The Secret to Injury Prevention, Pain, and Rehabilitation
Quite frequently I get a client that says something to the effect of “ I have shoulder problems so could we not overhead press or avoid involving my shoulder?” My answer is almost always, “NO! We are absolutely going to overhead press now.” First of all your shoulder is an extremely complex joint that is heavily involved in both pushing and pulling motions in any plane. If you really wanted to avoid using your shoulder, you would never move your arms again. Second the only way to improve upon an injury is to move through and challenge the motion or area that is causing you the trouble. That’s the basis for physical therapy. So what do you do after you're all done with physical therapy and your limbs don’t feel like they’re not what they used to be or are still causing you a bit of pain? The answer is you use strength/resistance training to prevent weakness, improve stability/integrity of the limb to help prevent the area from becoming injured again.
For the sake of argument let’s look at an ACL injury for example. When an ACL has been injured or any other injury for that matter the muscle surrounding the injured area tends to atrophy, or lose size due to a lack of use over the healing time. With loss of muscular size comes a loss in muscular strength and loss of muscular strength makes moving limbs uncomfortable and in some cases painful (Glass et al., 2013). One study conducted by Glass et al. (2013) found that women who were at risk or had osteoarthritis in the knee and had weaker quadriceps muscles compared to their counterparts would be more likely to experience worsening knee pain. Øiestad et al. (2015) found that individuals who had weak knee extensors (i.e. the quadriceps) were more likely to be at risk for developing osteoarthritis. Making the solution to the problem here a strong quad. But Brandon what if I’m too old or frail to build muscle, there’s no way strength training would work for me. Well you’re wrong. Bocalini (2009) found that when programming resistance training for postmenopausal women (≥50 years of age) they found a decrease in body fat% and BMI as well as reduced risk factors for bone fractures. Winters-Stone et al. (2011) when conducting a similar experiment with postmenopausal women who are also BREAST CANCER SURVIVORS, they found a similar result. So I’m not sure what excuse you think you have, but give me your best shot.
Let’s look at one of the most commonly complained about injury sites ever, the lower back. Lower back pain currently affects close to 70% of the population and of those cases close to 85% of those cases the individuals afflicted seem to be really unsure about why and how they started experiencing the pain (Searle et al., 2015). Searle et al. (2015) found after a thorough analysis of research resistance training is the most effective method towards reducing lower back pain. Some individuals would argue that stabilization or coordination exercises are a better way of improving upon a lower back injury (França et al., 2010). The point is that it doesn't really matter one of the most effective methods of improving upon your injury is to use the muscle or area that was injured if you plan on returning to whatever a normal capacity or improvement was for your limb regardless of age.
B.S. Exercise & Sport Science
Certified Personal Trainer
Certified Strength and Conditioning Specialist
Bocalini D. S., Serra A. J., dos Santos L., Murad N., & Ferreira Levy, R. (2009). Strength training preserves the bone mineral density of postmenopausal women without replacement therapy. Journal of Aging and Health 21(3), 519-527.
Glass N. A., Torner J. C., Frey Law L. A., Wang K., Yang T., Nevitt M. C., Felson, D. T., Lewis C. E., & Segal N. A. (2013) The relationship between quadriceps muscle weakness and worsening knee pain in the MOST cohort: A 5-year longitudinal study. Science Direct, 21(9), 1154-1159.
Searle A., Spink M., Ho A., & Chuter V. (2014). Exercise interventions for the treatment of chronic low back pain: A systematic review and meta-analysis of randomised controlled trials. Clinical Rehabilitation, 29(12), 1155-1167.
Winters-Stone K. M., Dobek J., Nail L., Bennett J., Leo M., Naik A., & Schwartz A.(2011). Strength training stops bone loss and builds muscle in postmenopausalbreast cancer survivors: A randomized, controlled trial. Breast Cancer Researchand Treatment, 127(2), 447-456.