Injury Comeback: Physical & Mental

Injury prevention is key to optimal health and wellness. Ways to prevent injury in regular life activities and in the gym include: proper technique, optimizing recovery and sleep, eating enough food and having good nutrition, and building strength. However, there may be times where something goes wrong which may result in injury. In the case of an injury, it is best to get the appropriate medical attention (if needed) and take time off to fully recover. If you stub your foot and get some nice bruised toes (this happened to me two days ago), that won’t take you out of the gym for long, if at all. Let’s say you have a severe injury such as tearing a hamstring; then that will keep you out from lifting on your normal training plan and performing certain movements for a while until you fully recover.  

Patience & Consistency:

In 2019, I suffered a very small injury while I was deployed. It all happened when doing deadlifts with improper form. In one of the reps, I dropped my hips too low which minimized the efficiency of the lift and put unneeded stress on my lumbar spine. I felt a little tweak right away. Due to my impatience and stubbornness, I ignored the pain and continued to train at maximum effort, which was a not-so-smart move. Eventually, that small pain increased to something larger over the weeks and at one point I had trouble walking because of the extensive hip and knee pain. 

At this point, I *finally* recognized the issue and knew I had to back off from making it worse. This didn’t mean I stopped lifting, instead I made modifications to help keep up with my strength training and progress slowly back to a healthy state. Was it discouraging doing exercises that were significantly less in weight than what I was used to? Absolutely. I wanted to jump back into where I was and continue lifting heavy barbells, but that was NOT the right move. Taking the time off to do the modified exercises was the best decision to heal properly while still maintaining strength and conditioning. It wasn’t a severe injury, so I was able to be back to my original plan within 3 months.

Create a Plan:

Creating a plan and adhering to it is one of the most effective things you can do in most situations. In the case of an injury, creating a plan will give you a roadmap with milestones on expected dates of recovery, small actionable steps, and guidance with how to progress. The plan should be modified based on athlete feedback and improvements.  This is where a professional, such as a physical therapist, comes into play. They are experts in this field and can provide the best guidance and routines for an athlete to progress safely. One of the most common issues is impatience and lack of progression. It’s very easy to want to jump right back in and take too big of a leap, but in the end it will bring the injury back and make it even worse. 

It’s always helpful to have an outside perspective to evaluate your pain and help you manage it properly with effective and tailored modifications. At Telos, we have Abby Bird (PT, DPT) of Warrior RX Tucson who specializes in this work. She’s extremely knowledgeable and has experience with athletes of all levels. 

Sports Psychology- Systematic Desensitization:

After a certain period of time you’ll get the green light to go back to your normal strength training routine. Physically you may be ready after completing hours of recovery work through physical therapy and other work, but there is a psychological side of it as well. It is very likely that you may have a mental block to overcome. Many times, the mind will associate the movement with the pain of the injury and the traumatic event can prevent an athlete from performing certain activities. You may even ask yourself “will I ever be able to perform as well as I did pre-injury?” 

This is an important area in sports and athletic training, especially those with high risk of injury such as olympic weightlifting, pole vaulting, and gymnastics. Severe injury comebacks are often handled by clinical sports psychologists with trauma work skill sets. 

Strength coaches are known to be experts in how to make athletes stronger, but another big part of their training is the psychology of athletic preparation and performance. They have to prepare their athletes mentally as well. One area they are expected to be familiar with is handling fear responses that their athletes are experiencing. One way to handle this is systematic desensitization (SD). This method involves combining mental and physical techniques to replace fear response to cues with a relaxation response. For example, if an athlete suffered an injury during a specific movement and is returning to training, they can use SD by visualizing the fearful event while engaging in diaphragmatic breathing and progressive muscular relaxation (PMR). PMR is centered around a “relaxed body promotes a relaxed mind”. This technique consists of tensing/relaxation phases of the muscles as the athlete learns to become aware of and control somatic tension. This is all done in a relaxed setting. The goal is to create a relaxation response that replaces the formerly fear-inducing stimuli. 

Resources to look into:

One of my favorite books is “Rebuilding Milo: The Lifter’s Guide to Fixing Common Injuries and Building a Strong Foundation for Enhancing Performance”. This book is centered around injury prevention and rehab, and is a good tool if you’d like to gain knowledge on this area of work. In the book, there are “tests and screens to uncover the movement problem at the root of your pain.” It is written by Dr. Aaron Horschig, a well-known Sports/Orthopedic Physical Therapist, Strength & Conditioning Specialist, and founder of Squat University– an organization that provides services and content that focuses on optimizing technique in strength training.

Injuries can be prevented through proper technique and quality warm up and mobility protocols. However, in some cases an injury may arise. At that point, be smart and don’t make it worse. Seek professional help to assist in your healing process. When it is time to come back to the game, remember to take it easy and get rid of the fear through meditation techniques as mentioned above. It all takes time, but when done correctly you can bring yourself back to the original plan.