Here at Beyond Movement PT, we are fortunate to work with active people all the time. Sometimes, we help our clients modify their training to maintain fitness while recovering from an injury. Other times (less often), we are working with people to get back into a fitness program after an injury or period of relative inactivity. Either way, we often have discussions on how to safely return to training. Our experiences have really given us insight into what works...and what does not. The purpose of this article is to highlight some of the most common mistakes people make when returning to training after an injury (or returning to training a particular body part after injury) so that you can avoid falling into the same traps.
MISTAKE #1: PROGRESSING TOO RAPIDLY WHEN CLEARED TO RETURN TO TRAINING
This is by far the most common mistake that we encounter. People start feeling good and decide to hop back into training at their prior intensity. They often will come into the office saying, “I did something bad. I was feeling good, so I pushed myself. Now my pain has flared back up.”
This is a preventable issue and can be fixed with clear communication. Your return to training and progressions should be individualized, but you should not expect to just pick up where you left off. The tissues have not been loaded and stressed like that in a while and will need time to adjust again.
During sessions with us, we will load you up safely to determine the best starting place when getting back into the gym or on the field. Set realistic goals and reverse engineer the process to determine an appropriate rate of progression.
MISTAKE #2: NOT CONTINUING BASIC MAINTENANCE AND SELF CARE
I will say this again: Just because you are back to feeling great doesn’t mean you are back to 100%. A common issue we see is that someone hops right back into training and decides they no longer need their “PT exercises” because they are not in pain.
This is leading you right back to your injury. We prescribe very specific self care exercises and soft tissue work to address imbalances and prevent the risk of reinjury. As the pain goes away, these maintenance activities won’t need to be performed daily, but should be a part of your overall training to avoid a set back.
It is usually very simple to add our maintenance work into your programming. We will typically prescribe a few mobility drills to be performed prior to exercise and some other drills to build up strength in underdeveloped areas either during or after exercise.
Some people require frequent adjustments to their maintenance routines and benefit from checking in with us on a regular basis. We built a monthly membership subscription for this exact reason, which saves you money and gives you ongoing individualized care to keep you healthy and doing the activities you love. Think of this as having your own PT that programs injury prevention and recovery sessions for you.
MISTAKE #3: FAILING TO RESTORE STRENGTH SYMMETRY BEFORE BILATERALLY LOADING
A general rule of thumb in sports medicine is that your injured arm/leg should be at least 90% as strong as your non-injured limb. Sometimes this can be measured with simple weightlifting exercises, or you could get more accurate with dynamometers.
You don’t need to wait until you have that strength ratio to return to training, but if you jump into high-intensity bilateral exercises (think overhead press, bench press, squats, etc.) with an imbalance, then you are going to learn bad behaviors and favor the strong side.
This is where isolated strength training performed unilaterally (think single arm DB press, single leg press, etc.) can really be beneficial. While developing this strength, you should work on low-intensity bilateral exercises with a focus on form and posture to relearn proper movement patterns.
MISTAKE #4: ADDRESSING ONLY THE SITE OF PAIN AND NOT THE ROOT CAUSE
Even though this has become common knowledge, it is not common practice. There are many variables to each injury, and each variable needs to be addressed.
For example, shoulder pain can commonly arise from restrictions in the spine or elbow, technique with exercises, programming, exercise selection, sleep hygiene, workload ratios, and/or muscular imbalances. Getting the pain out of the shoulder is the easy part of PT. Determining what needs to be addressed to get rid of the problem is the hard part, but this is what our practitioners are good at.
MISTAKE #5: TAKING A GENERALIZED APPROACH TO RECOVERY
Your recovery and return to training should be individualized to your specific needs. Many people run into issues by doing a general return to exercise program they found online or something their friend recommends. Sometimes, these programs may even sound like they are addressing specifically what you need. However, if you are subscribing to a generalized approach, then don’t expect to get the best outcomes.
Specific issues require specific solutions. There are many factors to recovery, and you want to make sure they are all being addressed.
MISTAKE #6: LACK OF COMMUNICATION BETWEEN ATHLETE, HEALTHCARE PROVIDERS, AND COACHES
Open communication is essential to an effective return to training. You should not have any unanswered questions on what you should and shouldn’t do. Your coach should know exactly what types of things are appropriate for you and have modifications prepared for you.
At Beyond Movement PT, we do everything in our power to to maintain open communication with you, your physician, and you coach(es) to eliminate misunderstandings. We strive to be as transparent as possible and offer direct lines of communication with your physical therapist via phone, email, or direct messaging on our client platform (PtEverywhere).
If you have specific questions about your own recovery, feel free to email me at firstname.lastname@example.org.
Corey Hall, PT, DPT