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When you've been told to take time off.

This is a story that most of you will be able to empathize with. It’s the story of “Joe,” who started training for a race 4 months ago. Now, he is panicking because he’s only 2 months away from the event, and he can hardly run due to the pain in his leg. When asked about how his problem started, he tells the story about a small ache in his calf that slowly progressed, and an initial fear of time off that kept him from seeing someone about it before. He tells me that he grew up hearing about how, when you’re injured, you are supposed to “R.I.C.E.” andthat we (healthcare providers) would have told him to take 2-3 weeks off and then slowly build back up to running longer distances. He also stressed how he was afraid of the looming race and how time off would potentially put him behind his goals. Now he is frustrated and feels like he’s going to be forced to take time off. He is similarly worried that he won’t even be able to compete because of his pain. 

This is also the story of “Jane,” who has recently taken up barre classes and is now feeling a “pinch” in the side of her hip when she walks. She knows that she should take some time to rest, but because of her upcoming wedding, she wants to keep exercising.

Furthermore, this is is also the story of “Jim,” who was a college quarterback and now has been experiencing pain in his throwing shoulder each time he goes and plays rec league football. He can’t understand how he lost so much strength over the years when his shoulder was once so strong. He decides that he’s going to take some time off and then build up the strength in his shoulder so that he can play without pain. 

If you’ve been around athletics for any amount of time, you can likely diagnose all of these injuries as “overuse injuries” or, as emedicine.com describes them, “cumulative trauma disorders.” All three assumptions are correct; taking time off and using the “RICE” protocol are viable options for getting rid of pain. The problem with this type of thinking, however, is that it assumes exercise is traumatic and should be feared. It also assumes that rest is the only option for treating “overuse injuries,” and that strengthening the area in pain is the way to keep the discomfort away. 

Naturally, I would like to add the disclaimer that there are times in which rest is essential to healing, that continuing without listening to your body can be hazardous, and that strengthening injured areas can also be helpful once inflammation decreases. But most importantly, there needs to be a paradigm shift. Instead of referring to them as “overuse injuries,” we should call them “underuse injuries,” which will help us see exercise as beneficial instead of traumatic and exercise as part of the solution. This will help diminish the fear associated with strenuous activity and fitness. It will also allow us to see that simply sitting on the couch for 2-3 weeks is not the only option and you can continue progressing towards your goals if you change your approach.

Let me explain. Joe started running and his calf was asked to do more than what it was capable of at the time, not because of weakness in his calf, but because of limited extension and internal rotation in his hip. In laymen’s terms, he overused his calf because he underused his hip. Jane started barre and started having pain in the outside/front of her hip because she was compensating and overusing her TFL and underusing her glutes. Jim started throwing again and had pain in his arm, and although his strength was not what it was in college, his primary issue was that his footwork and core weren’t helping as much as they were when he was in college. Essentially, he was overusing his arm and underusing his feet/core. Each of them were back to their desired activities quickly and without pain because their paradigm shifted and they took control of recovery instead of passively letting time pass. 

If you struggle with “overuse” injuries, it may be time for you to do the same. If you’re struggling with injury and feel that rest should not be the only option, T-Zero Physio is for you! To find out how you can take a more active approach to recovery email tzerophysio@gmail.com or call 909-573-3550 to find out more information.

“Enhance Movement. Enhance Life.”