Training Around A Chronic Injury

When I was a young(er) man, I played sports just about every day…hit the weight room just about every day…went running just about every day…and felt great all the time. Even after having reconstructive surgery on both knees (thank you football), I was right back at it…eventually getting strong enough to squat 760 lbs and fit enough to go running with the gazelles.

Fast forward to today…and I am constantly modifying workouts to help me and my clients…

  1. Get as fit as possible…
  2. While training around a variety of chronic injuries.

For example, this morning, I was chatting with someone on Twitter who tore their hip labrum back in 2009 and is now dealing with grade 4 arthritis in the joint…OUCH.



They were wondering how they would be able to keep up their squat workouts…and not be in excruciating pain from their chronic injury.

Here’s my advice:

  • Find the best orthopedist / physio that you can and make sure that the joint is healthy. Dealing with the arthritis is bad enough without worrying about re-tearing the labrum.
  • Noteher labrum is fine…but if it wasn’t, we would need to focus exclusively on maximizing hip range of motion while improving hip strength and stability. I would work with her physio to specify which exercise movements work best with her specific injury.
  • Since the labrum is in good shape, we don’t need to focus on specific rehab exercises, however I still want her to focus her leg training on minimizing the impact of her chronic injury by improving…
  1. Range of motion – with daily muscle flexibility (stretching) & joint mobility (myo-fascial work)
  2. Hip strength –  by using a variety of hip extension exercises based on Bret Contrera’s hip thrust model.

NOTE: The 2-legged barbell version is not the only way to perform this movement – if we use 1 leg instead of 2, we introduce all sorts of instability to the working hip and challenge it from all sorts of new angles…very effective. We can also perform this exercise standing using a cable stack or heaving rubber-strength band as resistance. This version of the movement brings increased focus on the core and helps improve hip function for squats, lunges, etc…

As her hip became stronger, I would re-introduce squatting while teaching her how to modify her squatting form to shift the load from hips to knees and vice versa. We would do a variety of different squat versions to generate a more thorough development of the muscles around her hips. Odds are her good hip is significantly stronger & more muscular than her damaged hip. We want to minimize that difference asap.

What does this have to do with you???

We all get older. And as we get older, almost unnoticeable acute injuries from our youth often reappear as chronic injuries. And while this fact of life sucks big-time, it’s something we’re going to have to deal with…whether we want to or not.

And like our friend with the torn labrum, you’re going to need to put on your thinking cap and start looking for ways to keep minor aches and pains from becoming major aches and pains.

Train smarter…not harder.

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