No Magic Pill

Knowledge + effort + time = success

Dealing with ouchies

Posted by Ben on Saturday, May 2, 2009

In a recent not-post post, I mentioned something about an injury. I haven’t worked out in about two weeks as every waking moment not spent at work since then has been devoted to moving except for a few hours when I was (a) trying not to pass out and (b) getting stitches. Monday before last, the first day of the move, was reserved for getting all the bigger-than-the-pickup-bed stuff moved in a rented truck, and that went off without a hitch. At the end of the day, though, I caught my hand on one of the dog crates and tore a lovely gash in my right palm, about an inch-and-a-half long and deep enough that the subcutaneous fat cells were clearly visible and teasing at escaping the wound, and the blood goes without saying (I’ll spare you the pictures). Fortunately, I didn’t cut into any muscle or other major connective tissues, and I managed to make it two days before breaking down and going to the hospital for stitches (free thanks to some connections, but still, second to my vasovagal response is my white-coat syndrome—I seriously get very mild panic attacks from just being in a hospital, which makes zero sense to me, just like nearly passing out from seeing blood leaving my body, but I digress). I can finally grip at full intensity with no pain again, and the wound site is almost completely healed up, so by the time I get back to training (hopefully in another week or so), all should be ready to go. I just need to figure out which tree branch is getting the climbing rope :)

Acute versus chronic injury

I’ve dealt semi-extensively with both types, and I mainly want to deal with acute injuries in this post since those are the sudden, unexpected ones that throw training into total chaos. Chronic issues arise gradually, sometimes imperceptibly enough that you think it’s an acute issue when it really isn’t, and usually in the form of most joint and ligament aches and pains—these get resolved through balanced training, some p/rehab work, and other corrective protocols. Acute injuries make everything else come to a halt so you can first deal with the immediate problem (first aid, see a doctor, etc) and then figure out how it affects your livelihood (where on your body is it, how severe, how long for recovery, what else will be affected).

Mobility

After all medical care has been rendered, the first consideration is if you can you get around on your own two feet, and if so, how well? It’s pretty cool to see how, say, an upper torso or arm injury can inhibit your natural walking gait since you’ll try to remain upright and rigid to minimize movement and therefore alter your stride. I’ll give you two injury examples from my own experience: first, my recent stress fracture in my left foot made simple walking fairly painful, but I was able to hobble around well enough and deal with compensatory imbalances with SMR and removing any exercise that put pressure on the forefoot, meaning no running or jumping of any kind. It was painful and is still annoying but not debilitating and easily worked around in training. Second, a torn right hamstring put me on my duff for a couple weeks, and then it took a couple months of physical therapy to get back to walking without a hitch in my giddyup, and that says nothing about the lost strength and deformed musculature that is only recently returning to a (good) balanced nature, two years later. Obviously, if you have trouble simply making it to the fridge and back or maybe just breathing deeply (from injury, not corpulence), there just isn’t a whole lot you can do. That’s not to say there’s nothing you can do (try isometric contractions for time), but you’ll obviously be severely limited.

What can you do without increasing risks of contamination, infection, etc?

You just experienced physical trauma. Your body must deal with it. Give it a chance to do so, especially immediately after the event. Also, are you in a simple, breathable wrap that you can change as needed, or are you in a brace or cast of some sort? Think about your personal hygiene here. One thing that would’ve kept me from doing a major workout of any kind with my hand injury before it fully closed up was sweat. Granted, I did sweat a bit while moving (I changed the dressing once or twice a day), but nothing like I do during workouts, and with the additional, intensive movements, there was a greater chance of getting sweat, dirt, and whatever else in the wound, not to mention biological resources being diverted to other parts of the body instead of focusing more on the healing process. Plus, there was simply a decent risk of re-opening the wound with inadvertent pressure or striking on the hand. It’s just not worth it.

Had I been free to work out this whole time instead of moving, there would’ve been no pull-ups, no push-ups, no rowing, no kettlebell swings, nothing that involved the hands (let’s just say loading and unloading trucks was interesting for a few days). I would’ve been limited to lower-body and core work, which is perfectly fine with me, but different injuries require different training modifications. If my injury was more severe and long-lived, I was fully prepared to eventually do a 400-meter walking lunge, more squats, lots of planks and bridges, and whatever else I could do, which was a lot considering the location and nature of my injury, but only when the wound finally closed up. Patience, grasshopper.

What can you do without pain and without prolonging the injury?

This is something every athlete and fitness enthusiast deals with: returning to action too soon. Pain is not an accurate measure of what you should be doing or can do in the first place. Again looking at my two examples: with the stress fracture, I could still do a lot, just no running or jumping, and any attempts to do so have been so have been rudimentary to a point of near-infancy (baby steps anyone?). With the hamstring issue, after the initial couple days of continuous throbbing, the pain subsided somewhat when I was sedentary, but any kind of movement brought it back. Later, simple knee flexion and extension didn’t hurt, but walking did. Eventually, that got better, too, but my strength and balance weren’t fully recovered, so I was at a greater risk of (re)injury until I developed more bilateral balance between my legs. My point is to not rush right back into things the first day you feel better. If you think your fitness progress is slow when you’re healthy, progress coming back from an injury is comparatively molasses running uphill in January, but just suck it up and deal with it unless you want to remain in pain at best or on your keister at worst. Focus on rehab and regeneration as intensely as a normal workout, and you’ll recover that much more quickly. Plus, if it’s a muscle strain, enjoy the warm, massage-like tinglies of your physical therapist’s ultrasound treatment :)

What’d I miss? Lots. Light up the comments.

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2 Responses to “Dealing with ouchies”

  1. Lori said

    Good info to remember here, Ben…. right now I’m dealing with a “quite less than acute, but nonetheless PITA” injury to one of my pinky toes…ran into a box of books while barefoot during one of my less than coordinated moments (I have those often LOL). It is KILLING me to take some time off from workouts, but I know that it’s pointless to try to do much of anything at the moment, since just wearing shoes is painful. My trainer took one look at my gait and pronounced it “completely messed up” *sigh* and so I practice patience….

  2. Ben said

    I have to say that lower-body injuries are the worst. When I have trouble just going for a walk, I get moodier than usual, and that’s pretty damned moody :) The really annoying thing with these and core injuries is that they may feel better, even completely healed, and yet aren’t. Of course, you think nothing of this until you go out to resume normal activity and *tweak*. Grrr…

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