Injury, Surgery, and Pain: Keep Making Progress!

Originally written November 22, 2017


It Can Be So Frustrating!


Injury, surgery, pain…they can make you feel like you’re stagnating, or even taking steps backward. But it doesn’t have to be that way!



Don't get trapped


Not exactly the kind of pain I meant, but we’ll address it, as physical and emotional/mental pain can be very much related. Let’s get the hell out of that glass case!



Allow me to share some of my experience, and provide some general principles to help you keep the foot on the gas pedal while training with injuries and/or pain.


I’ve been dealing with shoulder pain and dysfunction for all of my adult life, but two dislocations this summer (2017) identified a real need for change. So one week ago today, I got surgery to fix a bunch of stuff. Here’s what I heard from the doctors:


My shoulder joint was “very angry”


“There was a lot going on in there. It was pretty major.”


Terrific.


The first couple days after surgery were rough: I was very loopy and tired, and simple movements were challenging and painful. Then the nerve block wore off and sleep has been a bit of a nightmare since.


By the end of day 4 post-op I had weaned myself totally off the narcotics and was feeling really antsy. I was restless, frustrated, but also tired, unable to sleep and unable to focus. I’ve often found myself in this state that makes it difficult to do anything productive…even relax.


And yes, I do realize it has only been a week since surgery, but it’s tough when there seems to be a lot you can’t do – and it’ll be similar for a while.



In a moment when my shoulder pain was relatively low, I decided I absolutely needed to move.


Like actually move, not just walk around the house and stand about awkwardly. I’m accustomed to high levels of physical activity, so it had to help, right? I came up with a training plan that seemed conservative (for ME) but productive:


https://youtu.be/Q-9DxlC6WQc


And what do you know? I didn’t just feel better, I felt AMAZING! The combination of movement, exertion, and a sense of progress and purpose made an enormous difference.


My pain level dropped while my energy, creativity, and focus spiked. I was coming up with writing, exercise, and video ideas 10 minutes into my workout!


Now, this isn’t terribly surprising. I know from experience how movement and exercise make me feel. And science knows too, providing ample evidence of our positive responses to movement and exercise! So it’s not just crazy Brian being annoying by telling you to go move when you don’t feel well…





Much of the benefit may be attributed to increased endocannabinoid circulation. This can explain improved mood, increased creativity, and decreased pain. Our bodies are designed to positively reinforce MOVEMENT! That’s pretty awesome.


Check out the actual science if you’d like :) Click the links below:


2004: Endocannabinoids and Exercise


2017: Endocannabinoid and Mood Responses to Exercise



Without further ado, here are some powerful tips to help you make progress while injured or hurting: strategies for feeling better physically and mentally. With my personal experience below in italics.



Be Grateful


This is step one. It’s inevitable that you’ll feel down or frustrated by what you can’t do. That’s okay, regardless of severity. You can’t feel super grateful all the time. And gratitude and frustration, sadness, or depression aren’t mutually exclusive.


Simply try as often as possible to remind yourself of all the things you CAN do, and all the wonderful things that DO exist in your life.


I’ve certainly dealt with frustration and being down from this and other injuries – it can fluctuate quite a bit. But I remind myself at least 3-4 times a day how I have such amazing support, and access to high quality foods for recovery. And how I’m grateful to have learned and applied so much mobility training in the past few years – it makes functioning without your dominant arm much more doable. And how fortunate I was to even have the option of this surgery in the first place! Recovery may be rough, but I know now I’m going in the right direction.


When I’m struggling the most to be grateful and positive, I know it’s time to…



Move! Seriously, go move.


When we’re in pain, recovering, and/or feeling lethargic, movement can seem counter-intuitive. Let’s flip that. Make it a conscious routine to move when you’re feeling “off” until it becomes a natural response.


Hopefully you know by now that movement and exercise have much more profound effects than simply weight loss, improved performance, or improved muscle density and body composition. When you feel better inside out, you can do so much more!


Where do you start? Be conservative. Can you walk? Go do that, and progress from there safely by altering speed, grade (hooray for hills!), or duration.


