For most athletes or really anyone who has spent any time in the gym pain an injuries are an inevitability. It can come on because you didn't warm up enough that day, you didn't get enough sleep the night before, you're stressed about something at home or at work, or you pushed yourself a little harder than you planned to. Pain from training and injuries aren't something anyone every plans on, but we have all been there before.
So, tell me if this sounds familiar. You had a particularly tough day in the gym, you go home that night and you start to feel some pain when you are trying to wash your hair, or you bent over to untie your shoes and felt your back tweak a bit. You brush it off and say "Eh, I am sure it will be fine in the morning". The pain is still there a week later and you decide that you need to go see a doctor. You go into the doctor's office and he or she looks like she has never seen the inside of a gym and doesn't know the difference between a barbell clean and spring cleaning. You tell them about what you're feeling and they say "Ok, stay out of the gym for 6 weeks and take these pills".
I gotta be honest with you, this advice drives me batshit crazy. Even sitting here writing this scenario out has my heart racing with anger.
The truth is if you're dealing with any sort of pain, the answer is NOT to stay out of the gym. Instead you need someone to help you navigate what movements are safe and what movements might need some modification.
With this in mind, you need to think about how you classify your exercises so that you can keep yourself organized, safe, and progressing.
Exercises in the gym can get broken down into 7 different categories:
1. Upper body vertical push
2. Upper body horizontal push
3. Upper body vertical pull
4. Upper body horizontal pull
5. Squat like movements
6. Hip hinge like movements
Let me take a minute to break down each of these movements so you have a better understanding of what I mean.
Upper body vertical push
These movements are anything where you are pushing weight over your head. This can be a strict press, push press, push jerk, split jerk, handstand push ups or in CrossFit any shoulder to overhead movement you can think of. Also, although barbell and kettlebell snatches are classified as hinge like movements, you want to consider them here because of the finishing position with weight overhead.
Upper body horizontal push
These movements are anything where weight is moved from the chest away from the body. This can include barbell or dumbbell bench press, push ups, or pushes using a cable column. They can also include a lot of movements that include through a medicine ball.
Upper body vertical pull
These are movements where you are starting with your hands overhead and moving a load towards your head or shoulders. This can include pull ups, chin ups, muscle ups, lat pull downs, or even toes to bar.
Upper body horizontal pull
These are movements where your hands are starting out in front of you and you are moving a load towards your body. This can include barbell or dumbbell rows, rows on a cable column, or TRX/ ring rows.
Squat like movements
These are pretty much what the sound like. Any movement where you are simultaneously bending at the hip, at the knee, and at the ankle. This can include back squats, front squats, zercher squats, rear foot or front foot elevated split squats, lunges, or pistol squats.
Hip hinge like movements
These movements can start to get a little bit tricky, but they are any movement where hinging at the hips is the primary focus. This can include conventional or sumo deadlifts, romanian or stiff leg deadlifts, kettlebell swings, and any single leg variation of those movements.
This is where a lot of the fun happens, but it can be a little bit more challenging to define. I basically think of this category as "abs", but I think about how to train abs a little bit differently. So in this category you would think about a lot of your rotational movements, your olympic lifts that don't quite fit neatly into the other categories, and any of your loaded carries like farmers carries or overhead carries.
So if you are dealing with any pain or any specific injury, the first thing you need to do is to consider which of these categories cause an increase in pain or an increase in risk for further injury. Obviously, when training on your own you want to stay away from these.
However, you should be working with a qualified rehab professional like a physical therapist, athletic trainer, or chiropractor that can help you work back to your desired level of fitness. If you are currently rehabbing from pain or an injury, and you do not feel like you are being pushed back into these categories by your healthcare provider, when you finish with this article please take a minute to fill out one of the forms on my website so that we can hop on a call to discuss what it is that you may need to get back in the gym safely.
The other thing to consider when you are working round an injury is where you are placing the load, or how you are distributing the load while performing an exercise. If you are wondering what I mean by that, consider a squat movement. Some people may be having some shoulder pain when they reach behind their head. So for them a back squat would not be an ideal way to load their squat because they do not have the appropriate amount of shoulder mobility. So instead, we can have them perform a front squat or a goblet squat. Another example might be someone is having wrist pain when they do any overhead lift with a barbell. Well, you can give them dumbbells instead so that each wrist can find a safe and comfortable position to complete the exercise.
These are just some quick examples, but in 15 years of training and 10 years working in the rehab world I have yet to come across an exercise that cannot be modified so that someone can safely perform it.
Learning how to modify exercise based on category, position, and weight distribution is a whole other animal, and if you stay tuned for future blogs I will break down how I like to progress people through each category so that they can safely return to the activities they love.
If you or a loved one are avoiding an activity because you know it will hurt, or if you want to learn more about how your body moves and how it can move better please give us a call at (973) 542-4068, check us out on our website at www.mindfulmovementptnj.com, or click the link HERE to chat with a physical therapist about how we can help you.
In the meantime, if you want to learn some easy tricks to modify some exercises that may be painful go to https://www.mindfulmovementptnj.com/5-tips-for-exercise-modification and download my FREE guide!