I should lead with a disclaimer:
I am not a doctor or physical therapist. I don’t have a degree or formal education on this topic. I have years of personal training experience but that doesn’t mean I have all the answers. I do my best to base my advice in proven research, but if you have serious concerns about your physical health a thousand word blog post is nowhere near as effective as an in-person, trained professional. For my clients, if a problem doesn’t go away in a week they get benched until they are cleared by a doctor.
Getting Injured: Know thy enemy
If you’re spending any time in the gym, at some point you will get hurt. The “how” and the “why” may vary slightly, but the causes of injury are largely the same. Injuries generally fall into one of two categories: acute and overuse (1).
Acute injuries happen suddenly in an otherwise healthy person. For example, you’ve been killing your workouts for three months now and then go for a new deadlift max and “BAM!” Searing pain through your back. Whether it’s a herniated disc, muscle tear, or something else, you were fine and now you are not. There are four main types of acute injuries we see in the gym:
- Sprains (ligaments/bone-to-bone)
- Strains/Tears (Muscles/tendons/bone-muscle)
Odds are you’re familiar with fractures and dislocations. They’re pretty obvious when they happen and you should be on your way to the ER. There’s no ifs, ands, or buts about it. Sprains and strains are a little fuzzier though. Depending on the severity of these injuries, there are ways to treat them without a doctor.
Overuse injuries are sneakier, they develop overtime. You wake up one morning and your shoulders feel stiff and it pinches a bit when you reach over head. It’s not terrible so you keep working out. No pain no gain right? Well give it a couple weeks and one morning you’ll wake up unable to move your arm with a doctor saying you’ve destroyed your bursa/rotator cuff/labrum and need surgery. Some of the more popular overuse injuries are (1):
- Inflammation (Runner’s knee, Tennis Elbow, etc.)
- Ligament Degeneration
Chronic injuries happen from wear and tear over time. Over training and exercising with bad form are the biggest causes of these types of injury.
With all this in mind, overuse injuries can very easily develop into acute injuries when a damaged part of the body is put under stress (3).
Again, I’m going to refer to the disclaimer at the top. I’m not a doctor, go see one if you got hurt and aren’t getting better in a timely manner.
Treatment for both types of injury is fairly similar; in the case of overuse injuries treating at the earliest signs of injury is important. The first prescription for an injury will always be RICE: Rest, Ice, Compress, Elevate. For minor injuries, pain should go away withing 3 days. Severe injuries may require surgery or immobilization to properly heal (2). Generally speaking, moderately severe injuries can take up to 10 weeks to fully heal (3). If the pain starts to go down and you feel like you are getting better, rehab is the next step. Performing low stress exercises (80% or more reduction in capacity) helps to strengthen the muscle and promotes proper healing (2). Rehab is essential if you want to get back to you previous level of strength, but be especially careful with exercise inside the 10 week healing window. Specific exercises will obviously be dependent on the type and location of injury. You can find plenty of muscle specific rehab exercise online or from you neighborhood physical therapist. In addition to the traditional rest and rehab approach, there are more experimental procedures such as stem cell therapy, localized shock therapy, and laser therapy. These processes are lacking in substantial research which means they may or may not prove effective (3). I generally recommend at least one session with a doctor to confirm the injury is actually what you think it is and get a professional opinion on the best options.
Preventing Injuries: Know thyself
Now that you understand how injuries happen, we can talk about how to prevent them and why these strategies work.
Give your body time to rest.
Studies show that overuse can lead to tendinopathy (4). Research recommends 24 hours rest between bouts of exercise. This is tissue specific though which is how we get into programs like daily splits where we allow specific tendons and ligaments 24+ hours of rest even while working out daily.
Don’t overshoot your weights.
Overloading can accelerate tendon damage and make injury more likely (4). Moderate weight progression will allow for the tendons and ligaments to strengthen over time and reduce this likelihood.
Practice (necessary) correctives.
Non steroidal anti-inflammatory drugs are your over the counter pain killers (Ibuprofen/Advil and Naproxen/Aleeve are examples). They have ironically become the go-to treatment for many of these injuries even though research shows the reduce healing rates and effectiveness (5). You’re better off taking as little as possible if you want to make a full recovery.
- O’Reill, Naomi. “Sport Injury Classification.” <www.physio-pedia.com>
- Noonan et. al. 1999. “Muscle Strain Injury: Diagnosis and Treatment”. Journal of the American Academy of Orthopaedic Surgeons 7(4): 262-269
- Sharma, Pankaj and Nicola Maffulli. 2005. “Tendon Injury and Tendinopathy: Healing and Repair” The Journal of Bone and Joint Surgery 87(1):187-202
- Magnusson, Langberg, Kjaer. 2010. “The pathogenesis of tendinopathy: balancing the response to loading.” Nature Reviews Rheumatology 6(5): 262-268.
- Ho et. al. 2017. “Prostaglandin E2 is essential for efficacious skeletal muscle stem-cell function, augmenting regeneration and strength” P