For two years, a bump the size of a grape materialized on the side of my knee. At first I thought, “Oh I fell”, as you do when you play in a competitive flag football league, “and this is just swelling secondary to hitting the ground”. However, as time wore on, so did my pain. When it truly came to light that there might be something structurally wrong with my knee, I had already played two full seasons with the Boston Renegades, a semi-professional women’s tackle football team. Everyone surrounding me at the time had an ache or pain that outstripped the perceived caliber of my own. I watched one of our linebackers who had a separated shoulder stay in games and make defensive stops that rivaled highlights from the NFL. This past season, our quarterback even completed a pass to me after she had broken her clavicle during the previous play. The collective pain threshold of this team was something I had never experienced in my life, and because my own pain did not stop me from making plays, I played down the potential seriousness of my injury in my head. Whether or not I truly developed a higher pain threshold myself, I began to believe that because pain was expected, that pain was also chronically acceptable.
Now, this is a rather extreme example of a phenomenon we actually see all the time across the general population. As we grow older, we begin to notice that everyone around us begins to develop aches and pains. We hear constantly that low back pain is just part of the growing older game, and so this attitude is perpetuated by the belief that it should be happening. Well yeah, low back pain is certainly a symptom of living in lumbar extension, but that doesn’t mean it cannot be treated and abated – no matter how long it has persisted. [This is all, of course, assuming there are no major structural abnormalities.]
In my case, this meant that I had to swallow my pain-threshold pride and get the necessary procedures done to reveal that I had in fact torn my right lateral meniscus. Had I taken care of this injury the previous year, I wouldn’t have had to deal with pain and compensatory injuries for the majority of my second season on the Renegades. No matter how minor or how common you might perceive an injury to be, leaving it untreated typically lends itself to additional injuries or compensations up and down the kinetic chain. So let’s take a minute to be mindful of the loose ends we could help tie up ourselves.
Even if you are without an injury, chances are you have an asymmetry that exists someplace – perhaps you have better balance on one leg than the other, for example. These are still items worth focusing on and working to unpack and rebuild from the ground up. So, if you are in fact dealing with a chronic pain or an acute injury, here is a checklist of items to pack for your road-trip to recovery…
Physical Therapy (if prescribed)
Make time to keep up with these appointments! Let the time you spend with your physical therapist for manual treatment/manipulation be the classroom, and let your prescribed rehab exercise program be your homework! Going to PT isn’t going to do the work for you. You need to be the one to drive the vehicle to recovery on a daily basis. Your lifelong project is your body, and you should work hard every day to maintain proper neuromuscular functioning so that you don’t have to make concessions in your daily activities down the road!
To complement the physical limitations that come with the transient physical limitations from an injury, it is important to mentally adjust by creating a new baseline mindset. Recovering from an injury takes a tremendous amount of focus. It takes planning. It takes buying into the process of recovery. So, set process goals for yourself. On a daily basis what do you plan on doing to help yourself to recovery?
Injuries are actually a really great vessel for pressing the reset button and taking inventory of your own body. Usually you begin your recovery with very basic, body weight, movement patterns. Use this as an opportunity to focus on mastering the fundamentals and building yourself from the ground up, once again. Remember, we all at one point struggled with our movement patterns when we were first learning to crawl and then walk. Pure will and persistence to master those skills got us there. And keep in mind that we had developed no opinions or concept of self back then – so take an opportunity to once again learn to live in a judgment-free zone when it comes to your performance during rehab. Act like a toddler again, and the results will surprise you!
Patience and Mindfulness
Know when to put down the weights and when to pick them back up. It is important to be tuned in to your body. There is a distinct difference between pain and discomfort. Pain is a neurological response to sensory input from your environment telling you that your body is at risk for further injury, and that you may have pushed too far too fast. Discomfort is a part of the game for rehab (or any form of strength training), and if you have questions about where to draw the line, talk to your coach or your physical therapist!
Early in recovery, you might also have a day when you are feeling particularly strong (either mentally, physically or both) after you have reached the volume of work you were supposed to do that day. Good for you – now stop there! If you find yourself constantly going past your prescribed volume of exercise and you begin to notice swelling or shaking in the part of your body where you are injured, you have gone too far. Give yourself time to relax and recover, because your body needs more of that on the road back to 100%!
Nothing gets done without the liquid that is responsible for more than half of your body composition, and certainly no recovery gets expedited with a limited quantity of water in your daily consumption. Your muscles need water in order to train to their potential and to grow. With an injury, we usually see atrophy of the surrounding muscle tissue, so with this in mind, we must make an extra effort to fuel our power infrastructure! Make drinking water a habit. Keep a tally in a ledger or on a white board near your desk of how many full bottles of water you finish. This way you can keep track of your intake, and reflect on the feedback you naturally get from your body on days when you keep up the good hydration work!
You know this one. I know you know this one. But consider a study that compared a group of individuals who slept 5 hours versus a group that slept 8 hours. The group who consistently got fewer hours of sleep had elevated levels of the stress hormone cortisol. An increase in stress levels can delay recovery from physical activity , which is exactly what we are trying to avoid! So carve out an appropriate amount of time to sleep as part of your daily regimen, and try to go to bed consistently at the same time every night. Make this a priority!
Don’t let an injury keep you from being active in the gym setting. As long as you are cleared by a medical professional to continue a program in some capacity, you should do just that! Just make sure to be honest with your physician and/or physical therapist. If you have not gained the appropriate range of motion, you may not be able to complete certain exercises until you do.
During my first few days of recovery from a menisectomy (a removal of torn meniscus tissue), my knee was only truly comfortable in a slightly bent position. What I needed to do was work to fire my quadriceps in order to get full extension at the knee. Once I regained a near-full range of motion at my knee (and this took about 2 weeks), I made sure on a daily basis to get in at least one round of clam shells, band walks, glute bridges with band resistance, single leg deadlifts, and side rotation throws from a single leg balance on a blue Airex pad. All of these together on a daily basis helped to target that hamstrings, quadriceps, and gluteal muscles. This took all of 30 minutes with the inclusion of foam rolling. By strengthening the muscles surrounding my knee, and reinforcing stability at the neighboring joints (hip and ankle), I was able to make steady progress toward plyometric activities. By 8 weeks, I was running and cutting again. I reminded myself everyday of the daily regimen I needed to reach, and let myself off the hook if my body was simply not feeling in the zone for a particular movement or series of movements. So go ahead and use any of these pointers during your own trip to recovery!