Dealing With Dings: How to Keep Injuries From Keeping You Down

I believe that the majority of those who read IRON MAN are totally responsible for all aspects of their training, which means they have to take care of any injury they incur. Even though scholastic and collegiate athletes have the luxury of a trainer and sometimes a team doctor to take care of problems, they still have to be responsible for handling injuries that happen when they’re not in school, such as over the holidays and during the summer.

I’m not talking about serious injuries on the scale of fractures or dislocations but about dealing with the nagging, debilitating injuries that affect your training and that you can manage. While a few may be severe enough to be checked out by a doctor, most aren’t, and you end up rehabbing the sprain, strain or muscle tear on your own. I call such injuries dings—but minor injuries can still hurt like hell and bring progress to a standstill.

Anyone who trains seriously and is constantly striving to move his or her numbers higher is eventually going to sustain some type of injury. Those who stay with light weights aren’t exempt, by the way. In fact, I think more people hurt themselves using light weights than heavy ones. Because the poundages aren’t demanding, they don’t pay close attention to form, and that’s when problems occur.

You get dings for all sorts of reasons – failure to take the time to warm up properly, coming to the gym extra tired or piling on the work so much that you’re chronically overtrained. Often something gives because of a momentary lapse in concentration on a high-skill exercise.

There’s no doubt in my mind, either, that on certain days we’re just more vulnerable. I’ve received a number of letters from men dumbfounded that they got injured. They’d been doing exactly the same routine for a very long time. They warmed up the same, went through the same sequence and topped out with the same weights. Nothing was different, so why did the elbow suddenly act up? I wrote back that something was different. Your body is constantly in flux as your biorhythms go through their cycles. Several times during the year two or all three of the cycles cross the midline on the same day. Those are considered critical days because your body chemistry is changing from positive to negative or vice-versa. Should you be training on those days, the odds of sustaining an injury increase dramatically.

Some people think biorhythms are akin to palmistry, but many companies use biorhythms to cut down on their injury rate. Japan, for example, has a national program in which high-risk workers get a blue card in their time slots on their cross days and are relieved of hazardous work on those days. There’s been an 80 percent reduction in accident rates since the program was initiated.

I realize that you may not want to calculate your biorhythms and adjust your training accordingly. At one time I did, although I don’t any longer. What I do, however, is check my biorhythms when I get a ding that I can’t explain. It helps me eliminate some other cause. Biorhythms turn out to be the culprit more often than not.

Improper technique is high on the list of reasons for being dinged. Elbow and shoulder problems especially are directly related to sloppy form on the bench press. Rebounding the bar off the chest and excessive bridging will eventually take their toll. Auxiliary exercises, often performed with lighter weights, come last in most programs. The relevant muscles and attachments are already tired, and you don’t give as much attention to a high-rep movement as a low-rep, heavy-weight one.

Technique on exercises for the smaller groups also gets less care. I see bodybuilders jamming their elbows down while doing pushdowns and letting dumbbells jerk around during a set of curls. The elbows and shoulders are really quite fragile joints and can take only so much abuse.

Be sure you warm up properly. Younger athletes can get away with jumping right into their programs without any warmup, but it’s a bad habit to develop. Sooner or later training on cold, unprepared muscles and joints will result in a ding.

Another common factor is a quick change in the weather, from mild or warm to cold. Training in a cold, drafty gym without adequate protection can lead to a ding, I’ll talk more about that later.

Finally—and it’s only common sense—avoid exercises that you know are risky or have given you problems in the past. For example, I advise everyone to stay away from behind the neck exercises such as presses, pulldowns on the lat machine and chins. Why? Your shoulder girdle isn’t designed to move in that range, and the addition of resistance puts it under even more stress. Behind the neck movements are potentially harmful not only to the shoulders but also to the rotator cuffs. Since pressing, chinning and doing lat pulldowns to the front are more productive and safer than the same exercises done behind the neck, why take a chance and do the latter?

If you know that every time you put front squats back into your routine your wrists and elbows start hurting so badly that you have to gulp down fistfuls of pain pills to get through the following day, that’s a bit self-destructive. Every trainee has one or more exercises that he or she would love to use but realizes that they do more harm than good. Pick an alternative. Your objective in weight training, or any type of athletic endeavor for that matter, is to enjoy the activity and improve your overall health and well-being. Purposely performing a lift that invariably results in pain and injury is slightly goofy. Life presents plenty of problems without creating more unnecessarily.

