A question I often get asked is, ‘can I keep training with this injury?’. Many of my patients are passionate about their fitness pursuits, and the thought of missing a week or more of training is upsetting to them.

 

I can sympathise with this because I love to train too. I am currently training for an ultramarathon, and during my plan, I have had three niggles that I was convinced would stick with me until the race.

 

Well, thankfully, the short answer is, ‘yes’, you can train through injury. In my case, I made a few adjustments to my plan, and I was able to keep up with my weekly mileage whilst the injuries recovered. I am now back to running injury-free and I didn’t take any rest.

 

Before we get into it, I want to make a little caveat to this article; the advice here should be taken carefully. Some injuries should be rested, and I do advise this from time to time. I will try my best to explain how to train through pain, but if you are ever in doubt, seek advice from a professional.

 

With that said, yes, you can train through (most) injuries. The reason for this is that science is starting to realise that recovery from injury largely happens in the brain. There are cellular changes that need to happen locally in a damaged tissue, which is facilitated by the nervous and immune systems, but the way the brain processes what has happened and how it coordinates the body in response to the injury is perhaps a more important factor in one’s recovery.

 

When you are training, you are sending information up to the brain that helps it reconfigure your movement patterns, and this also helps coordinate the response from the immune system.

 

The other important benefit of continuing to exercise is that you are staying strong. Strength (or lack of it) is the number one predictor of one’s risk of injury. It’s important to note that strength is task-specific, so if you are a runner, it is important to stay ‘running strong’, and the best way to do that is to run!

 

The way I think about problems in the body is that if we are taking two steps forward and only one step back, we’re winning. So the goal when training is to not aggravate the system so much that you’re taking two steps forwards and two steps back.

 

If you are injured, I have a few rules to follow which should help you win the battle:

 

  1. Try to find a way to adapt your training to not aggravate the injury. With gym work, this is easy because you can always take out the movement patterns that aggravate the pain. For example, if you have a shoulder injury that doesn’t like overhead press but can cope with bench press and pull-downs, you can keep training your shoulders by avoiding the overhead press movement. Often, strengthening the joint with planes of motion that don’t cause pain will help the plane that is struggling.

    You can play with other variables too. Reducing the load, the speed and the range of motion can activate the muscles and joints in a way that is safer. Over time, you can increase these variables back to their original levels.

    With running, this can be a bit trickier. One of my injuries was a foot problem which caused stabbing pain in the ball of my foot each time it hit the ground. This isn’t ideal as a runner because my feet often need to hit the floor! I found a way to manage it, though, by changing my gait to more of a ‘waddle’, running on trails instead of roads and reducing my speed. Although this was a much slower run, I was getting the miles in, which helped me stay on track for the ultra.

 

  1. Pay attention to the first few minutes of your session, and things should get easier. If they progressively get worse, that is probably your body’s way of asking you to stop. Most problems get a bit easier when you are warmed up, and this is a sign that you can continue, but listen to the language of your body and stop if you need to.

 

  1. Get treatment and do the rehab. Getting a good diagnosis, hands-on treatment, and personalised exercises from a professional can help accelerate the recovery process. The body is a healing machine, and anything we can do to enhance the body’s natural power will increase the likelihood that an injury will recover even if you are training on it.

 

Are there any times that you shouldn’t exercise through injury? Yes, of course! Everything I have spoken about above involves adapting your training in a way where you manage the pain to prevent it from getting worse. This often involves reducing the intensity significantly to find a level of training that works for you.

 

Sometimes, however, this isn’t possible. This is why I often advise my patients to avoid matches, races and team events where the intensity is out of their control. It’s one thing to train on your own in an intelligent, controlled way, but another to ramp up the intensity and put your body at risk.

 

If pain and injury are holding you back, we can help in this clinic. We also like to discuss lifestyle factors, not just to get you out of pain but to live a healthy life with well-being as a priority.

 

Our shoulder is the most mobile joint in our body. A remnant from our tree-swinging ancestors, now it’s a joint that enables us to use our dextrous hands as the brilliant tools that they are.

If our shoulder is out of action, life suddenly becomes quite hard! Manipulating the space around us with our hands becomes much more difficult and we realise that our shoulder plays a role in pretty much everything we do. Even laying on them when we sleep can become a problem!

What Is ‘Frozen Shoulder’?

One of the more debilitating shoulder injuries is the so-called ‘Frozen Shoulder’. All the joints in our body have a bag around them called the ‘capsule’ which holds in the fluid. The capsule of the shoulder has folds in it like a curtain so that when we reach our arms overhead the capsule can stretch. In a frozen shoulder, the folds become sticky and inflamed and can be incredibly painful when you reach up. Movement becomes limited and the hand can barely be lifted above waist-height.

Frozen shoulders mostly occur between the ages of 45 to 60 and are more common in women than in men, but this is just a guide because I have seen them in many demographics.

They normally come on after an injury like a fall or an unexpected reach, like catching a falling glass, for example. What normally happens is that the shoulder aches for a bit after the incident which the patient thinks is normal, but then it continues to tighten up over the next few weeks and doesn’t seem to improve.

The Mind/Body Link

The really interesting thing about frozen shoulder is the link with the mind. This was summarised beautifully by one of my mentors when he said simply, “animals don’t get frozen shoulders”.

When we look at the difference in the stress response of humans and other animals, it’s got nothing to do with the chemistry that goes on in our body – that’s the same. The major difference is the time we suffer for. Animals fight, prey, chase, run, but then they go back to their life. Humans have bills, relationships, colleagues and rush hour traffic to contend with and our stress response can last months or years.

The link between our mind and our body is still not fully understood by science, but there is certainly a known correlation with problems like frozen shoulder and stress.

How To Treat It?

With this in mind (excuse the pun), what do we do about it?

Well, frozen shoulders have three phases known as ‘freezing, frozen and thawing‘ which relate to what is happening to the capsule and how much inflammation there is. The rehab and exercises needed in each phase are different so it’s important to have a clear diagnosis and make sure you are not doing something that will exacerbate the problem.

Minimising Stress

I also speak to my patients about managing lifestyle stress. Our body can’t speak to us in words, just symptoms, and something like a frozen shoulder can be our body’s way of saying “slow down”. Take note of the stressors in your life and see if you can minimise them. Maybe there’s a conversation you need to have with a loved one, or you may need to ask for help in your work or you might be doing everything for everyone else but not have any “me time”.

This may sound strange that there is such a strong correlation between stress and frozen shoulders, but I have yet to find an example where this isn’t true.

If you have a frozen shoulder, firstly deal with the mechanics by seeing a specialist who can tell you what phase you’re in and give the correct exercises for your stage of the injury. But you also need to look after your mind. Take time each day to relax – mindfulness meditation is the best form of this using an app like Headspace.

Ask yourself, “what is my body trying to tell me?”, because if you are honest and really listen, you will know the answer.

Get In Touch

If you need help with a frozen shoulder and want to take a holistic view, get in touch at [email protected] or you can call on 01245 522360 – we are here to help.

Have a healthy month!