TRAINING
AROUND INJURIES

Injuries when exercising are inevitable. You’re training hard, you’re pushing your limits; after training for a period of years, or even decades, you’re going to find yourself with a handful of minor aches and pains.They come with the territory.

The problem occurs when we allow these minor issues to develop into crippling injuries. How you respond to a strained lower back muscle, or an achy knee, or sprained ankle—that’s what is most important.

ARE YOU HURTING?
OR ARE YOU INJURED?

There is a difference between minor aches and pains and legitimate injury. Your aches and pains can frequently be resolved with proper prehab, mobility, and technique re-assessment. Real injuries often require the attention of a medical professional to properly treat. If you are uncertain, please allow an athletic trainer, doctor, and/or a physical therapist to shed some light on whether you are hurting or injured.

“Most people don’t understand the difference between being sore or hurting, and actually being injured. Being sore or hurting from hard work/training is normal and expected if you plan to improve your fitness level. Most of these issues resolve with increased attention to warm-ups, stretching, foam rolling, technique adjustments, and/or a short period of rest (one to two days) if necessary.

“When someone is truly injured, the pain/injury does not improve within a couple of days with the actions listed previously and may actually become worse over the same period of time. That’s when attention from a medical professional is necessary

(i.e. an athletic trainer, physical therapist, physician, or orthopedic).”

— Jose Roca LAT, ATC and Robin Gerber, MS, LAT, ATC

Some signs that you need to go see your doctor or physical therapist include:

• Is the injured area swollen, inflamed, or bruised?
• Is there sharp, stabbing pain, burning, tingling, or a numbness type of pain?
• Are you experiencing intolerable pain for more than three days after the initial injury?
• Is there nagging pain with no improvement two weeks after the initial injury?

“Acute soreness in your muscles after any kind of workout is a fairly normal phenomenon. It typically occurs due to a build-up of lactic acid and is felt hours up to a day after physical activity. Delayed onset muscle soreness (DOMS) results after strenuous physical activity and presents as muscle soreness one to three days after exercise, especially in eccentric based training. This is a result of microtears in the muscle tissue resulting in inflammation; both phenomenon are normal characteristics of muscle building as a result of increased physical activity.

With proper hydration, stretching, warm-ups, warm-downs, and rest time, both phenomena are easily treated and self-limiting. If the soreness lasts for more than several days, or becomes more intense, evaluation by a trained professional is recommended. In addition, soreness in the muscles being trained is typical, but when pain is located in the tendon insertions (e.g. Achilles tendon, patellar tendon, biceps tendon), a more serious problem may exist. If this type of pain persists or worsens, then once again, evaluation with a trained professional is recommended.”

— Dr. Frederick S. Song, M.D.

You can likely start easing back into your workouts when the original pain significantly improves with each day, and is completely gone within 3–5 days.

When looking to rebuild yourself post-injury:

• Get a second pair of eyes to look over your technique. This can either be a qualified coach (CSCS) or a training partner; they may be able to see something you’ve been overlooking for years.
• Avoid load dysfunction. Your injury may well have been a result of heavy weights and poor technique.
• Remember that strength takes years to build. Be patient and constantly evaluate what is important and why you are training in the first place. You can’t go from zero to a CrossFit hero in a matter of weeks!
• Work back slowly, allowing your body time to adjust to the additional volume/stress after time off from an injury.
• Be your honest with yourself. Was it too much volume in your programming? Bad technique? Bad technique and heavy weight? Forcing yourself through exercises that don’t match your ability, mobility and/or goals isn’t going to do you any good whatsoever.

“Pain does not have to be as threatening as most people think. It does not necessarily mean damage or that something horrible happened. It is your body’s warning sign that something is off. When it comes to training and improving fitness, it can be an indicator that you pushed yourself past your current abilities, which is not necessarily a bad thing because you need to be appropriately stressed in order to adapt or improve. On the other hand, it can be a warning sign that your movement quality and technique—your “form”—is off, therefore stressing certain structures in an undesirable way.

Now, if pain continues to persist despite quality training and coaching modifications, heed your body’s warning. If the injury is acute, the primary goal is to respect and manage that area so your body can heal. Depending on the injury, with the appropriate modifications you can definitely train around it; however, if it is something that is more chronic, has been nagging, or re-occurring, make sure you get to the root of whatever is driving that issue and address it from there.”

—Dr. Benjamin Fan, DPT, CSCS, CMP

Tips for Achy Knees

• Activate the glutes and hamstring muscles first in the workout.
• Perform ankle, hip, and t-spine mobility after activation work.
• Place a Deadlift and/or Hip Thrust before your Squat in your workout.
• Use a box when squatting to keep a vertical shin.
• Focus on building single leg strength.

Tips for Back Pain

• Activate the glutes and core stability muscles first in the workout.
• Perform hip and t-spine mobility after activation work.
• Place a Lunge and Hip Thrust before your Deadlift in your workout.
• Use a High Handle Hex Bar to keep an upright torso during a Deadlift.
• Focus on your core stability to ensure a neutral spine during all lifts.

You can persevere, continuing your training through minor aches and pains, but if you’re experiencing the same pain during the same movements for weeks at a time, know that you are setting yourself up for a major injury.