Rest assured, somewhere down the line you’ll incur some type of injury. It goes with the territory, and no matter how careful you are, on a given day something will go wrong. When it happens to me, the first thing I do is try to determine why I got a ding. In some cases, the reason is obvious, but in others I have to examine lots of factors. Mostly I can lay the blame on running my workload up too rapidly. Like my older friends, I still possess a competitive nature, and it’s hard not to add reps or move numbers higher when they’re there for the taking. It usually occurs after I’ve inserted a new exercise into my routine or one I haven’t done for a long time. Because it’s new, gains come rather quickly, and I continue taking them until my body tells me to stop. I’m aware of my situation and try to pay close attention to feedback from the muscles and joints involved in that exercise. When I pick up the early warning signals and heed them, all’s fine. When I don’t, I pay the price just like everyone else and have to deal with a ding.

That means it’s time for the familiar acronym RICE: rest, ice, compression and elevation. As soon as you feel pain, the kind that’s telling you something is wrong, stop doing the exercise. The dinged area should be rested. How long depends on the severity of the injury. For some, a couple of days is sufficient. For others it may be weeks. Just because you’re injured, of course, doesn’t mean that you can’t train. On the contrary, you should be exercising because movement will bring blood and healing nutrients to the damaged area. What you don’t want to do is some exercise that directly irritates the injury.

While you’re resting a dinged muscle or joint, it’s a good opportunity to spend more time strengthening some other bodypart. Decide what needs more work and go after it. The energy you used exercising the hurt area can now be used to make a weak group a great deal stronger. In that way, you can turn a negative situation into a positive one.

Ice the injury right away, the sooner the better. When you tear a muscle or tweak a joint, the blood vessels bleed, and the more blood that collects in a wound, the longer it takes to heal. Ice contracts the blood vessels and eases the pain. Crush some ice and wrap it in a towel before applying it to your skin. Keep the ice pack on the injury for only 20 minutes. Some authorities say 30, but I like to stay on the side of caution. When you leave ice on for too long, it acts like heat and blood floods the area, creating even more damage. I learned that the hard way when I pulled an adductor and packed ice on it while I drove an hour. My inner thigh filled with blood and was black from knee to crotch. If you aim for 20 minutes and forget and it ends up being 30 or 35 minutes before you remove the ice pack, you’re still okay. If you plan on icing for 30 and leave it on an additional 10 or 15 minutes, you’ll discover that you’ve made the injury worse. So ice for 20 minutes, remove for a half hour or longer, and then ice again. Do that until you go to bed.

While icing is recommended for any type of athletic injury, I’ve found that it doesn’t help with tendonitis in my elbows. Moist heat works better. I think that’s because the tendon isn’t damaged, only unduly stressed. And if I’m sure that my shoulder is hurting because I dinged my bursa sac, I prefer moist heat over ice. I know that from experience, and it may not apply to you. I do encourage everyone to try ice first. If you find that it adds to the pain, as I did with tennis elbow and bursitis of the shoulder, give moist heat a shot.

Even after the ding stops hurting, I continue to ice it for several days. It provides a bit of a bonus to the healing process and doesn’t take much time or trouble since I’m in the habit of icing every night anyway. Another thing I do as a precaution is to ice the opposing joint or muscle group that wasn’t dinged. If my right shoulder is acting up, I ice it, then shift the ice pack to my left shoulder. I figure that if some exercise I’m doing has stressed one shoulder, it is most likely stressing the other one too. It just hasn’t reached the breaking point yet. So I treat the healthy shoulder as if it were dinged. Again, it’s simple enough to do. You already have the ice pack ready and have to take a break from icing the dinged area.

Compression and icing go hand in hand. Wrap an elastic bandage over the ice pack and lock it firmly in place. If you experience numbness, cramping or pain from the wrap being too tight, redo it. You want it snug but not so tight that it cuts off circulation. When you remove the ice pack, you’ll also remove the wrap and leave it off until the next icing session.

Elevation is useful but just isn’t feasible for injuries to the back or hips. It’s for leg and upper-body dings. The idea is to keep blood out of the damaged area, so elevating your shoulder or calf while icing it aids in the healing process.

