Once you take away the daily grind you are left with what you love most: family, friends, and hobbies. But no matter what each individual may enjoy doing, injuries are a part of life’s journey. But there is a way to improve your recovery and get back to what matters most. It is the aspect of you; or to be more specific, your mind. The mind has an effect on our state of well-being and what we are capable of. Like the saying goes, mind over matter. At its heart is a simple concept that the better the attitude with which you approach an injury or recovery, the easier the process will be and ultimately the faster you recover.

But more often than not, injuries throw our lives into some level of chaos. Recovery is a hard journey because each individual will be dealing with a loss of some type, whether that is an ability, normality or convenience. That is why an individual will experience the 5 stages of loss/grief following the injury. This includes denial, anger, bargaining, depression, and acceptance. Some linger at different stages longer than others and have difficulty truly embracing the rehab process, thus making recovering from the injury seem insurmountable.

I have seen it time and time again, patients of all backgrounds and ages struggling to understand that rehab from injuries and/or associated medical interventions required is a process. At times, it can be a slow, extremely frustrating process and can very rarely be rushed with any long-term success. As a patient, you control so many elements of your treatment. Especially the mindset you approach your recovery with.

With that being said there are many ways to enhance the physiological well-being during the recovery process.

1. Accept it!

Accept the injury and where it has left you. You can’t change what happened. You can be angry, sad, frustrated, embarrassed, etc. but it won’t change what happened. This doesn’t mean that you accept that this is how you will be for the rest of your life, rather that this is your current condition. The faster you can look at where you are in relation to where you were objectively, the faster you can start rehabbing your injury and your mental health.  This is a difficult thing for nearly everyone. Much like when training for an athletic event, or trying to get back into shape, the faster you can realistically see your short comings, the faster you can start correcting those deficiencies and make yourself better. This may be the hardest and yet most important steps in your recovery, and yet can’t be faked or rushed. Each of us grieves in our own matter, and if we want to get back to living our lives than we have to accept what has happened.

2. Embrace the Current Norm

The next logical progression of getting your mind right during recovery is to embrace the rehab process. After your physical and emotional state is recognized, it is important to engross yourself in the process. Yes, this means listing and actively participating in the rehab. This includes asking questions of your PT and PTA. Telling them when things are getting easy in the clinic or at home and doing the home program activities.

Exercise has been clinically tested to enhance physiological well-being in addition to the physical benefits. It may not be what you could do previously and that’s frustrating but do what you can in your current state. These exercises may be irritating due to deconditioning, or as I like to say, the difficulty in simplicity. This means that the exercises are so simple when looking at it, but when a movement is broken down into smaller pieces and performing that small action on its own is so foreign, it is more difficult than the original movement. But that is why it is important to do them and ask why. If you were an athlete prior to the injury or someone who sees exercises as a means to an end, view rehab as your new training regimen for the time being, creating a new foundation that is stronger than the previous one.

3. Give Yourself a Break

Rehab is a very difficult thing for most patients. I know this first hand since I am still working to recover from my own ordeals. There are peaks, plateaus and even regressions in the rehab process and know that going in. You don’t have to like the times that you’re not progressing in a linear manner but know that it is going to happen. Attempt to take something good from those times and know that good things are coming. Don’t focus on the negatives and seek out a silver lining.

4. Communicate

This has been discussed previously but communication is key. We are social beings and we require interaction with others for our psychological wellness. Tell your PT or PTA in Physical Therapy how you are doing in dealing with the injury no matter what. If you are frustrated, be frustrated, if you’re sad, be sad but then talk about it. In physical therapy, we are always adjusting our treatment to adapt to the situation. This is increasingly difficult when we are uninformed as to your current mental state. Some are more apt to see emotions than others. It is up to the whole rehab team to commutate those emotions and that team includes the PT, PTA, PT staff, Physician if applicable and patient. The more you talk about your emotions and struggles the more you often find a solution or at the very least feel that you’re being heard and grant you peace of mind.