Fun fact: I’ve had clients who went on vacation and did no formal training for 1-2 weeks, besides walking consistently. They almost always came back with a similar or improved fitness level, often feeling better overall mentally and physically. I know, I know, the vacation probably played a role too.


Are you unable to walk? That’s okay, move your joints however you’re able – with minimal pain. Here’s a full playlist of CARs (Controlled Articular Rotations) on my YouTube channel. See which of those you can do, and do lots of them!


https://youtu.be/_PSJxYg9hdU?list=PLWDeaumTuS3Fs79pjtF405qM-jOYVmWlW


By moving appropriately more often, you’ll make more progress. You’ll be able to train more effectively, you’ll likely come up with some great ideas throughout the process, and you’ll feel better overall about what you’re doing.



Resistance Training


Resistance training helps to build muscle and strength. It’s also a form of movement, so there’s another win!


If you’re on an intense training program/routine and get injured or develop pain, don’t freak out. You can still progress. First off, you can train all of the non-injured stuff, right? Right.


Second, you can rehab the injury – treat physical therapy as a training session – that mentality will help.


And third, you can STRENGTHEN your injured area by training everything around it. Your body is a highly adaptable, highly connected system.


Additionally, there is a cross-education effect: training a healthy limb will actually strengthen the opposite side limb. Even if it is immobilized! Check out the links below for more info:


Cross-education and immobilisation


Contralateral Effects After Unilateral Strength Training


I’ve experienced the cross-education phenomenon personally and with a number of clients. It’s pretty amazing. And resistance training while injured is very doable. About 10 years ago, equipped with much less knowledge, I was forced to wear a walking boot for an achilles injury. Eight weeks later, when the boot came off, my overall strength was much improved because I had been consistently lifting for the entire duration of my rehab process.



The Training Specifics: Start and Continue Conservatively


1. Be careful with your movement and training. You can still be progressive, but the last thing you want to do is aggravate your injury or damage another part of your body.


  • Be careful if you’re on any meds. I waited until I was off narcotics and muscle relaxants to do anything involving balance.

  • Don’t chase fatigue or failure with exercises. Daily activities are already difficult, don’t make it worse by creating excessive soreness. I am especially mindful to not overly fatigue my right shoulder…because I kinda need it to do almost everything right now!

  • Choose movements that are safe for your injured area. You may notice a number of my exercises in the video are seated. I am also clenching my fist to help stabilize my arm and shoulder.


2. Be mindful of overall stress and how your training is contributing.


  • When your body is recovering from injury or surgery, it is dealing with extra stress and thus requires more resources. Ensure that your training is facilitating recovery and not detracting from its ability to recover.

  • Deep Breathing: practice at least once daily to promote rest, recovery and awareness of breath.

  • Resting Heart Rate: monitor daily to detect changes. If it rises that could be an indication that you’re doing too much.

  • Monitor pre/during/post exercise: if I am exhausted during training, I back off the intensity. If training totally wipes me out, I know that I need to go easier. Monitor your breathing during training. You should be able to control it.

  • My sweet spot is when I feel some muscular fatigue, and breathing is heavier, but my overall energy rises and stays elevated for some time afterward.


3. Figure out when pain is and is not acceptable with your training, and how much is too much.


You may need help with this. But ultimately, if your pain gets worse with training, you need to back off or change something. If I feel some discomfort in my shoulder while training, but it feels better later in the day, and continues to improve throughout the course of the week, I know I’m doing okay.


Take weekly inventory of your painful or challenging areas to keep track of how your actions reflect upon your body.


Oh bother, I almost forgot:


Hydrate and Eat Plenty of Fruits, Veggies, and Protein!


You all know that’s important, your body needs adequate nutrients for recovery (from injury, pain, or just training) so be sure to give your nutritional habits some attention.


I sincerely hope this has been helpful and informative, maybe even mildly entertaining. If so, please share! I’m sure we all know people this could help.


EDIT: now that I'm a full year removed from writing this initial post, another follow-up is coming soon. Stay tuned!


Brian

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