THE 7 STAGES OF INJURIES

(Author's Note: I tend to write a lot of these entries in advance and post them weekly.  I wrote this a week before my last competition, wherein I most likely tore my ACL [consult with ortho pending].  This all still applies, but it explains the context.)

Dear readers, your fearless author has overcome yet another ridiculous injury in his quest toward being bigger and stronger.  This was actually a 2 parter, and mainly the result of stubbornness and idiocy.

Many of you who are familiar with my training history are aware that I tend to get a recurring lowerback/glute injury about once every 6 months.  The very first time this happened, I couldn’t walk for 2 weeks and I had to give up on deadlifting for 3 years.  It’s now gotten to the point where it’s more a minor annoyance than anything else, as the injury happens less frequently and I’ve become (somewhat) smarter about handling it.

Well…I received this injury 2 weeks ago as of my writing this while performing a set of 2 mat high mat pulls with 600lbs+chains.  It was after the second rep, on the concentric for the third.  I was smart at the time and decided to shut down training.  However, I was an idiot a week later when I decided to try to do some speed farmer’s walks and really focus on exploding off the starting line.  I went from semi-recovered to completely relapsed.  I then thought I could “fix” the injury by performing 3 minutes of reverse hypers 3 times a day.  The next morning, I once again could not walk.

Things looked bad, and though I am now recovered (and will be competing at the end of this week), I felt it necessary to share with you the stages of being injured.  Much like the stages of grieving, it may help you process your own injuries and, for those of you that have never been injured before, you know what to look forward to.  This is pretty much going to be first person perspective, with what goes through my mind during these times.

STAGE 1: DENIAL

 
God I love that show

*TWINGE*

“Was that my injury?  Nah, probably not.  I’m sure It’s fine.  I’ll just rack the weight just to be safe, but I bet I’m fine.”

*5 Minutes later*

“…f**k”

Now, keep in mind that this stage tends to only be realized by those who have ALREADY been injured before.  I find that many new lifters have the opposite problem, and assume ALL pain is an injury.  I’m the opposite, and try to assume all pain is fine.  In reality though, yeah, it’s an injury.  Your best bet is to accept it as soon as possible, because the quicker you accept that you are injured, the faster you move on to rehab.

STAGE 2: PANIC

 
I mean, yeah, but I suppose he means soon

“Oh god, what if this is it?  What if I finally did too much?  Is my lifting career over?”

There’s no shame in these thoughts…right?  Yeah, it’s probably normal.  But seriously, panic is pretty normal right after an injury.  Keep in mind, you’re still jacked up from the training session, adrenaline is running high and you’re like a wounded animal.  Try to keep calm and composed.  I try to get ice on the injury ASAP.  I know that it’s trendy right now to debate if ice even does anything, but it worked just fine in the past, and once again, getting ice on the injury is all about ACCEPTING that you are injured.  You gotta get out of the denial crap fast so that you can start recovering.  I have wasted so much time trying to pretend like I was fine when I really just needed to BE injured and on the way to recovery.

STAGE 3: ANGER

 
For my younger readers, you NEED to see this movie.  The Hulk has nothing on this for rage

“Goddamnit, why did I have to go for one more rep?  If I had just stopped 2 seconds earlier, I’d be fine.  Why am I so stupid?”

Like I said, many parallels to the stages of grieving.  We’re basically grieving for our body.  Anger is natural to feel, but it’s also illogical.  Injuries don’t just happen (barring freak accidents), they are the accumulation of abuse that peak at one point.  Your injury was most likely inevitable, and if didn’t happen in this workout, it would have happened at the next.  Additionally, realize you are being angry, and try not to take it out on others, especially loved ones/training partners. 

You’re going to be an asshole while you’re injured.  Try to minimize it as much as you can, because you may need these people to get you some ice or nachos.

Also note that sometimes anger and panic switch on each other in terms of order.  You’ll most likely actually alternate between the two for quite a while.

STAGE 4: DEFEAT/”ACCEPTANCE”

 
Sometimes, even when you win, you lose

“You know, maybe this isn’t such a bad thing.  It might just be time to hang it up. I don’t really need to compete/do deadlifts/squats/bench/yoke walk/whatever it was that got me injured anyway.  Maybe I’ll just lift weights, or do bodybuilding or something.”

It’s very easy to think that this stage is a sign of maturity: we’re accepting the injury at full value and ready to move on.  In reality though, this is just another form of grieving over the injury, and a rush to attempt to get “closure”.  It’s much easier to just quit than it is to rise and overcome.  If/when you get to this stage, you need to recognize that it’s not the end, and just your mind screwing with you again. 

Almost all injuries are recoverable, so long as the willpower is there.  Brandon Lilly shattered both of his knees and came back to squat.  Matt Kroczaleski and Dave Tate have amazing injury lists and continued to compete/train in some fashion (Dave having recently recovered from a hip replacement and is STILL killing it in the weight room).  Examples are abound everywhere. 

