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Coaches Corner: Dealing with chronic pain and injuries

by Shaun Kober
December 14th 2020
00:18:27
Description

 I've had so many great conversations with friends and colleagues about what we see happening in the fitness industry, and thought to myself, "I wish we would have recorded that." More

what does it mean to live life to the fullest train to your potential and perform at your best, leave nothing on the table. That's a non negotiable is that I strive to be better every day, because if I'm not on top of my game, how is anybody else gonna follow me down the road? Keep demanding more of yourself to live up to that potential and to stay hungry. Training is progress, you know, when I look at the word training, I think of steps, baby steps to get somewhere that you want to be, and that is basically your life journey. That's a mindset in itself, man, it's like, it's not just about I know that for you, a lot of that's about the physical, but we're constantly in training, whether it's growing our skill sets, whether it's growing up physical bodies, whether it's growing our relationships, whatever, and all of that is a training ground and that kind of goes back to the mindset that we just talked about, You underestimate yourself and you don't even start, but then once you start, you often surpass what you thought you could do, perform at your best mate, that's that's sort of what life is all about, you don't have the knowledge and have the fitness, the healthy ambition and drive that no matter what comes along.

When that next phone call comes, I can just say yes, I don't have to worry, just go and do it, yo what's up guys, welcome to this episode of the coach's corner with my friend Cat, your nakase we've Previously gone through two episodes, the first one being what to look for in a coach. The second episode was all about how to implement functional training tools into your training regime and in this episode we're going to be answering a question regarding how to deal with chronic injuries and pain. Let's get this episode underway. This question comes in from Monk scher dot MTB on instagram, do you have any tips or strategies to recover from long term chronic injuries? Okay, so this is a really good question. Um it might take me a couple of minutes to go through because it's one that requires a lot of thought, I think. So, when we're looking at chronic injury or chronic pain, basically what that means is it's something that's either re occurring or persistent And it's usually after the acute phase of an injury, which means it's basically over 33-6 month month mark.

The other thing about chronic, So if you're using the word chronic or it's deemed a chronic injury, it means it does have an emotional response with it. And for a lot of people, that emotional response can be helplessness, it can be, you know, depression as well. There's a lot of things that can stem from a chronic injury and emotional response falls into into that umbrella term chronic. So when people come to me and say, you know, they say to me, I have patella femoral syndrome or I have a hamstring tear or I broke this bone and it's, you know, still causing pain. What I find is that a lot of people come with the diagnosis and all they know is the diagnosis and they know what hurts the next day, You know, they'll do something and it's like, hey, I sat for too long and now my hamstring hurts. So the three steps to understanding or kind of re establishing your chronic injury or pain is to go through three processes and they are relearning, re accepting and then re managing.

And when I talk about relearning, what I'm talking about is looking further into the diagnosis. So even if you've had an injury for 345 years, whatever it might be, what I want you to do is kind of think about and look into where does it actually stem from if it's something muscular, where does that muscle insert, where does it originate? What nerve innovates it, what movement pattern is it responsible for? And once you get to understand the nitty gritty of the actual, like muscle tendon or bone or nerve itself, it gives you a better understanding of what you can do to prevent pain or inflammation, you know, with movements that you've already got, because ultimately the pain is, you know, is out of our control, but the amount of pain we can actually reduce. So an example for this is I work with a lot of postpartum women and I had someone come to me and say, hey, I've got pure form asiatica and when I sit too long, my foot goes numb and I said, okay, great.

Um do you know more about this psychic injury? And she's like, no, not really. I just know that it's the psychotic nerve which runs from my lower back, which is true. So what I did was I say, okay, let's sit down and relearn and re evaluate what the pure form it's really is. So when we look at the pura formas biological for example, that is a abductor of the thigh. Okay, it's a lateral hip rotator and basically on your backside. Now when you're pregnant and your hips change, you start to tilt forward. That muscle in particular over works for a lot of people and that overworked causes inflammation and that inflammation is what pushes and puts pressure on the psychotic nerve because the psychotic nerve runs directly underneath the performance muscle. So when she got that definition and that understanding of ah it's actually the inflammation of the muscle and not the nerve itself. There was a bigger awareness about what she could do to help improve pain in her activities of daily living.

