Now more than ever with months trapped inside without serious physical activity, we are starting to get an influx into our clinic of tendon and muscle injuries that fall under the “overuse” category. Each of these has had a similar story behind it as well. As our old lives become more accessible, let’s talk about how to get back to physical activity safely!
One of my favorite truisms in sports injury is that “most injury comes from doing too much too fast, often after doing too little for too long”. While certainly not always the case in every injury, it certainly applies to a great deal of my caseload right now! Stop me if you’ve heard this one before: “Well obviously I couldn’t be as active as normal because of [workload, quarantine, etc], but now because of [more time off, reopening of my gym, etc] as I’m trying to do the stuff I was doing before, my [knee, ankle, hip, back] are starting to bother me a lot”.
When looked at through that lens, it becomes very easy to match that pattern. But it can be extremely frustrating! How can I lose so much so fast! To be honest, we’re still learning a lot about that. The most common reference point we have for deconditioning is in athletes, who at about 2 weeks off of training seem to take on average about 4 weeks to return to their prior levels of training. The exact rate and number of these conditioning losses is hard to pin down. Particularly because it is not very scientific to extrapolate professional athletic conditioning levels to me and you, but it does give us a big picture to look at. After a very short amount of time, it is possible to lose a great deal even if we are in the best physical shape in the world!
Keep Charging On
But don’t be discouraged! Just because not using it makes us lose it does not mean we can’t get “it” back! As illustrated above, returning to physical activity can sometimes be slow, so how do I know where I should start?
I usually have people cut their workload in half in order to see how they respond. Used to lifting 200 pounds? Back off to 100. Used to running at an incline of 6.0? Start at 3. Used to walking a mile? Hopefully you see where I’m going with this 😉
You may very well find that this is too easy! Well that’s ideal, that means we can incrementally build back up! Next session, try adding a couple of pounds, a couple of minutes, or a grade of incline. But this growth should be slow, because you are often looking not just at your body during the workout, but how it feels the next day or so after! If you start to get an unfamiliar pain that does not seem like typical post-exercise soreness, you may have worked at too high a level and need to back down a step or two next time. Spend a few more sessions at the asymptomatic level before building back up! You may require more or longer rests than before as well depending how long you have been out of it, and that is okay too!
Depending on how much time you’ve taken off, this might be a bit of a road, but you can get back! Start slow, start kind, and increase as your body allows for a perfect return to physical activity!