Additionally, this stage can last a LONG time.  I spent 3 years in this stage after my first major back/glute injury, and had sworn off deadlifts that entire time.  In truth, I was too damn young to have written off an entire movement/future in competition over one injury, and it took a massive kick in the ass to get me back into it, but eventually I moved on, and the sooner you can do that, the better.

STAGE 5: HOPE/REHAB PART I

 
Christ all of my references are old

“Hey…I can still move a little.”

Now the fun part.  We’ve made peace with the fact that, yes, we are injured, and we seriously contemplated hanging it all up and taking up roller blading.  Then, one day, we realize that we’re not dead yet and that maybe there’s a chance we can come back from this.  THIS moment is crucial toward recovery, and it’s why it’s so vital to get over the initial shock/denial/anger quickly, as the sooner we are ready to heal, the faster we can get to healing.

Rehab at this point needs to be incredibly rudimentary.  I’m all for pushing the body as quickly as it is ready to be pushed, but the key there is that it needs to be READY first.  If we just jump right back to the same poundages that got us hurt, we’re going to really do some damage.

Take some time to replicate the movement pattern that got you hurt in the first place.  Perform this slowly, with no additional resistance.  Find out WHERE within the ROM you feel pain. 

 
Oh right, everywhere

Now for the counter-intuitive part: keep moving through the painful part of the ROM.

Don’t explode through it: move slowly and intentionally.  You’re trying to restore function and ROM to the injured part of your body.  Many people tend to avoid re-inflicting pain upon themselves under the impression that this is necessary to promote healing, but all it does it train the body to NOT move through this plane.  This is why many people who employ an active campaign of heavy resting find that, though they are painfree once they are “healed”, as soon as they re-attempt the movement that got them hurt in the first place, they feel pain.  The body “healed” under the pretense that it would never need to perform a squat/deadlift/whatever again.  By keeping the motor pattern constant through the healing process, the body learns that it needs to heal while still being able to function.

This is going to be incredibly light and boring rehab.  My usual approach is 5x10 of slow bodyweight squats for hamstring injuries as an example, and I’ll progress to 3x20, 2x30, and eventually 1x50, gradually increasing speed and focusing on maintaining ROM.

STAGE 6: THE MANY FLAVORS OF REHAB/GETTING OUT OF YOUR HEAD

Like this, but if all 32 flavors were just pain and monotony...like being married to a Kardashian

“I’m feeling 70% healed…maybe 72%.”

If you’re diligent and smart with your rehab, it won’t be long until you move from bodyweight to weighted work again.  Usually, this is still a slowish transition.  I’ll go from the bodyweight squats to putting a bare barbell on my back and sticking with the same reps I got last time for bodyweight work (so 1x50 most likely).  From here, I try to progress to 100 in one set as quickly as I can get there, and then the goal is to get 100 with no rest within the set.  Usually, once I can do this, I feel ready to start putting weight back on the bar again.

However, just because your body is healed, there is a good chance your mind is broken.  Injuries suck, they are traumatic, and it’s typical to be worried about getting injured again, especially if you’re doing the same thing that got you hurt in the first place.  Some lifters are so weary of this that they won’t even watch videos of OTHER lifters getting injured, because it puts the bad juju in their head. 

 
So definitely don't look at that

This requires a careful balance of being smart but game at the same time.  You have to be ready to push your body, but also ready to back off when it starts pushing back.  Thankfully, through all of the rehab you should have a firm mastery of pain in regards to the injured location, and an ability to recognize the difference between when you are pushing the area enough versus too much.  You need to trust the process and get back on the horse quickly.  If you let the weights and movements scare you for too long, you’ll never get back to where you were.

STAGE 7: RECOVERED

 
I mean...maybe you shouldn't have said no no no to rehab

“Oh wow, I don’t hurt anymore.”

That quote actually speaks to a few layers of reality, because after you get injured, you’re honestly going to forget what it was like to live pain free.  The majority of an injury can heal quickly, and a muscle can be useable soon afterwards, but a lot of times little nagging pain will be there for a LONG time.  This is another one of the reasons why people spend so long avoiding movements after an injury: they assume any sign of pain is an indication of a lack of recovery.  You’ll probably be “98%” for months before you finally get to 100.

But, like everything else, you learn to live with the pain, to the point that it’s barely noticeable.  It’s a little nagging twinge every once in a while, and you learn some tricks about getting out of your car a certain way to avoid moving through the ROM or brushing your teeth at a specific angle to not bug your shoulder.  You continue to slug it out in the weight room, giving it your all, and usually don’t even notice it once the warm-up is over and the weight gets heavy.

And then, one day, while making a sandwich, you realize that you didn’t feel a little surge of fire in your forearm when you opened the mayonnaise jar this time.  You stand there dumbfounded in your kitchen, moving your arm through a bunch of planes of movement and trying out things that would always trigger pain, and realize that, at some point, you recovered completely. 

Though the moment of the injury was dramatic, the moment of recovery is lackluster.  And sometimes, if you’re super lucky, you injury something else while healing from another injury, and you focus so much on the new pain that you forget the old one.