So, you know, I'll talk about this in the second when I talk about re management, but lights went off in her head, she goes, oh, I shouldn't sit the way I'm sitting in the car, should I know absolutely not because you're putting pressure on that side of your body, that's inflaming the muscle, which is then pushing on the nerve. So the first recommendation is relearn and reeducate. Yeah, when we move away from that, the next step is re accepting and when I'm accepting, I'm talking about understanding that yet there is going to be an emotional response to the injury and it's probably something that is going to be ongoing because it sucks. You know, it might mean that you're no longer able to compete in the sport that you've been working out for years. Me, but what you have to do is understand that that now means that your journey and fitness is changing and you're going into a different phase and that phase can actually be relatively exciting because it opens up new doors and new avenues to find different things.

Like as an example myself, I tore my hamstring two years ago and I haven't been able to power lift ever since. While that sucks, It really does. If I hadn't have gone through that experience, I wouldn't have said, well why not try and prove my endurance on something like the rower and try that. So last year I found a rowing club in new york and it turned out to be the best thing that I did all year, because not only did I make a whole bunch of new friends, but I grew into a community and was able to just enjoy going to rolling classes two or three times a week. So as much as it does suck there has to be an acceptance around that it is going to be long term. Um The third thing is the you know the tips or tricks as this person is mentioned and that's the re management and when I look at re management I'm talking about basically overhauling what you're currently doing or improving it and that comes in four buckets and those buckets are firstly ergonomics, nutrition, hydration and mobility and none of them in any particular order or anything like that.

But if you have a better understanding like you know going back to your relearning of the injury itself and then start to look at ergonomics in your daily life, you can make a significant difference in reducing pain and inflammation and you know that can come down to what seat you're sitting at your desk, where or how high your desk is due in relation to your elbows, where your neck is position when you're looking at the phone or the computer, are you standing all day, Do you need a standing map? There's all these little things that you can start to consider if you know the injury better. So er ergonomics is something that's quite often missed and is something that is incredibly incredibly important to the point where you know I know people and this is part of being an O. T. But you know to the point where also change your door knobs because that's affecting how your hand function is. And we need to change that. We need to change your grip so we have to change your door knob and it's going to reduce the pain and your fingers if you've got arthritis. So there's all these things around ergonomics. The 2nd 1 is hydration, which I know sounds really simple, but the muscular skeletal system is dependent on hydration.

The fluidity and joints and in our muscles is dependent on water. And if you're someone that is like hey my knee hurts after I hike, well why don't we try and reduce that pain by making sure you're smashing water all day and keeping yourself hydrated. So hydration is something that is really overlooked and is truly one of the most simple ways to help reduce pain and inflammation. The 3rd 1 is nutrition and this is one that could be a whole separate podcast. But when we're looking at nutrition, what you want to consider is how can you reduce the pain today rather than tomorrow. So for example, if you know you're going to do a massive training session or if you're going for a hike and you know, it's going to flare up your injury, what can you do today to help prevent that? And one of the things you can do is focus on honing on your nutrition and that means looking at foods and increasing the amount of foods that are anti inflammatory, have high potassium levels for better recovery or have really good amount of omegas to help again increase the fluidity within the joints.

So think about what you're fueling yourself with, because I hear this all the time I went for a marathon run and then I down five beers, dehydrated myself and also had burger and chips. I'm like, great, that sounds, you know, delicious, but also where is that going to put you tomorrow? Think about what you could do today to help improve, you know, your inflammation the next day. So some pretty simple tips that I tell people is if, you know, you're going to have a session that's massive and it's probably gonna play yourself up adding some pomegranate juice to your day. It's incredibly high in potassium, which means that you're going to get a better recovery rate and it's also really good for hydration um and look at increasing your anti inflammatory, adding, adding some um you know, a couple of days before your training sessions or, you know, the day of your height, the day after your height, try and bring these things down. And then the 4th 1, which you know, you sort of touched on already is mobility if you have an injury and you're leaving the upstream or downstream muscle or bone that's around it.

All you're doing is you're potentially creating further injury for yourself or making it worse. So again, as an example with my hamstring, I work downstream by releasing my calf and I work upstream by releasing my lower back because everything is connected and I want to minimize the risk of getting injuries somewhere else. So consider mobility as well as a way of, you know, managing your pain or your um your chronic injury. Mm So many good points there, So many good points. Um where do I want to go back to? Uh let's discuss the because so many people have this where they don't really understand Sayaka and you know how many people are like, oh yeah, I get this pain going into my leg or my back or get some numbness or whatever and they don't realize that, as you said, the p reformists, if it does get inflamed, if it is overworked, then it can press on the psychotic nerve and then send those signals and you know, the world that we live in.