5. Make Time for You!

Much like training for a sport or keeping yourself in your best shape and health, it can be taxing. Make sure you take time away from the rehab and the injury. This can be difficult depending on the injury but then again it doesn’t have to be elaborate. Go see a movie, have a cup of tea or coffee, go see friends and family, or use the time to discover more of yourself than you have been able to due to time, willingness, or other limitations. Boredom and downtime can be pitfalls for rehab of the body and mind. So, find constructive ways to use your newly acquired time.

Using these tips can be helpful ways to physically and psychologically recover from injury, but remember the onus is on YOU.

It’s on you to seek help when needed and power through when you are able. We are stronger than we give ourselves credit for and can-do incredible things. But you may find yourself teetering between stages of grief or having difficulty keeping your mind on the task at hand. Know that you are not alone in this process.

At Foothills, your PT’s and PTA’s are there to support you in your journey and achieve your goals. Focus on rehabbing your body and your mind so that you come away from the injury stronger than you were prior in every way. Schedule an appointment to talk to a physical therapist about your pain/injuries.

With the New Year upon us, so are New Year’s resolutions, fitness goals, and, at times, those unfortunate pesky injuries. It becomes difficult to achieve all your resolutions when you’re completing injury rehabilitation for an injury that could have been easily prevented.

But how you ask? Let’s start at the beginning of your workout or physical activities.

Here’s the big question; do you stretch or warm up prior to exercises?

The answer should be yes, but more often than not the answer is to the contrary. Typically warm-ups are overlooked due to time constraints or lack of understanding about the importance of this step. Both stretching and warm-ups are beneficial prior to activity, not only for performance but also in injury prevention.

One of the best ways to achieve these benefits without taking up too much time is to combine the two activities into a simple fluid activity called a dynamic warm-up. So, let’s dive in and shed some light on this very important but perhaps not very well known element of physical fitness.

Simply put, a dynamic warm-up is a sequential series of movements performed prior to physical activity. It aims to increase blood flow to the muscles, increase functional mobility, and maximize available flexibility of the entire body prior to exercises.

As you can probably gather from the definition, a dynamic warm-up isn’t just riding the stationary bike or jogging for a few minutes then static stretching off in the corner of the gym.

Static vs. Dynamic Stretching 

In an attempt to eliminate some confusion, let me clarify static stretching. Static stretching is a stretch of a muscle/joint that emphasizes a longer period of time being held, usually 20-30 seconds minimum to be effective, and is performed without bouncing in and out of the stretch.

This type of stretching is great for increasing the range of motion and decreasing muscular tension. However, despite popular opinion, static stretching has been shown to not be beneficial prior to exercises. In fact, static stretching is more likely to have no effect or even hinder performance versus help it.

Instead, static stretching is best performed following exercise to help decrease the risk of injury. The vast majority of the public is unaware that there are different types of stretching, let alone knowing the appropriate time when each is more appropriate.

The truth is, the safest way to warm up prior to exercise is a dynamic warm up.

Guidelines for Dynamic Warm-Up

On that note, there are some general guidelines for each dynamic warm-up that should be followed in order to maximize your time and effort.

First and foremost, a dynamic warm-up should be done prior to an activity. It should be done at a moderate pace with an emphasis on slow progression into the available range of motion; don’t try and stretch as far as you can right away. Allow the body to “warm up,” letting the muscle generate heat, become oxygenated, and, in turn, become ready for a full range of motion and speed. Dynamic stretching is held for only 2-5 seconds and targets multiple muscle groups and numerous motions at the same time.

The next concern is the amount of time dynamic warm-up should occupy. A dynamic warm-up isn’t meant to be an hour-long workout in its self, but it should be emphasized. Depending on the activity you are preparing for and your level of fitness, the time can vary based on the number of activities in the dynamic warm up. Typically, the warm-up should only be 5-15 minutes and be performed no more than 15 minutes prior to starting physical activity.

As far as the order of activities in the dynamic warm up, they should be sequential and progressive. This means that the least invasive activities are performed first, slowly building up, activity by activity, to an ending with more explosive, higher-impact, or nearly-full intensity warm-up activities. Examples of the warm-up exercises that should be performed last in your warm-up include high knee runs, full golf swings, and short distance sprinting.

