I wish I could say that injuries don’t happen, but they do. Even well trained and seasoned athletes get injuries. One of the biggest challenges I see in my athletic population is how to satisfy their desire to still train at moderate to high intensity while looking after their injury. Physios also get injured from time to time, even if we lead you to believe otherwise.
So this leads me to a little case study involving myself.
For the last 3 months or so I have been battling with an injured calf (more specifically I had a 9cm tear in the medial head of my right gastroc). This happened during a low intensity run in my efforts to try and do some distance running again. I have always struggled with calf injuries since my first significant calf tear during a Crossfit workout. Workouts with a lot of jumping, burpees, sled pushes and skipping always make me nervous. The problem I (and a lot of my patients) face is that training with intensity is not only more fun, but it is also more efficient, can be more effective (depending on your goal) and is slightly addictive.
So the challenge really becomes, how do we maintain intensity while recovering from an injury? Sure you can train around an injury and still get your exercise fix which in my case could have been an upper body strength based session with perhaps some squats and deadlifts thrown in; making sure my heels stayed planted on the ground so that I did not load my calf too much. This type of training is fine, and to be honest is good for me, but it was some intensity that I was craving.
So what exactly is intensity? Probably the simplest way to describe intensity would be to look out how much energy is expended during a workout in a set time. Let’s use calories (unit of energy) per hour (unit of time). So the higher the calories per hour, the more intense the exercise. Now, before all the exercise physiology gurus troll my post, there is more precise ways to measure exercise intensity (such as %VO2 max or ml/O2/min) etc but when we start talking like this we lose a majority of people so for the purposes of this post let's keep it simple.
So back to how to train with some intensity while still looking after your injury. Here was my solution which worked in my case. I did what is known as an EMOM (every minute on the minute) style of workout.
Alternating EMOM for 20mins
What this means is that I set up two barbells, one loaded for the hang power cleans and the second loaded on a rack for my back squats. These two movements were picked to maximise joints moved in the session without too much pressure on my calf. With a clock running, at the start of the first minute I did movement 1 with the rest of the minute off. Then at the start of the second minute I did movement 2 as per the first minute. Repeated until I had done each movement 10 times for a total of 20 mins.
In 20 minutes, 230 calories burned. Average heart rate was 132bpm with a max heart rate of 157 (which is 85% of HR MAX). If we extrapolate this out, my calories per hour was approximately 700, which compares to classes such as F45 and our HIIT style workouts. Not a bad effort in my books, particularly since it only involved a barbell and some plates and there was not a box jump, burpees or double under in sight and most importantly, no harm done to the calf.
So the moral of the story, with some out of the box thinking, a good knowledge of exercise prescription and knowledge of the effects that certain movements and certain prescriptions will have on the body, a solution for intensity can be found, even when injured. This is where your health professional should come in and be your trusted advisor. The intensity came from adding a time domain to the workout, and picking a load that allowed for quick movements so that power was maintained.
Physiotherapists with a good understanding of exercise prescription are well placed to help you come up with great workout options while you are injured. In my opinion, physiotherapists are the best placed health professionals to prescribe exercise to injured patients because of our high level understanding of functional anatomy and musculo-skeletal pathology.
If you are stuck doing boring workouts because you are injured, or worse still have been told to rest, then give us a call. We will be more than happy to help you find some intensity again.
Yours in health
Chris from Out of the Box Physio