Disclaimer – I am not a Doctor. This is advice and perspective I am sharing from my own experiences and research. Take ownership and pursue at your own risk.
YOU WILL GET HURT!
YOU WILL GET HURT! It may not be today or tomorrow, but eventually, if you live long enough, you will encounter an injury. You can try to avoid it by being sedentary or avoiding strenuous physical activity, but then you’ll probably end up with worse problems brought on by an inactive lifestyle. Musculoskeletal injuries are a part of life and in my 41 years on the planet I’ve come to the conclusion that the motto ‘movement is medicine’ is true in a very deep and literal sense.
You can be a participant in the most well researched strength and conditioning protocol in history. You can have a personal chef cooking you meals based on the most non-inflammatory foods. You can have very little stress and get plenty of great sleep every night. If you get up everyday and live life, you’re still going to get injured at some point. The key is cultivating good movement patterns, avoiding stupid mistakes, and responding to injuries with good movement principles.
Preventing injuries is highly predicated upon doing the things we talked about in the last post. Rehabilitating injury is a process that sits on the same spectrum of our normal movement patterns except strength, control, and range of motion are usually limited due to pain. To review the last post quickly, quality movement is built on expressing strength and control through a broad range of motion. To increase movement quality and variation, requires that we increase strength and control through broader ranges of motion. Remember, this pursuit reduces the risk of injury by giving our bodies more room to displace external forces, safely.
Strength is force production – When we get injured, pain usually limits our ability to produce force in the areas affected at the same level as we could prior to the injury.
Control is the ability to express strength at varying speeds – When we get injured, pain usually limits our ability to express the same type of speed (both fast and slow) we had previous to the injury.
Range of motion has to do with how well and how far we can articulate (move) our joints – Again, due to the sudden onset of pain usually from acute injury, when we get injured we usually can’t move the affected area as far as we normally would.
How Do I Define ‘Injury’ ?
When I say ‘injury’ I am usually referring to a sudden insult to the musculoskeletal system or chronic inflammation to the musculoskeletal system that results in abnormal pain. As a practicing martial artist, Former US Army Green Beret, and someone who loves moving his body, I’ve had plenty of both types of injuries. What I’ve learned from rehabbing these injuries over the years is that pursuing neurological activity through limited movement (Strength and Control) creates blood and lymphatic flow that then removes swelling and inflammation while bringing vital nutrients to the area for healing. This process then restores range of motion over time. This is the exact same process as building movement quality and variation that I mentioned earlier.
What many of us will struggle with is the sense of remediation that comes with injuries. It sucks when you have been playing pickup basketball hard every weekend and suddenly your knee blows up to the size of a basketball and you can barely put any weight on it. But remember, injury is a part of being active. It’s not about never getting injured, it’s about properly applying the principles of movement to the affected area. It’s similar to having diversified financial investments across the companies of the S&P 500. The strategy is diversity of investment and if you hold for the long haul, there will be economic shocks that negatively impact your investments at the moment (injuries). However, over the long run if you hold your strategy your wealth will trend upwards (improved movement). Athleticism is not exactly the same, but similar in the sense that if we adhere to good movement principles we can see athletic gains for quite a while. Yes, injuries will force us to take a step back in our capacities at times, but we just have to hold the high quality movement strategy. Trust the process.
Rehabbing My Right Knee, Twice
In the last couple of years I’ve injured my right knee twice while doing martial arts training. Both times it was my fault. I was pushing my body in a way that it wasn’t ready for which resulted in damage to my knee. The first injury involved spraining tissue on the inside of my knee (possibly ACL or MCL) and the second time involved spraining tissues on the outside of my knee (possibly LCL). I say ‘possibly’ because I don’t know precisely what happened in either situation. I only visited the doctor for the second injury because I heard a loud ‘pop’ when it happened. This load ‘pop’ from the knee is commonly known to be accompanied by a ruptured ligament in the knee but the provider found no evidence of rupture on inspection.
In both injuries the immediate impact was swelling, pain, and limited range of motion within 24 hours of the incident. Within 48 hours I was having trouble lying down with my leg straight and walking was very painful on the second and third day in both cases.
The swelling and pain limited my ability to express strength and control in my right leg. Of course the swelling and pain also vastly limited my range of motion in my right knee. My first step in both cases was to begin finding a range of motion that I could tolerate in my right knee and begin slowly moving my leg in that limited range. In each case I would lie down on my back and attempt to bend my knee toward my chest as far as possible. I would also work to rotate my right ankle and articulate my right hip to encourage blood flow and synovial fluid in the muscles/joints above and below the knee.
As I gained the ability to pull my knee into my chest with relative ease, I then progressed to a half squat, then to a full squat with assistance, then a full squat without assistance, then a split squat with assistance, and then a split squat without assistance. This progression is shown in the video above. Now about 3-4 months since the last injury which caused me to visit the ER after I heard a loud pop in my right knee, I can do unassisted split squats while holding 15 lb. dumbbells. I’m stronger than I was previous to the injury.
Injury Prevention and Rehab happen in Your Strength Program
I understand that I am someone who is a movement nerd and I’m always thinking about how I can move better. I’ve gotten hurt plenty of times while training martial arts and part of how I rehab is the fact that I also have a regular strength training and mobility routine. So if I hurt my knee then I have a strength routine that will tell me how bad I’m hurt by virtue of my ability to do or not do certain exercises. I then scale appropriately as described previously. The problem here is that this assumes you have some kind of strength and mobility routine which I assume most people don’t have.
I’m not going to reinvent the wheel and write you a specific protocol when I know someone who has worked with thousands of people and had great success. I’ve mentioned him before and I personally follow many of the training principles of Ben Patrick (AKA – The Knees-Over-Toes-Guy).
Aside from his website and youtube channel which are great resources, he has a book available on amazon (Knee Ability Zero) that requires minimal equipment to get started.
Remember, prevention of injury is based on pursuing high quality movement patterns which are built upon developing strength and control through increasing ranges of motion. That said, you will get hurt. When injured, regress normal movements to easier variations and pursue pain free
strength and control through increasing ranges of motion. It’s a ‘buy and hold’ strategy similar to the stock market.
Other Considerations
I’ll briefly go over several other situations to consider that can help guide your own research. I don’t yet have the same mastery in understanding these topics but I have used these methods to help resolve pain in times past:
- Neural Flossing (Nerve Gliding) – Nerves can get pinched in a multitude of ways. The tunnels that our nerves travel through (in particular those that travel the length of our arms and legs) can narrow and put pressure on nerves causing pain, numbness, and tingling. Neural Flossing is achieved by positioning the limbs in certain ways that stretch those tunnels out and ‘lengthen’ the nerves. This probably isn’t the best way of describing it so do your research!
- Self-Myofascial Release (AKA-Self Massage) – Sometimes muscles develop knots and other connective tissues in our bodies develop adhesions. This can restrict movement, mechanically shorten muscles, and create pain over time. SMR uses tools like foam rollers and lacrosse balls to massage these sticky points out of the body. Again, do your research.
Conclusion
You will get hurt! The key is learning to respond with solid movement principles. As I’ve said many times, quality movement is built by chasing greater strength and control through broader ranges of motion. I can write it here but you won’t truly understand it unless you pursue your own strength and movement journey. Take ownership and get after it!
One other thing…
Something that has truly helped me over the years with injuries is viewing them as opportunities to learn more about my body. This is something I talk about in my TEDxTacoma Talk, Pain… A Good Thing, every obstacle is an opportunity for us to grow in some way if we choose to see it that way.
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Travis Daigle 
Thank You!
Excellent read!