Making a Comeback after Injury? Set Yourself up To Avoid Re-injury
By Jennifer Emberton, O2x Injury Prevention Specialist
Injuries happen, and they can seriously derail your fitness, your job, and your lifestyle. After you’ve taken a step back, rested, iced, stretched, and rehabbed, you’re ready to make a comeback. Now what? What you may not know is that having had an injury makes you much more susceptible to having that same injury again or having a similar injury later.
So, how do you know you’re ready to get back into action? Is there a way to improve your chances of staying injury-free and beating the odds of a re-injury?
Whether it’s your first bout of back pain, or you’re recovering from surgery, it can be difficult to navigate the way forward to recovery. The following are general guidelines to consider as you plot your comeback.
4 Guidelines to Coming Back Stronger
Guideline #1: Prioritize Rest and Recovery
As you resume your workouts and job-related tasks, remember your injured body part is still adapting and needs time to return to its pre-injury strength. One misconception is that you need to be at 100% before returning from injury—that’s simply not true. After all, how could you truly be 100% before you get back to your regular routine, the pre-injury level of fitness, work ability, or training?
You’ll be building back up to 100% though, and that “building up” process takes time. Remember that your body requires rest and recovery periods. With that in mind, a good rule of thumb is to avoid performing the same strenuous activity on back-to-back days, and limit repeating the same workout to 1-2 times a week when you’re starting out.
It’s completely normal to have some pain and discomfort as you progress in your recovery. This pain may be like the pain you felt early in the injury process, or it may be different. The key is to listen to your body. For example, if you’ve rested for 2-3 days and your pain or soreness subsides after you warm-up, it is usually okay to move through. Pain that worsens with activity and remains worse after you are finished is not okay. In that case, if you have fully rested and are still having pain, or you’re not sure what you should do next, reach out to a skilled provider.
Prioritizing rest and recovery also means you should be getting plenty of sleep! This is when the real repair and healing process can take place. Make sure you aim for 6-8 hours of sleep each night. Of course, when you’re on the job, that may not always be possible. The key is to learn to listen to your body again and know that high intensity workouts or strenuous work activities on days you are sleep deprived may carry more risk than reward.
Guideline #2: Practice Mobility Work
After injury, you’ll likely have some limitation in movement or inability to participate in activities you would normally. This is good/necessary/essential because it’s how we give our bodies the time and rest to heal. But after that acute phase of the healing process has occurred, it is normal to feel stiff, sore, and have difficulty moving the injured body part like you did before.
The old saying, “If you don’t use it, you lose it,” is very much true when it comes to how our joints move! Without regular exposure to the FULL range of motion, the connective tissue around joints can begin to stiffen and eventually lead to loss of range.
Many daily activities, such as walking, sitting, standing, or doing usual things around the house, only require what is considered “mid-range” of motion. This means that going through day-to-day life does not typically require us to use our joints to their full capacity. For the tactical athlete, this is not reflective of the type of motion that is required for work or physical training! Things like climbing through confined spaces, hanging from a pull-up bar, performing Olympic lifts, or simply reaching into your backseat all require a substantial amount of range of motion.
Think of mobility work as the strong foundation upon which you can build your return to activity. It’s much easier to gradually build strength on top of solid mobility than it is to try and use strength to overcome deficits in mobility—this is almost a sure-fire recipe for re-injury! Once you are moving well again, then you can more confidently transition to Guideline #3.
Guideline #3: Push the Limits… But Be Smart
It is completely normal to be unsure/cautious of resuming certain activities after an injury. “Won’t I hurt myself if I try to do something too strenuous?” The truth is yes, you are more prone to injury after having sustained an injury.
But the best way to address/counteract the risk is by gradually getting back to all the basic and essential skills required for your work and your lifestyle, not by avoiding them. In truth, by avoiding exercises like squats, push-ups, or deadlifts you are only increasing the odds these movements will potentially cause you trouble in the future. This is because these types of movements are unavoidable and 100% essential to life and work!
Consider this: you have been feeling pretty good and have recovered mobility again after a painful episode of back pain and you think you are ready to get back to the gym, but you say, “I’ll stay away from deadlifts, so I won’t hurt myself.” But what about grabbing your fully loaded pack/gear off the floor, or picking up those 45# plates for your bench press? Whether it’s one or two heavy lifts on the job or just an accumulation of all the small lifts you do each day picking up around the house, you haven’t retrained your back to sustain that kind of load. A much better option is to approach those movements or activities with a gradual approach.
If you ran 15 miles a week prior to injury, you would still benefit from a gradual walk to run progression. If you deadlifted 500 pounds before you hurt your back, you will still need to start back with some light lifting. If you’re having pain or difficulty with push-ups, try working on a weightlifting bench or on the wall. Push yourself in these areas by finding a starting point that you are comfortable with, and keep moving forward from there.
Guideline #4: Prepare Yourself
Setting up the right expectations for your return from injury is an important mindset piece that has the potential to make your break your outcome. A large-scale research report compiling the results of multiple return-to-work studies found that “expectations of recovery and return to work” were a top modifiable factor in successful return from injury. An optimistic mindset is one aspect of these expectations, but also simply expecting and preparing in advance for how to manage a flare-up or set-back in your recovery can make it even more manageable when the time comes.
Occasional flare-ups of pain or swelling are almost inevitable and are just a sign you need to take stock of several factors. Lack of sleep, poor nutrition, an increase or decrease to your routine physical activities, or just not giving yourself enough time to recover between tough workouts can all result in a temporary set-back. So brace yourself and be prepared for a few detours on your path toward your goal.
Laying the Groundwork
These guidelines provide just a few insights into laying the groundwork for a successful return from injury. You know your body better than anyone, but sometimes, especially after injury, it can be difficult to trust it. When in doubt, always reach out to a specialist or a provider you trust to guide you toward the goals you have set for yourself.