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The Exercise "Special"ist (Part 3)

Welcome back! Thank you for joining me for Part Three. In today's segment, we will be addressing another group of individuals who spend countless hours becoming "special"ists in a specific sport. The ones to which I am referring here are called athletes. Now while we think of these people as professionals shown on television, not everyone fits in this category but is indeed an athlete in their own way. In fact, a very small percentage of human beings are seen in this light and what they do is what makes them so special. However, the endless daily workouts a recreational gym bum puts in should not go unrecognized. So, for the purpose of this blog, and the direction I'm hoping to go with it, I am referring to an athlete as someone who partakes in regular physical activity whether it's a full-time job or merely a hobby.

It takes a lot of commitment and tedious repetition to learn and perfect a skill or reach a fitness goal. But what happens if, somewhere along the way, an injury occurs and throws a wrench in training? Depending on the severity of the issue it could take days, weeks, months or even years to fully recover putting plans on hold. So what can be done in the interim? Just like the infant born with a "defect" or wounded warrior we met in Part 1, there are ways to work around (or with) whatever body part is affected. My hope, by the conclusion of this series, is not only to show how to get up, get out and get moving but also to keep up (your fitness levels), keep out (of doctor's offices and hospitals) and keep moving (forward) despite obstacles that pop up during our journey.

Many times it is not an issue of "if" but rather "when." While in most cases an injury is a temporary setback, it can have lasting effects on movement patterns due to compensating factors during the healing process. In these incidents, the focus needs to be on regaining range of motion (ROM), retraining the connective tissues and muscles in the area, and strengthening the entire kinetic chain to reduce the chance of re-injury.

When ailments occur due to exercise, there is usually pain and swelling that signal rest is required. This, for some, is the hardest part of the recovery, but is by far the most important for the initial 48-72 hours. Both symptoms listed above can cause a body part to become hurts so you don't want to move it...and swelling that makes moving it difficult. These are best treated with RICE-rest, ice, compression, and elevation and can take several days or more to dissipate so please be patient with your body and know that all activities involving the affected body part should be avoided. More severe injuries such as dislocations, fractures, or subluxations may mandate splinting or even surgery. Extreme cases like these take additional recovery time. Each individual's timetable will vary so as I have mentioned in past blogs, there is no exact date or one size fits all strategy for returning to pre-injury status or sport.

Once a person is pain and edema free and limited movement has returned, it is at this point the rehab portion can begin. Establishing a full range of motion prior to initiating a strength program is imperative because if you can't freely use a joint, how will you be able to exercise or play effectively? Using passive techniques performed by athletic trainers, fitness professionals and/or physical therapists are beneficial in improving movement patterns. Gravity aided activities help improve ROM by decreasing the strength necessary to perform an exercise and rely on the natural force of the earth to complete them. For example, a frozen or post-op shoulder can gain as much as 10° (or more) of flexibility in one session by doing a front raise lying face up on a bed or table. The further above 90° one achieves, the more gravity takes over and pulls the arm and hand downward and toward its desired target. As with any activity program, alterations and progressions can be made to ensure goals are being met.

The next two phases of the "return to sport" I think are the most fun. Beginning a strength training routine makes one believe they actually will get better and that there really is a "light at the end of the tunnel." Earlier in this writing I mentioned retraining the affected part. You may remember from a previous article that because the whole body works as a unit, it is virtually impossible to isolate only one section. So in reality, if you tore up your knee, you would have the ankle, lower leg, hip and lumbar spine contributing to the rehabilitation as well. To lessen the "takeover" so to speak healthy body parts have, doing active or active assistive movement in a seated position can drastically affect your results. The strength portion of recovery will include full body weight bearing exercises so they need not to be of primary concern yet. An isokinetic Cybex quad extension machine is helpful because it can be adjusted to each persons specific body proportions and can provide variable resistances throughout each degree of movement. In a nutshell, it optimizes ones strengths and develops their weakness at the same time. Other things that can be done here are riding a stationary bike with little to no resistance, Terminal Knee Extension (TKE) exercises over a Pilates ball or rolled towel and wall sits which emphasize periods of a static hold.

Approaching the final stage and return to normal, basic fundamental movements should be automatic and executed without deviations or thought. With a physician's approval, the use of bands for rotator cuff exercises, bodyweight for core stabilization and lower body work, BOSU balance trainers, light dumbbells for bicep curls and triceps kickbacks and medicine/stability balls for plyometric training can mean your injured days are nearing their end and the freedom to do what you love is right around the corner.

So yes, get up, get out, and get moving. Just proceed with caution and seek advice from a corrective exercise specialist, doctor, fitness professional, personal trainer, or physical therapist if unsure of what is okay or not or what you can do. Keep in mind that although the initial issue has, for the most part, been alleviated, a flare up can occur without warning, so it is always a good idea to take what you learn throughout the healing cycle and include it in your everyday regimen to prevent future problems.

None of us like the annoyance and inconvenience of injuries but, like any well-oiled machine, athletic "special"ists bodies don't come with lifetime warranties. Hopefully by knowing your own body, listening to it, taking time off when it breaks down, treating it properly, and understanding its limits, it will require fewer trips to the repair shop. Join me again next week for the finale when we get to know the most "special" people of all. I leave with you this one final thought:

"Everything is possible as long as you put your mind to it and you put the work and time into it."----Michael Phelps

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