Overcoming Injuries Without Giving Up Exercise

Written by Physiotherapist Kym Siddons.

It’s always so hard to tell people that they can’t do a particular activity because of their pain, problem or injury. Majority of health professionals, who understand the huge benefits to staying active and mobile, are very hesitant to say ‘stop’ exercising altogether.

Keeping active is of great benefit to your body’s healing systems- in reducing inflammation, reducing your pain perception, reducing your risk of symptoms or the injury becoming chronic (i.e. long term) and maintaining your cardiovascular health. In most cases, there’s usually a safe way of modifying what you can do, so you can stay as active as possible!

Keep in mind the following boundaries I give my patients:

These parameters help you monitor how any exercise is affecting the injured area, the other parts of your body and your body’s response and reaction systems.

1) Don’t push into pain:

Rate the symptoms- like pain, stiffness or swelling- you currently have, before you start exercising, out of 10. As a general rule, you do not want to increase the pain, stiffness or swelling you experience during exercising more than one or two increments above that level.

For example, my shoulder might feel a bit sore as it’s the end of the day. I rate the soreness 3/10. While going for a brisk walk, I want to make sure the soreness doesn’t escalate above a 4, maximum of 5/10.

There are some situations when you might be advised by your health professional to push through pain with exercise. This is sometimes the case with a chronic injury, such as a tendinopathy. You will be told exactly why you need to push through pain and be given strict instructions around exactly what to do that’s appropriate for your specific injury.

2) Stop just short of fatigue when you’re exercising while trying to recover from an injury:

"How do I know when that is?" Look out for signs that your body is feeling a bit tired or weak in the affected or injured area.

If you’ve had your problem for a while you might get a ‘warning sign’ that you’re starting to feel a bit fatigued. This is your cue to stop or take a break!

For example, I often see people that love walking, but get sore in the later part of their walk or afterwards; let’s say in their lower back. I ask them to start out their walk by switching their ‘core muscles’ on as they’ve been shown, to keep nice and tall in their spine and feeling ‘strong’. When they start to feel they can’t switch their ‘core’ support system on, they take a break.

That might just mean stopping briefly and doing some stretches or upper body exercises on a park bench. After a rest, if they can switch on their ‘support muscles’ again they can continue on. If they’re struggling to maintain their form or stay symptom-free, it’s time to call it quits. Pushing on would only put the injured structure/s at risk and likely lead to pain/ swelling etc.

Applying that principle to other injuries and exercise regimes is usually a great way to gradually and safely build up exercise tolerance a little at a time. We even use those principles for rehab with elite athletes. The only difference is the speed and supervision, aiming for a higher performance outcome!

3) Take note how you feel in the few hours after, and the morning after exercising:

If you pull up with more stiffness or soreness or swelling (i.e. with your symptoms more than a couple of increments higher than the hours/day before) you need to back off next time. Find a level where you don’t pull up worse than before.

The idea is to succeed at the activity or exercise you choose without making your problem area worse, so your injured area can gradually tolerate more load.

4) Consider the other parts of your body:

There’s lots of evidence to show that moving and exercising other, uninjured parts of your body can help your injury get better sooner. It helps prevent chronic pain conditions and keeps your general strength and fitness up so you’re more likely to return to your pre-injury level of function quicker.

If your injured area needs to be kept still or immobilised with a cast or moon-boot, splint or strapping, via crutches or even surgery there is still a chance that you can be exercising other areas of your body. Immobilising the area just allows the affected structures to heal more effectively and efficiently.

Keeping the unaffected parts of your body in shape can put you ahead of the game when the time comes to getting rid of the crutches/moon-boot/cast. For instance, if your arm is in a cast, strapped up or had surgery, you might be able to get on a stationary bike, walk (possibly even jog), and do some lower body strength exercises.

Ask your treating health professional to brainstorm some things that suit you.

 

"If you don’t take care, you may be placing those uninjured areas at greater risk of injury!"

Consider what might happen if you injure your knee and are limping significantly.

Your opposite leg takes the brunt of the load and so is put ‘out of kilter’ when you’re walking. This requires a great deal of strength and stability in the ‘core muscles’ of your trunk and the hip that’s suddenly doing a lot more of the work.

In this case, walking is probably not the best form of exercise for you right now. Swimming,upper body exercises and specific rehab exercises for your lower body are much better options until your knee is moving better. Even gentle stationary cycling can be beneficial, gradually increasing as your knee improves.

 

"So, when it comes to keeping up exercise when you’ve got an injury listen to your body and use your common sense!"

 

If you’ve been struggling with an injury for more than a couple of weeks it’s unlikely for it to get better without some guidance. Or at least not without shunting load and risk of injury to other areas.

Physiotherapists, especially those with Sports and Musculoskeletal expertise are great at assessing, managing and guiding you through your injury so you can feel better, move better and function better in the least possible time!

So, ask us!