The dynamic warm-up should focus on full body movement with multiple muscle groups being emphasized at once. Example: don’t simply do a walking lunge; add a rotation of the upper torso over the front leg or a side bend.

Furthermore, a dynamic warm-up should be specific to the activity or sport being performed. Not every version found online is appropriate for you.

For instance, if you are preparing for your weekly round of golf, your warm-up is most likely not going to be exactly the same as the collegiate track and field athlete, nor is a basketball player going to need the same warm up as someone preparing for baseball/softball.

Don’t get me wrong, there are similarities and actions that will be the same, but different muscles and movements need to be emphasized for each activity, so each warm-up is slightly different. Your age, health, and other functional limitations should also be considered when utilizing a dynamic warm up.

Lastly, as we age the elasticity of our muscle and overall flexibility decreases naturally. This progression can be slowed down slightly but not completely prevented. Thus, this should be considered when we perform all activities, especially stretching and performing a dynamic warm up.

I often tell patients that it took a long time to develop the muscle tightness and restrictions and it won’t come back in a day — so please don’t try. Don’t push too hard with any kind of stretching.

How does this prevent injury?

Some statistics to show the importance of being prepared for physical activity:

  • Injuries to skeletal muscle represent upwards of30% of patients in sports medicine clinics.
  • In a 2011-2014 sports- and recreation-related injury study, 4%of the injury diagnoses involved strains and sprains.
  • According to the CDC, estimates suggest that more than half of all sports injuries in children are preventable.

When done properly, a dynamic warm-up helps the whole body prepare for activity and help avoid adding to these statistics.

As previously stated, this isn’t necessarily to help improve overall flexibility or range of motion of the joint like static stretching, it’s meant to optimize what is there. Moreover, a dynamic warm-up is meant to increase body and muscle temperature, increase oxygenation throughout the extremities, and obtain fully available muscle length prior to an activity.

A popular analogy for this is a frozen rubber band. If you attempt to stretch a rubber band to its full length without bringing it back to at least room temperature, it has a higher probability of breaking. Similarly, if you attempt to stretch a muscle to its full length or participate in full speed activities without warming up, the chance of injury is heightened and performance is likely decreased as well.

Ultimately, from professional athletes to retirees getting ready for their early morning round of golf, all could benefit from a proper dynamic warm up.

Dynamic Warm-Up Example

Below is a sample of a dynamic warm-up that we teach to our patients. This suggested workout hasn’t taken into consideration your specific ailment or medical history so don’t automatically assume it is for you.

Each dynamic warm-up is catered to the activity being performed and the individual, so reach out to your physical therapist first.

Don’t hold a stretch for a long period of time and alternate legs while moving forward until full 10 yards has been achieved for each exercise.

  • Knee to chest: Standing straight, pull one knee to your chest, wrapping your hands around the knee to help pull it up. As you’re raising the knee, lift onto your toes into a calf raise on the standing leg. Be sure to keep your chest up, without leaning backward. A stretch should be felt in the buttocks of the limb being brought to your chest and possibly the front of the hip for the standing leg.

Knee to chest

  • Heel to butt: While standing straight, heel-toe your legs close together. Pull your left heel towards your buttocks, using your left hand to help you do so. As you bring the heel towards the buttocks, press onto to your toes of the standing leg and reach upwards towards the sky with your free arm. Be sure to keep your chest up and your pelvis/front of your hips forward to keep your back straight. Stretch should be felt in the front of the leg and hip on your left leg.

Heel to butt

  • Knee to opposite shoulder (piriformis stretching): Standing straight, draw your left foot up, using your left hand to hold your knee and your right hand to hold your shin. Slowly pull the knee and the shin simultaneously towards your right shoulder. Keep your torso/chest up and don’t lean backward. Stretch should be felt in your left buttocks.

