What's your take on recovery from injury, specifically nutritional/supplemental strategies to speed recovery? And perhaps, what do you feel helped you recover so quickly from the hamstring tear?

-Adam

Adam, injury is something that any serious lifter will likely have to deal with at some point during their training. In my experience, things that are worth doing come with inherent risk.

The best way to deal with injury is to avoid it in the first place. However sometimes, bad things just happen. In this article I’m going to discuss ways to prevent injury, including things you can do and things to be more aware of. Many times injury is preceded by warning signs which are not heeded. It’s important to identify when your body and mind are telling you it’s time to back off. I’m going to discuss what those signs might be and what forms “backing off” can take. I’m also going to discuss what can be done if you are injured. I won’t get into specific injuries because they can be wide ranging, but instead what to do in general in the case of any injury occurring.

One of the most important things a weight lifter can do is to warm up properly. Muscle tissue is more malleable, less prone to injury and functions better when warm. Warming up prepares the body for proper ranges of motion so that when heavy weights are introduced they are lifted safely. Warm ups also help to ingrain proper form before engaging in heavy lifting.  Warming up should be a part every lifting session, but what form it takes can vary. As a broad recommendation, begin with a general warm up which serves to elevate heart rate, increase body temperature, and activate the sympathetic nervous system. This tells the body it’s time to move. This can be a quick jog, calisthenics, or even some light-weight sets. Follow this with a more customized warm up for your body and the activity you’re performing. This can be a range of activities including dynamic stretching, neural activation, foam rolling, mobility drills, and other advanced techniques. Instead of writing a whole article on warming up, I’ve linked an excellent two-part article by renowned author and physiologist Lyle McDonald on the subject:

http://www.bodyrecomposition.com/muscle-gain/warming-up-for-the-weight-room-part-1.html

http://www.bodyrecomposition.com/muscle-gain/warming-up-for-the-weight-room-part-2.html

The best time to improve flexibility is after weight training. Some forms of stretching like myofascial release (foam rolling), dynamic stretching (movement prep), and in some cases static stretching occur before you train with weights, but their purpose is to prepare you for lifting, not to increase flexibility. Not only are you warm after lifting, but studies have shown that muscle strength is temporarily impaired immediately after stretching. You don’t need to be a yogi or a contortionist, an overly flexible joint is just as at risk as an inflexible joint. You just want enough flexibility for proper form and range of motion. You can also do flexibility and mobility training on your day off. Taking a day for active rest, including light cardio, stretching and foam rolling is a great way to improve recovery and prevent injury. Sport and deep tissue massage and other bodywork techniques like ART (Active Release Technique http://www.activereleasetechnique.com/) can also be useful depending on the individual case and issue.

Another important aspect of injury prevention is nutrition. Adequate calories must be eaten to support repair of tissues. Of course protein intake is important but with inadequate carbohydrate, exercise- recovery and glycogen replenishment are compromised, less protein is spared and muscle catabolism occurs. With inadequate fat intake hormonal balance is affected impairing recovery and repair. Competitive bodybuilders cannot always increase calories to where they would be best for injury prevention, but there are some dietary supplements that can help. I believe HMB, glucosamine, chondritin, msm, and cissus quadulangarus are worthwhile based on a number of studies, personal experience and a large volume of feedback from clients and fellow athletes.

That being said, no diet, supplement, bodywork treatment or amount of warming up, active recovery or stretching will prevent injury if you’re over trained or overstressed. “Overtraining” has become a controversial subject in bodybuilding, mainly because it is not properly understood. The “overtraining syndrome” is a reality and it can lead to injury. It is rarely attributed solely to how you weight train. You may follow a program that doesn’t yield results or yields sub optimal results because it is excessive in volume, intensity or frequency, but excessive training alone rarely leads to overtraining. Our minds and bodies are not separate; the stress of one affects the other. To determine whether or not you are overtraining, take a look at the big picture. Is your diet supporting your training and recovery? Are you getting enough sleep? Are you stressed in your life or job? Are you training too hard, too long, or too frequently? Is your cardio regimen too intense, too long or too frequent? Is there emotional stress in your life?

Stress can be good or bad, a successful but challenging career opportunity or the death of a loved one are both stressors. Whether we label them positive or negative is inconsequential in terms of how our body responds. There is an optimal level of stress and doing too little or too much is unhealthy, finding balance is the key. How do we know when we are headed down the path of overtraining as opposed to just training hard? And, what do we do about it? There are common themes that come with overtraining: decreased performance, loss of appetite, increased heart rate and blood pressure, sleep disturbances, emotional instability, inability to concentrate, decreased motivation, depression and susceptibility to disease and infection. These symptoms vary from person to person, with psychological components being just as important as the physiological. A properly periodized training plan helps to avoid the issue of overtraining, but if you suspect you’re overtraining it might be time to reduce your volume, intensity, or frequency or even to cease training in some cases. If you become aware of the situation early, reducing volume by 50% and reducing frequency to training body parts once weekly while still lifting heavy is a way to maintain strength and allow recovery. Normally one to two weeks is all that is needed, except in cases of chronic overtraining or during periods of stress outside of training.  

