Pain is a problem, but is it the real problem?

“My friend got back pain from doing this exercise. His back also hurts if he does that exercise and he doesn't do squats because they hurt his back”

This is a paraphrased version of a real conversation earlier today.

Now, let me ask you a question

Do you think the back pain is the problem or a symptom of a problem elsewhere?

I know I haven't specified the exercises, but they're all hip dominant movements.

Is the back the problem?

I don't think so.

Very often pain will present in an area that is being over stressed.

And it's over stressed because that work should be spread out over a wider area, but something somewhere isn't pulling its weight.

Kind of like having a team but only one or two members are grafting, the rest are cruising and one or two just didn't turn up!

We've all been there….

This is why I spend so much time looking closely at how people stand and move when they come into me with pain.

It's also why I ask so many questions about your history

What sports and training you have done.

What your Job entails, including stress levels

And a run down of old injuries as far back as you can remember

The more information I have, the better we can price together the action problem and come up with a plan rather than simply treating symptoms or avoiding them all together.

So many people have come to me with issues that have seemingly crept up on them out of nowhere.

Back pain being the most common.

But on investigation we find old head injuries, sprained ankles, a broken collar bone from 10 years ago, a family history of pain in the same area.

All of which suggests the pain isn't the problem

The back [or region of pain] is actually a victim.

Yea, of course sometimes the problem is actually the problem.

Especially if there is an acute injury there.

But many times we find putting movement through that old collar bone break, or that old ankle takes pressure away from the current pain site and the pain starts to lessen.

Then we teach you to put movement through the body in ways that keep the pain away.

It's simple, not easy.

But it can be done.

So often a breathing drill to manage acute stress, a reach to open the shoulder, a knee bend to challenge the ankle is all it takes

And other times it takes a training plan and a period of gradually building the body back to strength and fluid movement.

But what never changes is that it is your body, and the only person who can make a real difference is you.

All I can do is guide you

Regards

Dave Hedges

www.davehedges.net

Did Will reveal the secret to good rehab?

“I have 2 minutes all the time” - Will Garnsworthy

This is such a great line, I suggested Will puts up on the wall of his training centre.

He already has combined 2 of my quotes, “Attitude is everything” and “everything is trainable” into a piece on his wall, “2 minutes all the time” belongs beside it.

What does he mean?

We were discussing his knee rehab.

We’re in the later stages of the rehab and looking to add in some more intense exercises into the training, so moving some of the Anatomy in Motion based rehab protocols out of the training and filtering them into the day.

This works really well as we’re often trying to get the nervous system to accept the movements / loading patterns, it’s not just about tendons, ligaments and muscles.

And to get into the nervous system, we’re better off thinking along the lines of skill training, and skills require high frequency, with minimal fatigue to learn.

And this where Will dropped his magic line.

I said can fit it in through the day and he flippantly responded “Oh yeah, I have 2 minutes all the time” meaning as busy as he is running his own training centre and being a dad, there are frequent moments where he is between tasks.

So why not utilise them to get in a few reps.

5 reps here, 3 reps there, another 5 reps a bit later, then 8 reps then whatever and whatever more

Without actually adding much time and effort to the day, you could easily add 30+ reps of high quality work into a day.

That then is less work needed in your warm ups, so more time and energy to put into the training.

The goal is to be ready and able to do anything you choose to do.

Needing extended warm ups to manage injuries is contrary to this goal

So lets take a leaf out of Will’s book and find those 2 minutes that we all have an abundance of through our days.

Just like my little Meg, the 4 legged start of many of my social media posts this last while.

Meg will rest and when she is ready to get up and play, she will stretch forward and backward (up and down dog, or the Pump movement)

This is a natural and instinctual behaviour that us “smart” humans seem to have forgotten.

Take frequent moments to stretch and “pandiculate” through the day, if you are rehabbing and injury, these movements can be your rehab drills.

It really is simple, and surprisingly easy.

If you are looking for help with injury and rehab, I am still running movement assessment sessions for free in my Dungannon clinic until the end of January.

If you want to take advantage of this, book in through www.davehedges.net or hit reply

Regards

Dave Hedges

www.davehedges.net

I got annoyed by a conversation recently

Not a question today

More of a rant.

I train at my kids' hurling club gym.

It's small, but has everything I need, more or less.

Some days I am in with some of the players,which I enjoy.

And I often ask them questions about why they're doing particular exercises or offer tips for improving an exercise if appropriate.

The other day I saw one lad bench pressing with his feet up.

Before I got to ask why, one of the other lads did.

And he told us about his back injuries.

And then mentioned an old hamstring issue.

Later, it was just he and I left in the gym and he was doing some back squats.

I was impressed.

And related how my own history of back injury made the back squat impossible for me for several years.

He opened up at this point, and this is where my rant begins…

He told me he was following his sport S&C program today.

He also had a physio who gave him a rehab program that he follows, mostly at home.

When he does the physio program he is fit to play, when he stops he quickly suffers with symptoms once again.

This has been a multi year cycle at this stage

This is not rehab.

Neither is having 2 separate programs that means he has to train/rehab 6 days per week just to keep the symptoms at bay enough to play.

Physios and S&C coaches should work together as a team.

The two programs should amalgamate into a single plan

After all, both the S&C coach and the physio have the same goal.

To help the player play to the best of their ability.

This was the precise reason I had a network of physios in Dublin, we would refer clients to each other, I'd send them for initial physio and they'd send to me for continuation of that physio into a training plan and not only back to fitness, but beyond the point they were when they got hurt.

Good thinking and programming shouldn't simply mask an injury, keep it at bay so long as you are doing an hour plus a day, but reduce it as far as possible.

Granted, I prefer to use the term “injury management” because I know many injuries actually cannot be totally fixed, but we have to manage them.

But the goal is to not have to manage them, wisdom though, that tells us we can't always reach our goal.

Injury management should be simple.

A small handful of movements that can be fidgeted with through the day, used as part of a warm up and even during breaks in the sporting arena

A good S&C training program takes the rehab into account and build on it, add intensity to it. It should take the rehab and smoothly transition it into effective training.

It's not a generic collection of Squats, rows and presses, but it's a thought out, dynamic program that evolves the rehab into training and on into performance.

Yes there will be variations of a Squat, variations of a press, variations of a pull, but these will be chosen according to the athletes needs.

Done well, some injuries disappear completely in time.

Others will need some degree of ongoing maintenance.

But we shouldn't need hours per week spent just to be able to move, excepting for that initial post injury stage.

If you do get handed a plan that takes hours to follow on a daily basis, you may be wise to get a second opinion.

And if your S&C/fitness coach isn't looking at the notes and exercises the physio sent you, then consider a new coach or at least ask them to do better.

I have likened a team of coaches and physios to the spokes in a wheel. The hub of that wheel is you, the athlete.

And if each spoke does their job in conjunction with every other spoke, that wheel will roll straight and smooth.

It's simple, not easy

But you, the hub, the athlete, the person hiring these professionals to help you, you are the boss.

--

Regards

Dave Hedges

www.DaveHedges.net

www.WG-Fit.com