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Movement Modification

When recovering from injuries like this, it helps to be stricter with your movement and position. Reducing the length and eccentric contraction of the hamstring during a lift can take stress off the muscle as it heals; and allow you to continue to train. Anterior pelvic tilt/lumbar extension is necessary to lift heavy weights, but increased anterior tilt puts more stress and stretch on the hamstrings.   So it may be necessary to bring the pelvis back underneath you a little bit more, to a more neutral position. This can be done by posteriorly tilting the pelvis. Now, under load, you do not want to perform that posterior tilt to the point of lumbar flexion, obviously. However, if you are recovering from a hamstring issue, a slight posterior tilt to neutral can make a profound difference in your symptoms.   As your injury resolves, you will slowly be able to increase the amount of anterior tilt you are able to tolerate.

In addition to modifying your pelvic position during your lifts, modifying the lifts themselves can aide in keeping you in the gym, while dealing with a hammy. For the squat, this is where a box comes in handy to reduce the depth and allow you to control your position easier. This doesn’t mean that you sit way back and try to keep your shins vertical, with your toes off the ground. Keep your squat movement the same. The box will just allow you to squat to a depth that’s comfortable, and will also allow you to control your pelvis.

You can also use the pins and perform Dead Squats. Set the height of the pins at a height you are comfortable with, and get under it to the point where you feel balanced and stacked, then explode up. Again, this decreases the eccentric loading, but still allows you to feel some weight. Here’s a video.

This is how I felt in 2009, and again in 2010. I tore my right ACL, then followed it up 15 months later with a left ACL tear while playing premier and collegiate soccer. On top of this, I was dealing with the pain associated with spondylolysthesis (spine injury) and battling bouts of flares from Systemic Lupus Erythematosus. Two knee surgeries, a few back procedures, dozens of doctors appointments, and many days away from training, I was certain my athletic career was over.

Five years later, I’m deadlifting 405, benching 165, and squatting 315 pain free. My body is stronger than it ever was, and I attribute this success to proper programming. After tearing my left and right ACL, I sought out the guidance of Ryan Gleason, an athletic and strength coach in Southern Connecticut. Ryan helped me rehabilitate my injuries, return to the soccer field, and even influenced my decision to become a competitive powerlifter.

I want to preface this entire article by saying two things. First, much of this article is a personal narrative of how I dealt with injury and what I uncovered about competing, programming, and even myself in the process. Second, what is written here is not medical advice. If you are struggling with an injury, seek out the help of a medical professional, and contact a trainer who has experience working with athletes who have sustained injuries. If you need help, check out the Clinical Athlete to be directed to a medical professional who will understand your goals and aspirations.

Ryan’s first and most important rule: if it hurts, stop. This stuck with me for a few reasons. First, I was always someone who pushed my limits, regardless of how I felt. I had the all too familiar ideology, “no pain, no gain”. Push through it until you can’t push any further, right? This is the furthest thing from the truth. If it hurts, STOP. Now don’t get me wrong, there is something to be said for people who can work through discomfort. However, there is a HUGE difference between pain and discomfort. Take the time to get to know your body (although pain should be a fairly obvious feeling) so that you can easily differentiate between the two. Pain is a direct neurological response your body uses to tell you that you are risking injury, and should therefore stop what you’re doing because you may be inflicting harm. When you have pain, you oftentimes also have inflammation. You don’t necessarily need to SEE swelling to have inflammation, which is your body’s way of protecting itself from harmful biological agents. Allow your body to thoroughly rest and recover before pushing yourself to do more. Your program needs to incorporate plenty of time to rest as you rebuild your athletic stamina. This might mean going to the gym 3 days a week to start and increasing the amount of time you lift as your healing/muscle building progresses.

The next critical component of proper programming post injury is to incorporate strategic exercises that isolate the muscles you are attempting to strengthen. For my knee injury, I focused on unilateral, or single leg work. The type of exercises ranged as well; non-weight baring exercises, body weight, resistance movements, functional movements, stretching, and weight training were all incorporated, depending on my goal for the day. The major focus areas were functionality, strength and hypertrophy. Because the unilateral exercises were minimally eccentric, I was able to recover quickly, allowing me to do more. Most of the work mentioned here took place about 2 months post surgery, after proper mobilization, flexion, and extension have been achieved through my work with physical therapists. A typical lower body training day for my post-ACL tear had various combinations of the following:

Warm-Up / Foam Roll / addition of light plyometric exercises as strength increases
3×10 Single Leg Box Squats
3×10 Leg Extension with resistance band
3×10 Side Step with resistance bands
3×12 Lunges – progressively adding weight
3x 8 Step-Ups
3×10 Glute Ham Raises

As I became more comfortable and some strength was regained, the following exercises were incorporated:

Glute bridges
Goblet Squat
Romanian Deadlifts
Calf Raises
Reverse Hyper
Back Squat

Of course there are a multitude of other exercises that could be added to your rehabilitation program. Please seek a coach or a physical therapist that can help you in exercise selection.

