So…you’ve recently been hurt or are experiencing a bout of pain and are curious if you can still work out? Below is a guide on how to manage exercising while working around pain or an injury. I am frequently asked how one can manage to work around pain and still make it to the gym or group fitness class. The easy answer is, yes you can still exercise barring you are not suffering from a very serious injury, serious pathology, or recovering from an intense surgery. The hard answer is also yes, however, the hardest about this is understanding the multitude of factors that need to be considered when exercising with pain.
1. You need to accept it is okay to Modify
I see this all the time with patients who have a competitive side to them and can’t seem to drop their ego for a short period of time. For example, the powerlifter or CrossFit athlete who refuses to drop their weight, reduce total volume, or change the exercise with shoulder pain. This is easily the hardest part of the rehab process. There are SO many ways to get stronger or exercise while dealing with pain but refusing to temporarily change HOW you do it for the sake of recovering from something will be your downfall. Once you accept you will be doing something different for the time being, you are ready to start the rehab process the right way.
2. Modifying Variables
There are a plethora of variables to modify when experiencing pain. This is where the art and philosophy of being a clinician come in as there is no single right way to do it. In addition, not only is selecting the appropriate variable to modify important, but the dosage as well. You’ve probably heard me say “the dosage makes the poison” before. Too little or too much can be harmful. We need to work together to find the perfect Goldilocks not too little, not too much dosage as well.
Here is a short list of variables that can be potentially modified throughout the rehab process:
- Acute Volume (set and rep scheme for the day)
- Total Volume (weekly load)
- Range of Motion (pain-free ROM)
- Biomechanical Load (foot or hand positioning)
- Tempo (slow and controlled tempo)
- Exercise Selection (squat vs split squat)
- Degree of Stability (double vs single leg)
- Intensity (50-60% of 1RM instead of 80-90%
- Type of Resistance (band, weight, machine)
This list does not include all variables, but there are many different ways this can be done. For example, if you cannot barbell snatch because 1 shoulder is hurting, do single-arm dumbbell snatches. Or if you’re hurting mid-set, drop the weight or reps. Or do a box-squat. We can go all day! You get the point.
3. Determine Baseline and Progress
You will never know how far you come unless you determine what you can do, how you can do it, and how you feel while doing it. If not done in the office, the process should be
A. Find a tolerable baseline. Establish at a minimum of WHAT you can still do
B. Establish a load tolerance. Figure out HOW MUCH you can still do
C. Establish prescription and monitor response. Determine HOW you felt
D. Gradually progress/regress as needed and retest.
These are all important factors to remember as we tend to just analyze how we feel versus what is actually going on. There have been plenty of times when someone may FEEL the same amount of pain or discomfort, but their weight or load has increased significantly. It is important to see and understand the little victories in the rehab process. If you’re interested in learning more about how this process can be applied to your pain or injury, Strength & Spine Chiropractic is here to help! You can always schedule your appointment at strengthchiro.com, call, or send a message on Instagram at @strengthspinechiro
Dr. Cameron Gholampour