When I tore my hamstring during my 2009 season, I was training as hard as I could with weights and cardio and I was eating a low calorie diet; however, just months prior my father died. I would be foolish to imagine that this had no effect on my susceptibility to injury. Again, I emphasize overtraining is caused by ALL stress in our lives, not just excessive training or sub optimal nutrition. Self awareness is the key.

Even with self awareness, periodization, flexibility, warm ups and cool downs, injury can still happen. If it does there are steps to take to optimize recovery. First of all, one should contact a doctor specializing in sports injury to deal with the injury in the acute term to begin the process of rehabilitation. There are entire books written on athletic injury rehabilitation and it is beyond my scope of practice as a personal trainer and beyond the scope of this article. That being said once injured, doing everything that your specialist recommends is paramount to your recovery. When I tore my hamstring I followed my rehab plan to a “T”: initially I stayed away from anti-inflammatory medication, I used ice, elevation, compression, crutches, therapeutic sports massage and time away from the gym. I then progressed to doing passive stretching and isometric work, to bodyweight exercise, unilateral training, and more aggressive stretching and eventually I was lifting heavy again. I regained my lost strength and eventually surpassed my old strength levels!

Beyond any rehab program, nutrition plan, surgery or treatment, the most important thing to do when injured is to get the right mindset. Focus on what is true, not what your fears are. After tearing my hamstring, the only thing that was true was that I had a torn hamstring. My fears were: “I no longer will be able to dead lift”, “my season is over”, “I have to quit bodybuilding” and other things like that. These thoughts were only true if I believed them. We don’t have complete control over what happens to us, but we do have complete control as to what we do in response. It is a choice to be a victim; it is a choice to believe that an injury leaves you without options and to let your training-career go down the drain.  I would even say it might be a necessary phase to go through sometimes. We may need to grieve, be negative, feel hopeless and hit rock bottom before we bounce back. But bounce back we must.

I offer some examples of champions who have made this choice and as a result have seen miraculous success. Alberto Nunez in 2008 had an injury that prevented him from doing any weighted squats or deadlifts for half of his 8 month prep. He did what he could and not only did he win three pro cards, he did it standing on these legs! Believe it or not, these are the product of months of only bodyweight squats!

Another example is Layne Norton, who 2 years ago had a horrific pec tear. He is now a world record holding power lifter, and is preparing for his natural professional bodybuilding debut. He happened to be the first person I called after I tore my hamstring and he provided me with some very valuable perspective. Here he is mere days after surgery doing everything in his power, never the victim! 

Our sponsored athlete Richard Knapp has multiple sclerosis. He competed in the INBF doing very well until he became wheel chair bound. He had the choice to quit bodybuilding, and no one would have questioned that choice. But instead he chose to keep pursuing his dreams. He is now deep in prep attempting to become the first WNBF Pro Wheel Chair Bodybuilder. By the looks of it, I wouldn’t doubt what he can accomplish!

The most important thing I learned from my injury is that there is reality, and then there are the stories we tell. I chose to tell the story of a man who, in the face of tragedy and injury, was still able to pursue his passions and dreams. Here I am, shy of a year post-hamstring tear, dead lifting 100lbs more than what I was dead lifting when I tore my hamstring.

There is a great book that was made into a movie on the subject of living life actively and not as a victim that specifically deals with overcoming severe athletic injury. It is called “Way of The Peaceful Warrior” by Dan Millman. Both the book and movie are excellent and will change your perspective for the better. I highly recommend them both.

Truly, one can view every obstacle as a stumbling block, or as a stepping stone. It is your choice.

References

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Valvason C, Musacchio E, Pozzuoli A, Ramonda R, Aldegheri R, Punzi L.  Influence of glucosamine sulphate on oxidative stress in human osteoarthritic chondrocytes: effects on HO-1, p22(Phox) and iNOS expression.  2008 Jan;47(1):31-5.  Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani, 2-35128 Padova, Italy. 

Bruyere O, Pavelka K, Rovati LC, Gatterová J, Giacovelli G, Olejarová M, Deroisy R, Reginster JY. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomized, placebo-controlled trials.  2008 Feb;16(2):254-60. Epub 2007 Jul 27. Encyclopedia of Nutritional Supplements, p.341

M. Lawrence, M.D., Ph.D, Sanchez, D.C., C.C.S.P., Grossman, D.C. Lignisul MSM (Methylsulfonylmethane) in the treatment of acute athletic injuries March 12 2001.

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