So many people have up across syndrome, lower cross syndrome. Again, tying into what you're saying with people working on computers, you spend a lot of times sitting throughout the day, your hip flexes become short and tight, Your body starts adapting to that position. Then when you stand up it tilt your pelvis forward. Now your hamstrings lengthen, your performance is probably having to work hard. Um you know, it could be potentially pressing on the side of nerve and it's not just pregnant women who get that anterior pelvic tilt people that spend a lot of times sitting throughout the day might get it as well, you know, and we have so many nerves up around our neck, at the base of our skull. And cat mentioned before, simply changing how you look at your phone. That's a big one. How many people lay in bed and their head is jammed forward. A simple thing that you can do is just take your three pillows away and lay your head flat on your back, flat on your bed. You know, so many people struggle to do that, but it makes a massive difference.

Um let's talk about acute pain versus chronic pain as well. I think that's an important thing to bring to the table. Um, acute pain is a blunt force trauma and injury where you land on your knee, your um, you know, something pops whilst you're doing a certain exercise, you're sprinting or something like that. Something pulls something tweaks, okay, that is an acute injury. It's something that happens right there. And then a chronic injury is something that happened long term and I'm sure you're the same pat where you've had people that say my elbow hurts, my elbow started hurting a couple of years ago. It would only hurt when I did certain exercises. Um and then I just trained through it. Um I kept bench pressing, I kept doing whatever and then after a certain period of time, like my shoulder started hurting as well, it started locking up and then it was only hurting when I was doing certain exercises but then it started hurting all the time and now I can't do any upper body movements and I can't do any bench pressing or whatever because it's always hurting.

You know this is to do with your motor unit recruitment patterns. So when you learn something your brain has to expend a lot of energy trying to figure out how to do that thing. If you want to squat your brain goes court, I need to fire these muscles, get these stabilizers working so that I can complete this movement. And the more you do something the more you practice it, the more it becomes ingrained. And if you're not paying attention to your movement and you're practicing poor movement from the start then your brain it just goes I need to do a squat so it just starts firing that blueprint that you've created and you've reinforced over and over again. And if you don't have the right muscles firing at the at the right time in the right order. Now again you're taking your joint through that range of movement with a muscular imbalance or muscular dysfunction which then puts a lot of strain on the connective tissue of the joint ligaments, tendons, cartilage bursa etcetera.

So you know if you have when it comes to pain like if you have like a little flare up in the elbow or the knee or something like that and it doesn't happen all the time, Like just when you do certain exercise, that's your body, talking to you, that's the check engine light coming on and saying, hey, there's something not quite right here, you should probably address this right? So if you've already got a chronic injury, it's hard. You know, you've got to re learn how to do certain things. You've got to address the muscles that aren't firing properly, that allowing your joint to be pulled into a poor position. And I mean, it's difficult to self assess and for the most part, like, doctors aren't going to have a look at your movement and say, oh well your hips fucked because you've been moving this way your whole life, you've got muscular imbalances here, which is now jamming the head of the fema into the side of the assad pabulum. So every time you squat, dead lift, walk, lunge, whatever that's causing pain, it's grinding away.

It's putting a lot of pressure on the soft tissue of the joint. So yeah, very complex topic. Um, but this is where working with a good coach comes into play. If you get a good coach, they're going to do a movement assessment, they're going to have a look at any dysfunctions you have, and they're going to start addressing that within the training session, cool, anything else that's it, I think, touched on as many tips and tricks as you can without going into a full podcast on it because it's definitely, it's definitely a big topic. Uh, I know it's and, and all of these are like massive topics. We could definitely talk on all of these subjects in a lot more detail, but we could quite easily get bogged down in details and then we'll start speaking way too cryptic and people don't understand what we're saying. Anyway, Yes. And that rounds out this episode of the coach's corner with my friend Cat Tanaka's of Macron's muscles mindset. We have one more episode to drop in the coming days where we're going to be answering a question regarding whether it's beneficial to train in a similar emotional state as to what you'd experience in competition.

So stay tuned for that one, guys, as always any five star ratings and reviews are much appreciated. Anyone who does leave me a five star rating and review will receive precedents when it comes to answering these questions on the podcast. Much Love Guys piece

Coaches Corner: Dealing with chronic pain and injuries
Coaches Corner: Dealing with chronic pain and injuries
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