Tell Me What I Can Do: Recovery Strategies
Certified Athletic Trainer
As a certified athletic trainer I spend about 60 percent of my breath telling people what they cannot do, reminding them not to do things and encouraging baby steps towards healing.
However, what I enjoy the most is explaining what they can do, not only after healing, but in the meantime.
Continuing to exercising and doing what they enjoy while they are healing speeds the emotional and psychological process. I enjoy the challenge of creating clever and safe alternatives in order to stay active during recovery from an injury.
So today, I want to tell you what you can do.
But first, please remember:
- Clear activities with your doctor if you are under the care of one
- Listen to your body
- If pain occurs, stop and see a doctor
- Make sure to rest, recover and eat well so your body will heal
- Use good common sense
Because so many activities and sports involve our legs, and because if you’re injured it’s nearly impossible to not be weight bearing, I am going to focus on lower body injuries. Before we dive in, here’s some necessary terminology.
Non-weight-bearing activities: Any type of cardio, strength or flexibility training that does not apply stress or weight to the lower body. Swimming is an awesome non-weight-bearing activity I will often prescribe to my athletes. They can run, jump or sprint underwater, without applying weight to their injured area. Any activity that allows sitting with limited stress or weight shifting through the feet and legs is also non-weight-bearing (i.e., seated upper body weight training, stationary bikes, upper body hand bikes (upper body ergometers), etc.
Weight bearing activities: Any type of activity that requires weight or stress to be transferred through the lower body. Running, walking, weight lifting requiring stable base or stress shifting through the legs.
Full range of motion: Moving any joint completely through a total arc of motion allowed by that joint.
Rehabilitation protocol: Set of instructions or limits a rehabilitator specialist/physician may have you follow during the healing process following surgery or injury. Each protocol takes into consideration the time and stage of healing and the appropriate exercises allowed at that time period.
So here are some common injures and what you can do. Remember to clear all of these activities with your physician or therapist.
Injury: Plantar fasciitis
As long as you are able to bear weight and without bracing, limit your mileage, intensity or weight of training. For cardio, try
- pool jogging/running (using a flotation belt like Aqua Jogger)
- stationary bike
- spin classes
Weight training should not pose an issue, but if so, decrease weight and stick with low intensity lifts (avoid strenuous plyometrics like box jumps, burpees or high weight).I have had athletes complete their running workouts in the pool and return to land with little decrease to their performance.
You can also use ice like crazy and stretch those calf muscles a lot. I also adore rolling your arch over a tin can or tennis ball when you wake and then do the same arch rolling over a frozen unopened water bottle after exercise and at the end of the day.
Injury: Shin splints (anterior compartment syndrome)
Make sure you have a physician rule out a stress fracture. Also, make sure you have the correct running shoes for your foot strike, and use proper mechanics. In my experience, the three biggest culprits of shin splints are
- doing too much distance or volume of exercise before you are physically ready,
- shoe design and/or
- hard surfaces
These all stress the front muscles of the legs, creating inflammation. You can continue to exercise, just decrease distance and how much. Change to a softer surface and limit your distance, intensity or duration of cardio until pain subsides. Then, slowly increase cardio work.
Limiting weight bearing activity. A great way to do this is to alternate land and water cardio, stationary biking, etc. Finally, if you are running a great deal, make sure to visit a reputable shoe store that will assess your running style and foot strike and make proper recommendations. Pool workouts, yoga, weight training should not be affected.
Injury: Muscle strain
I have witnessed quicker improvements to muscle length and recovery with movement than immobility. Unless the muscle is completely torn… then that is a whole different conversation.
Pain should be your guide. Go as tolerated. The main issue is how tight the muscle is following injury. Yoga would be a great alternative to your daily workouts until the muscle is fully healed. Long distance running at a moderate pace usually feels better than sprinting. Low load, low intensity weight lifting versus the high intensity jumping and Olympic lifting is the appropriate choice to maintain your muscle strength and endurance.
I often recommend active stretches (movements that place affected muscles on a stretch) as well as stationary stretching to maintain and improve flexibility. Any activity that gently elongates the muscles versus powerful quick stretches is a smart way to keep exercising without causing further harm.
Injury: Patellar tendonitis
Well, this injury is just a nag. It’s usually due to prior ACL tears and surgery or lots of jumping, and it is hard to be fully pain free. However, the trick is to know what triggers painful inflammation and avoid it at all costs.
So pay attention to your training. You may be able to do your same exercise or sport, but alter the surface. For example, if you enjoy soccer but the indoor hardwood floor kills your knees, then natural grass may be better. Or try a different shoe type, say, soccer boots versus turf shoes with better padding. Maybe it’s an alteration that needs to be made. Sometimes it is a muscle fitness issue. Pay attention to how you feel with these adjustments.
Make sure you are working on your quadriceps strength and keeping the hip muscles and hamstrings in balance with the quads (see last month’s post on strength training for exercise suggestions). Regardless, you can continue to run, find a softer surface, make sure to alter the paths you run on, remember roads are canted (slanted) surfaces and can stress one leg over the other. Try a couple of days a week running in a pool. Cross train and make sure you get adequate rest for recovery. Use yoga to increase strength and flexibility. Try stationary bike or road biking. Traditional weight training versus aggressive plyometric training is better.
Injury: IT band syndrome
YOGA!! Also incorporate a good strength training program for the hips. Run on a flat track or in a pool and give your legs a break from canted (slanted) surfaces. Stretch and stretch some more. Finally, decrease mileage and intensity and focus on mechanics.
Remember to let the sprain heal initially. Slowly begin to return to activity. Weight training is usually not an issue, just decrease the weight. Increase strength to normal before jumping back into plyometric activities (CrossFit, Barre, etc.). Running for cardio is ok, just take it slow, as gait may be affected so don’t do too much too soon or you can end up with knee, hip, back or neck pain. Gradually increase mileage and volume of work. Pool rehab, stationary biking and yoga are all safe while healing.
Hope this bit of information helps as you heal.