What about painkillers? Take them whenever you get dinged. They help break up the pain cycle, and that’s beneficial. Painkillers will also help you rest better, and rest is valuable when you’re rehabbing an injured area. Do not, however, take them prior to training. That’s often done, and it’s a huge mistake. You don’t want to mask the pain. Rather, you want to know precisely how any exercise is affecting your ding. With pain pills—aspirin, acetaminophen and ibuprofen—you could do more damage to the dinged joint or muscle without knowing it and greatly escalate your problem. After training is fine, but never before.

Increase your intake of vitamin C and protein whenever you get dinged. Also add B6 to help you assimilate the protein. Magnesium/calcium tablets are beneficial as well and will help you get to sleep and obtain the therapeutic rest that’s so critical to recovery.

Between your efforts and those of Mother Nature, your pain is gone, and you decide to start training the dinged area again. Step one—select an exercise or exercises that will flush blood into the joint or muscle without aggravating it. It may take a bit of trial and error. For example, not all triceps exercises will achieve that end. The first few reps will tell you if that exercise is helpful or hurtful.

Keep in mind that at the beginning of the rehab program you most likely will experience mild pain in the damaged area. You must learn how to differentiate between a dull, aching type of pain, which is not harmful, and the sharp, stabbing pain, which is. It’s often a thin line, but you’ll know you’re on the right track if the initial discomfort starts going away after you reach eight or 10 reps. That’s the movement that will restore your strength. First workout back, do only one set, and limit the reps to eight, 10 or 12. Use light weights, and leave two to three reps in the bank. If you feel that you can do 12 easily, stop at 10.

That night and the next day, determine how the dinged area feels as you go about your daily activities. Should it be fine, then you can begin to add to your workload. I can’t emphasize enough the importance of proceeding slowly. Not doing so is the greatest mistake most athletes make. The very last thing you want to do is aggravate the ding and have to start all over again. It will result in another rehab period that will be at least two or three times longer than the one you just went through. Should you continue to be foolish and reinjure the same area over and over, that minor ding suddenly becomes a major problem requiring medical attention.

Although the dinged area is feeling stronger, continue to treat it as if it were still hurt for several weeks. Stay with lighter poundages and higher reps for two to three sets. Keep icing after each session, and be sure the dinged area is thoroughly warmed up before training.

Muscle rubs and wraps are valuable aids. I find the type of wraps that Tommy Kono designed are the best for elbows and knees. They’re made from the kind of rubber used in scuba-diving suits and really hold in the heat. If they’re not available, get a set of wraps that powerlifters use. They’re much more supportive and retain the heat more efficiently than elastic bandages. Should the ding be in an area that’s not conducive to wrapping, use plenty of muscle rub, and make sure to cover the area with plenty of clothing. That’s particularly beneficial when you train in a chilly, drafty facility during colder months, which was the case at York Barbell. When Smitty made a supply of Hoffman’s Rub, he set aside a batch that hadn’t been diluted with alcohol like the kind sold to the public. That he gave to the York lifters. It was extra potent. We quickly learned to use it sparingly because it would set our skin on fire. At contests other lifters would bum some from us, and even though we warned them to use only a very small amount, they’d slap it on anyway. After all, it was free. Moments later they’d start dancing around, frantically trying to wipe it off with a towel or T-shirt. When that failed, they’d sprint to the
bathroom and douse their beet-red skin with water. Seldom did anyone ask for more.

When you do a rehab exercise, you must do it in absolutely perfect form. Any lapse in concentration may set you back to square one. That’s why rehabbing is so exhausting. It forces you to tap into your nervous system much more than usual. Having to perform every rep precisely, however, has a nice carryover benefit because it helps improve your technique on that exercise.

Everyone is different, of course, but the guideline I use for rehabbing is that once I can do three sets of 20, I’m ready to start lowering the reps and handling heavier weights. That needs to be done slowly, not abruptly. Lower the reps to 15 and stay with that for a week, then to 12, 10 and finally back down to fives. If it takes you three months rather than two get back to full strength, what does it matter in the long run?

Knowing how to treat minor injuries on your own is very gratifying, and all it takes is the resolve to take the necessary steps consistently plus a large dose of patience.

Observant readers will notice that I’ve focused on the upper body and legs while mentioning little about the back. Rehabbing the back is a different ball game and deserves its own extensive presentation. Watch this space.