Thursday, May 30, 2013

It can't be done? REALLY? The evidence suggests otherwise......

Admittedly, I am not a professional writer or master of prose.  I am, however, a person that has invested a lifetime pursuing methods of helping injured athletes at all levels achieve their goals and return to optimal performance.  Over the past twenty years of working with athletes during adversity, here is what I have learned........we humans are more capable than we believe, we just need a little help to guide us.

The evidence is all around us; elite athletes coming back from life threatening injuries to fully compete again....80 year olds fininshing an Ironman.....amputees taking back control of their lives and returning to competitive sports, etc. etc. etc.  Nearly all things are possible, but there are two key ingredients to make the seemingly impossible possible.   (1) A complete commitment of the individual to overcome and succed and (2) access to accurate information and resources to allow success.

Commitment is an individual choice, and nothing is possible without total commitment.  Commitment is personal and essential.  A motivational video or someone selling a program for "guaranteed success" may motivate us to start to tackle a goal, but unless there is complete conviction, success will be short lived if it is even achieved.

Access to accurate information and resources is another matter.  The "misinformation" highway that the common recreational or age-group athlete looks to for resources on recovering from injury or improving performance can be a little misleading, many times asking for a blind investment from a company, product, or individual and trusting what they are being told or sold will work.  Can most people afford this?  I think not.  In my position, however, we are able to evaluate and try most avenues being developed to help people achieve their physical goals, particularly when injured. The purpose of this blog is to share information from research and personal experience and make the trip on the "misinformation highway" a very short trip. I hope it will help others dealing with injuries and setbacks guide themselves to achieveing their goals.

Monday, May 27, 2013

The Insanity of Chronic Sports Injuries Revisited

They say insanity is doing the same thing over and over and expecting a different result.  Simply resting an overuse/chronic injury until it feels better then returning to sport only to see the problem arise again is (by definition) unnecessarily insane.  Resting and resolving symptoms won't necessarily correct an injury brought on by mechanical overuse.  The repeating stresses that bring on overuse injuries in an athlete must change, or the same resulting repeating injury will occur; to think otherwise is plain crazy (pun intended).  When an injury occurs, most athletes are told to treat the area with some type of physical modality to reduce their symptoms (i.e. ice, ultrasound, electrical stimulation, etc.), rest, and return to activity when feeling better.  They treat the resulting symptoms instead of addressing the source of the problem, return to activity, and, at some point, incur the injury condition again.  This is the insanity of chronic injuries. If you are in this category, there steps to take to stop the madness........

As athletes at all levels are now training year-round at higher and higher levels to achieve better performance, there is an inevitable accompanying risk of injuries to soft tissues.  Muscles, ligaments, tendons, and bones subjected to stresses that exceed their capacities result in injuries.  Sometimes this is an acute strain, but more often than not, it is a gradual onset of pain that eventually disrupts workout patterns and routines if not handled correctly and/or rested.  Ultimately, overuse injuries are caused by mechanical inefficiencies and/or imbalances of the body.  We all have differing areas of mechanical inefficiencies and thus have varying areas of soft tissue overload. This is why two people performing exactly the same workouts might have two different areas of soreness or injury following a workout. It is also why treating or rehabilitating an injury with the same methods for two different people might not yield maximum recovery results for both athletes.  Injury treatment regiments and injury rehabilitation programs should be individually constructed for every person, addressing the source of their problem to help reduce their symptoms and developing a specific plan accordingly.

In any soft tissue/overuse type of injury, determining the mechanical causes and developing correction strategies is the biggest challenge for the sports medicine specialist. What causes IT Band Syndrome in one athlete might be different than the cause of the same condition in another.  The same holds true for patellar tendonitis, plantar fasciitis, metatarsal stress fractures, SI joint/back pain, etc.  Athletes should be leery of a particular technique, product, or method that claims to "cure all of problem X".  There is no shortage of products being advertised reporting to be the complete remedy for all sorts of sports related maladies.  Pick up any fitness related magazine, and you will find the supposed sure fire cure for whatever sports related injury you might have.  Sadly, there are no immediate shortcuts to solving a chronic injury problem.  Most of these products can assist in treating the symptoms of injury and get pain to subside in the short term, but long term, the problem will most likely return unless other changes are made.  Some products can help to correct the mechanical problems leading to injury, but must be used specific to the injury condition to be effective.  It all seems quite confusing and leaves many people with chronic injuries feeling hopelessly helpless.

If you suffer from repeated injuries in particular areas, there are five general rules to follow to guide you to a maximum recovery with smallest chance for repeated injury:

1. Identify a sports medicine professional qualified and experienced in diagnosing mechanical problems and muscular imbalances in athletes and who has a track record of correcting these problems.  To help you with this, look for a certified athletic trainer (ATC), sports physical therapist (PT) or physiotherapist with experience in these areas.  Ask around for recommendations from higher level athletes, professional sports teams, or major colleges, or seek out professionals who work with athletes at the highest level.  They will be most familiar with these correction strategies.

2. Develop an understanding of the injury and it's causes and work with the specialist to develop a plan which corrects the problem's source, not just treating the symptoms. This must include a corrective exercise plan to address the identified mechanical issues which are causing the problem.  (If the person you are working with can't do this, you picked the wrong person)

3. With your sports medicine professional, develop a comprehensive corrective exercise plan to address your mechanical inefficiencies and adhere to it religiously!  Good sports medicine professionals will help you do this while working around your planned workout schedule.  This may include the use of specific devices or therapeutic techniques to help address the underlying mechanical problems that have resulted in injury.

4. Every good corrective exercise program will involve development and coordination of the core muscles during this program.  Without a strong core for a solid foundation, other corrective exercises may not be effective in the end.  (More on this in an upcoming blog)

5. Be cognizant of your limitations while recovering from the injury, adjust your workouts accordingly until the problem is resolved, then develop a progressive return to specific activity plan taking advantage of your new mechanical corrections. (alternative methods to maintaining your conditioning while injured was the topic of two previous blog posts).

6. Don't be closed minded to the fact that some of your workout choices, athletic gear (shoes, bike, racquet, etc), and workout conditions may be contributing to your problem.  Be prepared to make changes in areas within your comfort zone.  Athletes who find the right sports medicine professional and trust and adhere to their recommendations typically respond the best.

As promised in the last blog, we will focus on providing information to help guide you through all of the misinformation.  The next five blogs will focus on information from the five tips above to arm you with information to win the overuse injury battle and avoid the chronic injury asylum.

Until then, train hard, train safe, and train smart!