Why Rest May Not Be the Answer
Most of the shoulder injuries that happen in the gym or work place are a result of inflammation or strains in tendons or muscles of the shoulder joint. I work with a lot of gym rats in my practice. One of the most frustrating things a gym rat encounters is a strict recommendation for rest and ibuprofin as a prescription for recovery.
New research in rehabilitation typically tells us that this line of thinking is outdated. Most every condition from pneumonia, to post-surgical recovery, to concussion, to ankle sprains all have favorable responses by starting a movement and exercise program sooner rather than later. Proper rest from exercise is important, but one of the most important lessons you can learn about recovery is this:
“Exercise is medicine” Not just in the sense that it promotes weight loss and prevents cardiovascular disease, because any schmo on the street is aware of that now. But increased movement, mobility, and exercise is associated with improvement in almost all of the most common conditions and causes of disability that we know of.
What Did You Do Doc?
But what will happen to all of my gains?! Or you can strategize your training so that you can recover and continue to build strength and fitness.
Here’s a run down on how I approached my injury. I won’t get into specific exercises and stretches that I did myself because those things will be unique to your specific injury. Today, I just want you to become familiar with the thought process of building strength in an injured limb.
- When mobility plateaus, Get Outside Help – Listen. Even the best doctors and therapists in the world cannot treat their own case. When I got injured, I sought help from my chiropractor. For situations like this, it helps to find a doctor, PT, or chiro that understands athletic performance and sports injury. I also find it particularly helpful if your doctor trains or is an athlete themselves. A combination of prescribed exercises along with certain adjustments and manual therapies can do wonders in restoring pain free range of motion.
- Protecting the Injured Wing – Single Arm Metcons – What do you do when you can’t do barbell movements because of an injured shoulder?Research shows that training a single arm can still provide strength gains to the opposite arm. The neurological and vascular changes that happen when you exercise will apply to both sides over the course of a few weeks. When a workout called for a barbell clean, I did dumbbell cleans with the healthy shoulder. When they involved presses, I used kettlebells. Injury doesn’t mean you have to stay home and rest. Even if the arm is too painful to use early on, your other shoulder is still capable or keeping your conditioning up.
- Strengthen the Injured Wing – Start simple, get complex – When you have an injured shoulder, it will take some time to make it strong enough to do work again.When I couldn’t do complex lifts like jerks, dips, or muscle ups, I was still able to do the most basic movement. A push up.You can start with a simplistic movement with a similar goal. For presses a push up is a simple as it gets. For a pull up, a banded row, or ring row may fit the bill. Find one that you can do without pain. As you train, you can gradually increase the load (weight) and then incrase complexity. I went from push up to a bench press. I then went from bench press, shoulder press, shoulder press to dips, dips to the bar muscle up, and bar muscle up to the ring muscle up.You will run into blocks where the movement is slightly painful which means you still need to scale back and keep developing the strength and skill to get towards pain free again.
- Dumbbell Freedom – A bar bell or pull up rig can reduce the free range of motion you use to accomplish a movement. Thankfully dumbbells were created for this reason. A dumbbell or kettlebell allows your body to use slight variation in your range of motion to find a zone that is pain free. I found that my normal barbell grip didn’t allow for a good amount of internal and external rotation of my shoulder. When I used a dumbbell for presses, I was able to add torque into the movement which provided extra stability while my shoulder was recovering. Using dumbbells to explore your pain-free range of motion may allow you to quickly progress through movements while you strengthen your injured limb.
- Get strict and get strong – Don’t get me wrong. I love doing movements with speed and efficiency. Kipping pull ups, kipping ring dips, push presses, push jerks are fun. It’s a big reason why I enjoy Crossfit.However, we can often lose some of the best strength benefits for our bodies by avoiding strict movements. Strict movements provide targeted load onto the tendon and muscle tissue that allow the tissue to become stronger and more resiliant. They also add different loading patterns to stress the muscle in different ways that promote control and stability. Plus, there’s just no substitute for being stronger. Being stronger is correlated with resiliancy to injury of all causes.Additionally, if you’re kipping on a bad wing, you expose your joints to an increased probability of tissue shear.I went with a Grease the Groove approach to strict movements.5×5 Strict press 50% 5×5 Strict Ring Dip 5×5 Strict Pull up
Results:
Pre Injury:
Clean and Jerk Max – 245 lbs
Max Bar muscle up – 3 reps
Max Strict muscle up – 0 reps
Post Injury:
Clean and Jerk Max – 250 lbs
Max Bar muscle up – 7 reps
Max Strict muscle up – 2 reps
Despite the injury, my performance went up in 3 different exercises that require strong shoulder output. While my handstand push up is still a little uncomfortable, movements like the thruster, jerk, and shoulder press feel lighter than they have before I got hurt.
Injuries don’t have to wreck your gym schedule. They don’t even have to prevent you from getting stronger.
They do require strategy and a little outside help to explore the full function and output of your body.
Did you like this article? Feel free to share it with the people you care about and see if a Complimentary Consultation is the next step to regain their health. Dr. Chung is a practicing Structural Chiropractor in the West Palm Beach area. He has been published in peer reviewed scientific journals and is a sought after speaker in health and wellness. Follow his blog at http://chiropractorwellington.com/category/keystone-chiropractic-blog/ or find him on twitter at @drjonathanchung
