Dealing With Injury

Any well designed program should do everything possible to reduce the risk of injury and even prevent future injuries. But try as we coaches might, occasionally injuries happen. Often times they result from something we do outside the gym, maybe a prior history compounded with a few other factors, or any other number of things. I get enough questions about how to deal with bumps and bruises that I thought it may be helpful to put a few of the more common answers to paper, so here are a few quick guidelines and suggestions on how to deal with pain while training.

Zero Points for Tough Guys

I’d like to say that we’re starting with an easy one, but our first guideline unfortunately gets broken enough that it’s not as obvious as it should be: Don’t train through pain. Pain is your body’s way of alerting you that something is wrong, and training through pain is blatantly ignoring a clear signal to stop. Pain isn’t a warning sign that something may go wrong, it’s a sign that something is wrong. So the first rule of training with pain is simple: stop. This isn’t to say that if you experience a twinge or a pinch that you’re on lockdown until everything is perfect, it just means that you stop what you’re doing and reassess. A good coach should be able to give you guidance about whether the issue is one that you can work around by modifying the workout, or if you should perhaps call it a day. Any workout should be series of decisions (either you’re making them or your coach is) as to whether or not this action will make you better. If the action results in pain, it will not make you better. Training through pain is not glorious or badass, it’s just stupid. No coach or training partner worth a lick will be impressed by gritting your teeth and pushing through an injury during training.

Now this conversation is quite a bit different if you’re Kerri Strug at the ‘96 games, or Kirk Gibson pinch hitting in the World Series. When there are millions of dollars, World Championships or Gold Medals on the line, sure, you do what you need to do to win. But training and competition are very different animals. When you train you’re working to be better tomorrow. With competition there is no tomorrow. The point of competition is to win. The point of a training session is to be fitter and healthier afterward than when you began, and the odds that you’ll get there when you push through pain are essentially zero.

The Problem With “I’m Just Going to go Light”

One of the more common workarounds for dealing with an injury is to reduce the weight. The trouble is that it’s seldom the excessive load that’s causing the problem. Sure there’s risk when testing a 1RM or doing an otherwise terminally heavy set, but those instances should be few and far between. Usually nagging injuries are caused by a particular movement or posture more than they are by heavy weight. Taking 50 pounds off your bench press won’t help if it’s the bench press itself, with any weight, that exacerbates the issue. Of course weights that are too heavy and cause your posture to falter are a problem, but that’s a bit different. You should always aim to choose weights that encourage movement quality so if the weight pushes you away from that then of course you should adjust, regardless of whether or not you're dealing with an injury.

Not only can reducing the weight fail to solve the problem of avoiding pain, in some contexts in can invite more trouble. In the world of CrossFit and other HIIT and interval programs workouts are often designed to be done quickly. Speed and intensity can be powerful tools when used correctly but as the speed of a workout increases it’s often the case that the movement quality falters. So the trouble with going lighter is that it can allow you to move faster, which leads to more speed and more volume, which can lead to poor mechanics, and poor mechanics are very often the reason you’re injured in the first place. You know which recreational activity has the highest percentage of injured participants? Running. You can’t blame heavy weights for the countless running-related injuries out there. Without any resistance there’s very little feedback as to whether or not you’re moving properly. Compound an often-improper movement with tons of volume (You think 4x10 back squats is a lot of reps? Weigh that against how many steps do you take when you go for a 3 mile run) and you have a perfect recipe for injury.

This is one of the many reasons why I’m a big proponent of weight training. Heavy weights may be intimidating in the face of a nagging injury, but proper weight training is done deliberately. Slowly, even. A steady cadence is imperative for training proper mechanics, and proper mechanics are crucial to avoiding and fixing injuries.

Focus on the Solution, not the Problem

It’s pretty common that the source of the pain isn’t always where the pain is manifesting. It’s easy to focus on what hurts, but fixing it lies in finding what’s causing it to hurt, and they’re not always the same thing. One comment that we hear pretty frequently while front squatting is something to the tune of “my wrists really bother me, I guess I should stretch my wrists”.  Sure, but more often than not I find that the problem isn’t so much in the wrists, but in the shoulders. If your shoulders can’t adequately rotate around in the front rack, your wrists have to bend further back than they should. A little work on on shoulder mobility and the wrists cease to be a problem.

The most regular example of this problem/solution conundrum has to be lower back pain. Lower back pain is pretty darn common if you spend a good chunk of your day sitting in a chair, and it can become more problematic when you exercise. Any time somebody comes to me with a sore lower back, the first thing I check is to see how tight the hamstrings are. Probably 9 out of 10 times, lower back pain is correlated with some pretty tight hammies (see the running example from earlier). If your hamstrings aren’t flexible enough to do basic stuff like bend over and pick something up, your lower back has to make up the difference by working itself into some compromising shapes. Shoulder mobility can also be a culprit here too. If you’re doing overhead exercises (like a push press, for example), you obviously need to support the weight above you. If your shoulder flexion is lacking, you’ll have to arch your back so the bar is over your center of gravity. Your back may hurt because it’s bridging the gap, but the pain has very little to do with your back.

To clarify, this isn’t always the case when dealing with injuries, and I realize that there are plenty of serious conditions far beyond the scope of what we’re addressing here. A slipped disk or a broken bone requires more direct medical intervention than stretching and foam rolling. I’m not intending to state that all injuries can be treated with this sort of relatively simple approach, but if you’re still capable of going to the gym and working through an injury, I’d certainly hope that it’s nothing especially serious that we’re dealing with.

Noah is Co-Owner, Head Coach and General Manager of CrossFit Praxis in Washington, DC. Between years as a coach and competing in the CrossFit Mid-Atlantic Regional Competition every year since 2012, Noah is relentlessly enthusiastic about refining and improving workout programs for elite athletes, teams, and beginners alike.

Noah Gabriel-Landis

Noah is Co-Owner, Head Coach and General Manager of CrossFit Praxis in Washington, DC. Between years as a coach and competing in the CrossFit Mid-Atlantic Regional Competition every year since 2012, Noah is relentlessly enthusiastic about refining and improving workout programs for elite athletes, teams, and beginners alike.