My back injury, spondylolysthesis, is a chronic, degenerative disorder in which the vertebrae are fractured and slip out of place. To treat my spondy, I have continually sought out medical treatment. My medical team includes a physical therapist, my strength coach, my chiropractor, my orthopedic doctor, and my massage therapist. These individuals work together in conjuction with me to ensure I am pain free and preventing further injury. With the help of my team, I have been able to identify movements and activities that aggravate all of the muscles associated with my condition. Weight training, luckily for me, happens to NOT be one of them. In fact, proper programming for my back injury has actually improved my symptoms and strengthened the surrounding muscles so that I am able to do more than I was previously able to do. Examples include: Deadlift, good mornings, low bar squats, sumo deadlift, glute ham raise, 45 degree back extension, deficit deadlift, and chest supported rows. One key factor here is that these exercises will not help you, and may even hurt you further, if you do not execute them with proper form. This is critical. A typical initial back rehabilitation training day for me looked like this:

Warm-up / Foam Roll / light plyometric exercises
3×10 Military Press
3x 5  45-Degree back extension – the amount of reps dramatically increased throughout a cycle

3×10 Chest Supported Row

3×10 Med Ball Circuit (straight leg sit-up, toe touches, russian twist)
3×10 Glute bridges – add marching as you advance
3×3 30 Second Planks alternating sides (forward, left, right)

Deadlifts and Good Mornings were added once pain was properly managed.

Again, there are a multitude of other exercises you can choose to maximize stabilizing and strengthening your upper, mid, and lower back.

My training has consistently focused on strengthening my back, continues to incorporate exercises that help prevent pain, and allows for proper physiological functioning.

A component of my training that still poses challenges is completing cardio. Whereas I used to simply run, I now have to be very strategic with my cardio. Things like thrusters, jump rope, kettle bell swings, and running cause significant pain and tightness. I tend to avoid any exercise that puts high stress on my low back. Any dynamic movement that requires the force to be absorbed by the spinal column has to be avoided. My cardio program now consists of circuits that are high intensity. One of my favorite intervals looks like this:

Ropes – 30 seconds

Rest – 20 seconds

Wall ball – 30 seconds
Rest – 20 seconds
TRX Pike into pushup – 30 seconds
Rest – 20 seconds
Rower – 30 seconds

Repeat 3-6 times with maximal intensity.

I recommend doing this with a few other motivated friends because it really sucks otherwise. If you need more ideas for creative cardio, I suggest Jen Sinkler’s book, Lift Weights Faster. She gives tons of quick circuits and cardio ideas that are powerlifter friendly.   

Bracing and breathing have played a critical role in my training regimen. Dr. Quinn Henoch of Darkside Strength has designed a program specific to my condition and my goals. When programming around your injury, you need to remember that weightlifting is not the only component that needs to have a focused program. My bracing and breathing program incorporates hip flexor stretches, increasing my range of motion with hip extension, pelvic control, increasing tolerance to braced extension, improving the squat pattern, and core stabilization. It it imperative to uncover the root of the problem that caused your injury, and take the time to then correct it. Giving yourself the necessary time to improve physiological function will prove beneficial for future success in lifting.  

The last, and in my opinion, one of the most valuable parts of programming around your injury is rebuilding confidence. I distinctly remember my first time getting back onto the soccer field after my ACL tear. My emotions were raw, overwhelming, and uncontrollable. I was filled with angst and excitement, fear and anticipation, all at the same time. The same goes with getting under the barbell again for the first time. Returning to squatting and attempting heavy singles after one of my many back procedures was a defining moment for me. It was a sort of, “make it or break it” scenario. My heart was beating in my throat and even if I wore metal armour I would not have felt safer under that bar. My confidence was faltering; I had been away from squats for so long. But with each successful rep, I felt better, calm even. I was slowly restructuring my mental game. I say “restructuring” rather than rebuilding here with purpose. I was not passively gaining confidence. I was mentally building myself up.  I was explaining to myself that I am adequate, ready, and strong enough to be successful again. I was rethinking how I felt about the iron. I was distinguishing pain from discomfort. I was composing myself before each squat, creating new, improved cues for successful execution, and positively reinforcing each motion. I was actively building mental stamina. This factor often goes unnoticed and undiscussed in athletics. However, I feel that a great strength coach will build a successful program for those recovering from an injury only if they can anticipate the feelings of their athletes, whether or not they show those emotions. Choosing an adequate recovery pace, very discrete training cycle goals, and providing mental and emotional support to the athlete needs to be indispensable when creating a recovery strength program.