Knee to opposite shoulder

  • Lunge and reach: Step your right leg forward into a lunge and keep your chest and torso straight so you’re not leaning forward. You can either bring your left knee down to the ground or let it hover just above the ground.
  • Next, reach your left arm straight up and a little over to the right, so your hand is over your head. A stretch will be felt in the font of the left hip and possibly on the left side torso. Additionally, think about gently tucking your tailbone under your hips, so you slightly decrease the curve in your low back.

Lunge and reach

  • Lunge and twist: Perform the same lunge as the “lunge and reach” but instead of reaching overhead, twist your torso slowly toward the front leg. Stretching should be felt in the front of the down hip and in the torso on the same side.

 Lunge and twist

  • Inchworms: Starting in a push-up position, keep your hands in a fixed position while walking your feet toward your hands. Keep your legs straight and attempt to drive your heels into the floor. This stretch should be felt in the back of your legs and calves but not in your lower back. Think about your low back staying flat and stop performing the stretch if you feel any pain.

  Inchworms

  • Side lunge: Begin by standing straight and then take one large step wide sideways, making sure both of your feet are pointing straight ahead. Then, bend one knee and shift your weight onto the bent leg while keeping the trailing leg straight. Continue to lean into the leg with your chest only slightly forward until a stretch is felt on the inside of the straight leg.
  • To achieve greater stretch, attempt to drop the inner portion of the straight leg hip towards the ground. Repeat the same sequence on your other leg.

Side lunge

  • Inverted Hamstring: Start in a standing position with your arms straight out, forming a “t” at shoulder level. Slowly lean your chest forward with your back flat and one of your legs kicking off of the ground behind you.
  • The chest, back, and leg should move as one in a straight line until a stretch is felt in the back of the standing leg. The standing leg can be straight or slightly bent to your comfort. For this stretch, progress backward to reach 10 yards.

Inverted Hamstring

  • World’s greatest: Lunge forward with your right leg, keeping your left leg as straight as possible. Allow your chest to drop toward the right knee while keeping your back straight. A stretch may be felt in the front of your left leg’s hip.
  • Next, bring your right arm/elbow toward the heel of the front leg, connecting your bent elbow with the inside of your right ankle. This will allow for a greater stretch of the same area, but be sure to keep back leg straight.
  • Next, place both hands on the floor, on either side of the right foot.
  • Finally, try to straighten your right leg while keeping your left leg straight and your hands on the ground. You should feel a good stretch on your right leg, without pain.
  • Come out of this stretch by bending the right knee, shifting your weight into the right leg, and standing up.

Worlds greatest

  • Opposite hand hamstring straight leg kicks: Keeping your chest up, gently kick your left leg up, with the knee straight and facing the ceiling and your toes flexed. Put out your right arm straight in front of you, palm down, and aim your left foot to your extended right palm.
  • Kick as high as you can without pain. A stretch should be felt on the back of the kicking limb. Make sure you don’t allow your back to round forward.
  • Spider-mans: Starting in a push-up position, attempt to bring one of your feet to the outside of the extended arm on the same side, allowing the knee to bend. Keep your hips and chest low and squared to the ground the whole time.
  • Next, walk your hands forward while dragging the extended leg and keeping the forward leg foot still. Continue to walk your hands forward until you return to the starting push-up position.

 

One of the best ways to avoid time-consuming injury rehabilitation is incorporating a dynamic workout. Remember to contact a physical therapist or other sports medicine specialists to tailor one to your body and activity.

Are you interested in a dynamic warm-up? Schedule an appointment with us to get started.

References

Woods, Ak & Bishop, Phil & Jones, Eric. (2007). Warm-Up and Stretching in the Prevention of Muscular Injury. Sports medicine (Auckland, N.Z.). 37. 1089-99. 10.2165/00007256-200737120-00006.

Patel, D. R., Yamasaki, A., & Brown, K. (2017). Epidemiology of sports-related musculoskeletal injuries in young athletes in United States. Translational pediatrics, 6(3), 160-166.

Yahtyng Sheu, P. L.-H. (2014). National Health Statistics Reports: Sports- and Recreation-related Injury Episodes in the. Hyattsville, MD: U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES.