The “doing” can be the “fixing”

Simply participating in the activities you love (what I might sometimes call the ‘goal task’) is important – whether it’s jogging, martial arts, weights, gardening, walking, or ten-pin bowling! What’s neat about the rehab process is that sometimes you can simply perform the goal task as the rehab exercise by manipulating any relevant variables you want.

Often I’ll have someone come to me who has experienced some pain with the deadlift. And almost always we’ll start by finding a tolerable deadlift for them to do by simply manipulating variables while avoiding breaking pain rules (pain during, pain after, pain trend over time). Perhaps we decide to:

• change to a dumbbell (DB) deadlift (with a single DB between your feet), 
• place the DB on a box (reducing the range of motion [ROM] used), 
• adopt a more upright/sumo stance (widen your stance and point your toes out more, an example of changing form)
• Increase rest periods between sessions (DB deadlift ~1-2x/wk)
• and lighten the load (% of 1 rep max)

We’re cooking, not baking. This means some freedom and flexibility rather than following a rigid recipe.

These are just options. There are heaps of things you could change. Perhaps you keep everything the same except you change to a trap bar. I know some clients prefer to change one thing at a time so they can have some idea of what has actually made the difference for them.

And it’s very often the same thing with running. If your goal is to run 10km without pain (and you can only run 5km currently), the rehab exercise can still be running. It doesn’t need to be a fancy rehab exercise program. You may need to perform some trial and error in manipulating variables to gradually increase your capacity to tolerate the goal task (10km of pain-free running). Perhaps you decide to:

• shorten your stride lengths (manipulating form), 
• reduce your pace (manipulating intensity), 
• and increase the rest periods between sessions. 

Running got you into this mess and running can get you out of it

Greg Lehman

Running is just a stimulus that can catalyse adaptation. And nothing prepares you for your goal task like… just performing the goal task! If you hurt your shoulder throwing a jab, the rehab exercise can still be punching! Perhaps you decide to temporarily: 

• hit the bag or pads and avoid live sparring (limiting degrees of freedom), 
• throw with reduced power and reduced intensity of effort 
• change the punch to one that’s not provocative (try a lead hook) 
• and increase the rest periods between training sessions

In all of these examples (and they are merely rough examples), you are slowly building your capacity to tolerate the desired movement/exercise/task by modifying something about it. You have a lot of options when it comes to manipulating variables and the above is merely a suggestion. And remember, this process involves trial and error (cooking vs baking), and you may cause a flare-up! But don’t worry – it’s a part of the process and the learning!

My quick takeaways

1. Find what you can currently do and do that

2. Slowly progress the activity

3. Avoid super aggravating things that cause big pain flare-ups, but then gradually add them back in as your symptoms plateau or improve

4. Progression is rarely linear. Flare-ups are normal

5.  It’s okay to lean into pain (just don’t be stupid about it) and it’s also okay to back off. It can be difficult to know when to do which but that’s where we can help!