Summary:

Properly programming for a lifter after they’ve sustained an injury is crucial to their success on the platform long term. Returning from an injury is not a rapid process, and the athlete’s program must therefore provide short term and long term goals for sustainability. The program must also focus on improving the athlete’s functionality and strength. Resist overload work in the early stages, and include lower weight hypertrophy training. Ensure to focus on the root cause of the injury, and use both medical and strength training strategies to physiologically correct the problem. Work on injury prevention techniques, such as breathing and bracing in order to continue executing lifts with proper form, even after the athlete has recovered and is back to lifting heavy weight. Finally, remain positive throughout the process, so that your athlete is also positive. Not only is the brain creating neurological connections that result from repeated and corrected movement patterns, but also from the way the athlete is thinking and feeling about his or her training.

Cover Photo by 9for9 Media

Being able to maintain hard training as you work around injuries is critical to maximizing long term strength. Dr. Quinn Henoch and Chad Wesley Smith show you some effective ideas to help you keep your squat moving while you deal with common setbacks.

When we finally return to a consistent training schedule, we very mistakenly believe that we were able to sustain the level of strength and fitness with our sporadic training schedule and quickly get discouraged when we find the opposite is true. But still we plow ahead, banging ourselves up until we get hurt or completely regress. Sometimes returning after training

Even if we pretend like it’ll never happen to us, at some point career or family will distract us completely from our training. But instead of jumping back in it and using the same intensities and volumes we were working with before the break, you need to have a plan on how to build the strength and fitness you lost back. So here are some guidelines to help you evaluate yourself, guidelines to keep you safe, and a plan to build yourself back in a much more effective and practical way from either a long hiatus or from just a week of missed training sessions.

Lower The Volume More Than You Think Necessary

First we’ll tackle how to handle training after an extended period off. After returning from some time off, sometimes you can feel just as strong as before. You may think you can exhibit the same levels of strength with the same volume, and maybe you can. But that doesn’t mean you should. Just because you feel strong doesn’t mean you’re body is prepared to handle the same workloads. Your body, the musculature and connective tissues, are de-conditioned. It’s not used to handling the same stress of those kinds of loads with the same frequency you were just a few months earlier. You need to admit this to yourself.

Anytime, as a college strength coach, I had an individual athlete returning from an injury or personal time off, I’d tell them to do half the volume of work I had planned for the rest of the team.

You haven’t been practicing the skill of lifting weights and you most likely will have less than optimal movement patterns initially, despite your extensive background. The deficiency in technique will put more stress on the working musculature and connective tissue especially as you try to work with the heavier loads that were once routine for you. The more unnecessary fatigue and stress you put yourself through, the great chance of an overuse or acute injury soon after returning to training.

Try this instead: Consider how much total volume you feel you should start with and then cut it in half. Even if you choose to use the same weights you were using before your break, outline a plan on how you’re going to progressively increase volume from this starting point. Write this down before you begin training so you’re not winging it each week. You may think you’re increasing volume by the same amount each week but we’re all very good at lying to ourselves and without this concrete plan in place we’ll probably over or underestimate what we’re actually doing.

Keep To Submaximal Training

Forget about what training style you prefer or what methods you believe are best for training. You’re rebuilding and the safest and most effective way to increase strength potential and prepare yourself to hit maximal weights is through increasing workload with submaximal weights.

Just find an adequate program within those guidelines and do it, there’s definitely enough of them out there. Jim Wendler’s 5/3/1 method is great to start after a long time away from training. But if you choose to program for yourself, take Wendler’s advice of only using the minimum dose of volume needed to affect change and focus on quality sets and reps with submaximal weights. Too much too soon is what you’re trying to avoid.

