for my own issues for my entire adult life, and many of my client's, ranging from sprained ankles to slipped disks.
I'll share one critical caveat before I share the text-icle (article plus text, get it?), which is this - when you're injured, confidence in your body plummets. This makes it exceedingly difficult to steer yourself toward effective rehab, because 1) you're in pain and you don't want to be in more pain and 2) what if you make it worse?
In The Weightlessness Process | 12-Week Mind Body Program we traverse a wide range of mind-body principles, tools and tactics, and we customize them to where you're at in the here and now.
One of the most foundational, and for that matter, most overlooked by those in the fitness (and perhaps physical therapy) industry, is this - health and fitness ought to be the same thing.
We live in an odd time where knowledge is fractured across these domains, where the things people do to look great in a bathing suit are different from what people do to heal a back injury. This, according to yours truly, is a misunderstanding of the way the mind-body both heals, and grows.
This doesn't mean the volume, intensity, or selection of tools should remain the same for your injured or most athletic selves, but it does mean the principles of growth don't change.
Healing IS growth.
If properly understood and practiced, the principles that make you your strongest should make you your healthiest.
If you've been in the game a while, know how to get that body in top shape, but rush for external support when aches and pains (and perhaps more serious issues) arise, it may be time to audit your foundations. Hopefully the following provides a little insight into that transference of knowledge.
AND! If you don't have a copy yet, one of the many awesome chapters in In Pursuit of Weightlessness goes into greater depth and detail on this. That chapter - Forever Young: The Secret Science of Cheating Your Way Strong - is in Part 2.
With that said, let's get into it.
The Text:
"Going through a bit of an injury at present, and figured I’d share a few thoughts on how I generally approach such things. Have rehabbed my own for over 25 years, and injuries of clients for about 15… and it’s a bit unorthodox.
But since it’s present of mind, and I know Maddy (Read Maddy's awesome mind body transformation) has a few tweaks she’s working with, it might be good to apply what you’ve already learned to rehab.
Disregard if you ain’t interested.
My injury/pain is lower back… by far the worst location one can trigger. It’s difficult to diagnose without an MRI, and it could have multiple causes/symptoms. I’ve been doing landscaping in the backyard for a few weeks, lifting 70lb stones at various heights, and shoveling. I may have also over stretched a few weeks ago. One of those is likely the cause.
Been experiencing pain for about two weeks, and it’s of the order where I feel nauseous/globally weak if I bend and trigger it. Soooo… it’s NOT a light issue, to say the least.
Step 1: Don’t panic, and immediately avoid anything that remotely triggers pain in the region.
Step 2: Rest. Allow your body to prove the magnitude of the problem. Many issues resolve after a few days of rest. Those that don’t, need to be addressed.
Step 3: After a few days, work around the injury, and test global strength. i.e. I can’t bend, but can I push? Yes.
Pull? As long as I’m not bent, yes.
Squat? Not really…
Run? Adequately.
Reintroduce those things, being attentive to the injured region. This step does not negate the rule of step #1.
Step 4: Explore functional range of the injury (movement that won’t make me puke). Can I test that range with sound structure? i.e. neutral spine, glute/hamstring activation, etc. Barely… but yes. I can access a few inches when I hinge from hips.
Step 5: Begin to load (marginally) the injured site in the strongest range of motion… which is basically the only range I can access. Can I manage that without compromising my structure?
Yes. Not pretty, but yes.
Can I do it without pain? No… VERY uncomfortable… noted.
Put the weight down. Rest.
Try another set. Explore the same range.
Same pain? Yes… shit. Try it again.
Same pain? Not sure… but range is easier to access. Good.
Rest a day.
Step 6: Try again the next day. Same weight. Range explored with load. Same pain? No… it's different.
Less pain. More control. Good.
Now… there are two options. The pain is dispersed across my lower back. Ruling out kidney damage, I’ve either slipped a disk, which is unlikely, because I don’t lift or shovel without conscious awareness of my spine (deadlift anyone???), but I’m not infallible, or I’ve strained deep fascia (doesn’t feel muscular/erectors) across the lower back.
Regardless of cause, my approach would be the same.
If this was a disk issue, however (must confirm with MRI), my first goal would be to get that pain to centerline… and with time, gone. Symmetrical movements with minimal spinal flexion are critical until then.
With what I believe the issue is, the pain is unlikely to localize (center), and may take some time to heal.
Over the weekend, the pain had nearly cleared, until last night I picked up a big box of cat litter, instantly retriggered it… despite attention to alignment. So, as much as it sucks, I’m resting the back today (but worked around it and did a full push and press workout - push-ups, handstand push-ups, flys and upright rows), and will return to step 5 tomorrow.
Without experience, this is not an ideal region of the body to experiment with, but without bullet holes or bones sticking out, most pains and injuries can rehab with similar strategies and efforts. Once you understand your force vectors (listed on your prescriptions as push, pull, squat, press, and twist) and the strongest range of motion / greatest points of leverage (mechanical advantage) therein.
To sum:
1) Test range - is there any range of that vector that can be accessed without severe pain?
Hint: If yes, it’s always in the strongest range of motion, so start there. In my case, the top 3 inches of the deadlift (or erect standing position). Sucks… but it’s something.
2) Load the sight with good structure in the strongest possible range (we discussed mechanical advantage in chapter 2 - this is a high level application) for short range reps in the 5 to 20 rep range. I’m only doing 5-8 reps now, will increase reps as pain dissipates to increase blood flow and tissue activation.
3) When pain dissipates, reintroduce targeted stretching to explore unloaded range. This should begin with stretching / loosening muscles contiguous to the problem region, as tension there can further aggravate or strain the injury. Example - if your back is injured, make sure the glutes and hamstrings are loose, before attempting to stretch the lower back.
4) Increase the loaded range gradually to full range reps and standard sets…
5) Avoid cat litter.
No matter how cautious you are, shit can happen. And it usually happens outside of training with less conscious awareness of movement. At such times it’s important to ask yourself “what can I still do?”
There are those that avoid training because their shoulder hurts.
Ok... but your legs? Core?
Half your body is pain free!
And when one pillar is taken outa the game, can you still stretch? No?
Ok, can you breathe? Good, then show up. 💪🙏😊
Stay weightless gang."
Tom
Weightlessness | Mind Body Performance Coaching