Not only is a good idea to plan for your work sets to include lower loads, but basing your percentages and goal weights off of 90% of what you think you’re capable of doing in the main lifts is a sure way not to overestimate yourself. If you’ve lost weight, consider dropping that to 85%.

You may feel like the weights are too light but that’s ok. Just focus on the practice and refinement of the movements. By delaying yourself from hitting your top weights, you can increase work capacity and build greater levels of strength potential that can help push you to new levels of strength once you remove the greater volumes that you’re first working to.

Gauge Your Training With a Simple Scale

Even with a solid plan in place, you may hit some snags in your training. Even with the guideline, you may have planned for more volume than you can recover from with your current fitness.

Rather than pushing through and possibly risking setbacks and injuries that could force more time off, record how you feel after each training session and week. You can use a simple 1-5 rating scale. Record a 1-2 rating if training was easy and you felt as if you could have done more than three extra reps than what was planned on every main lift. Record a 3-4 rating if the work was more challenging but still doable and you felt as if you could have done one to three more reps on every set of every main lift without pissing blood. Finally, record a 5 rating if you felt like you were pushing max weights when you were supposed when you had lower loads prescribed.

At the end of the week, look over your training log and the scores of each day. If you’re hitting 5s on a daily basis you may have overestimated how much strength and fitness you really had starting out and need to adjust your volume and intensity accordingly. But if you’re consistently at a 1-2 rating than you’re in the clear to increase the volume and/or intensity within reason.

Recover Like It’s Your Job

Pretend like it’s the first time you fell in love with lifting during this rebuilding period. Just like you did then, take every measure to eliminate distractions and do all the mundane tasks needed to improve. Eat more frequently and eat better. Focus on picking the quality whole foods you know you need to recover and grow. Do everything you can to get enough sleep. Consistently getting eight hours of sleep will help you build back muscle and strength more than almost anything else.

Take some extra TLC during the first couple of weeks back. Block out some time later in the day after your training session for some SMR and mobility. Your body will get stiff and sore pretty fast and if you haven’t lost much strength you’ll be producing forces with tissues that aren’t very pliable anymore. You need to address this as soon as possible to make sure you don’t injure yourself or throw your mechanics off.

Pick a problem area, some particular area of soft tissue or capsular restriction, and address it every day with some form of SMR. Schedule it into your day like it was your second training session.

Increase General Strength and Fitness Qualities First

Even if you you’re an advanced lifter, any length of time off will reduce the level of specificity you need to become stronger in your preferred group of lifts. You probably don’t need to start with an intensive four time a week squat progression, even if you are a competitive powerlifter. In fact, a specialized training cycle with no room for accessory exercises or general work capacity drills can hurt more than help a lifter returning from time off.

Be safe and smart and instead focus on developing general strength and fitness qualities. Pull sleds and push prowlers. No need to plan anything too complex or intense, just a few sets of Famers walks for twenty yards at the end of training will do fine.

Remember that tissues need to be conditioned for the work load you want to sustain and lower stress activities that not only make you stronger but condition connective tissues, build muscle, and increase aerobic capacity like these do just that. With dedicated time towards these activities, you can improve general fitness specific to your goal of building size and strength so you can support the demands of specialized strength training. You don’t need to run the NYC marathon, just pick up some heavy shit and walk a little before you head to the chinese super buffet.

Learn How To Easily Come Back From A Week Off of Training

While all these tips are great to keep in mind, a lifter who’s only taken a week off from training doesn’t need to overhaul their entire program. But many people are even more confused on how to pick up again after missing only a week of training.

I’ve heard some pretty complicated ideas on how to reduce total volume or intensity based on how many days you’ve missed from some strength coaches but I’ve never seen them work for real people. After coaching my share of athletes and lifters, I found that if you tell them to repeat the previous week of training (assuming it’s a fairly linear progression) they can progress through the rest of their training cycle without a hiccup.

So if they complete week three of an eight week training cycle and they missed week four, I would have them repeat week three again before moving through the remaining weeks of training. If they missed two weeks I would send them back two weeks in their training cycle.

It’s also important to make sure you don’t go from sitting in a cubicle for a week at work to squatting five sets of five reps without a day to restore range of motion and function. Spend a day doing some mobility drills before you begin training again.

Remember You’re In This For the Long Haul, Again

Just as when you begin training, training needs to be focused on building general strength safely during the acclimation period after time off. If you ignore this and jump back into highly specific training, you may be able to reach your former working weights sooner but it will probably be at a cost. Even if it takes longer, build the base wider again so that you can build yourself up again higher than before.