Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
22 Jan

Exercising Through Injury

brokenlegLuckily, when we get injured, we can have surgery and then simply recline on the couch and catch up on old episodes of “The Wire” in between visits to the physical therapist. And for us Primal Blueprinters, staying off our feet doesn’t necessarily mean we’ll gain weight. Our body composition is, after all, mostly determined by diet, so sticking to healthy fats and protein (with copious amounts of vegetables) while watching the carbs will keep us trim. Grok didn’t have it so easy. If Grok broke a leg or dislocated a shoulder, he wasn’t bouncing back after a quick visit to the local shaman. He became a detriment to his clan, unable to hunt, forage, or fight. Without the type of medical knowledge we’re lucky to have today, what would be a relatively simple injury for us could end up being a life ending calamity for Grok, especially if necessity demanded he fight through the pain and risk further damage.

So while we may have it easier, that down time is still painful, especially for folks that are usually active. Even though we’re staying trim and we still look pretty good in the bathroom mirror, we just feel different when we don’t exercise. Whether it’s the lack of post-workout endorphins (to which we’ve grown addicted) flooding our system or the nagging sense that our once-firm musculature is going soft, staying off your feet throughout an injury is difficult to deal with. Do we really have to deal with it?

For the most part, yes. Listen to the doctors. Most times, what your injured limbs require is simply time (something Grok couldn’t really afford to give, sadly) to recover, and pushing them will only hasten a relapse. Attend your physical therapy sessions and do what they prescribe.

But that’s probably not enough for our active readers who still yearn to sweat and strain. What follows are a few general observances, things we Worker Bees have learned from our respective downtimes about exercising through injury.

Safety First

At some point, your doctor should give you clearance to “test it out.” Light jogging, some light weight work, hiking – these are normal for a doctor to prescribe to a patient coming off an injury. It’s sound advice, too, but be careful. If you’re coming off a knee injury, don’t go jogging on hard concrete. It’s hell on the joints, and it could just aggravate your injury. Instead, opt for sand, trails, grass, or even a rubber track. Anything with “give” will do. If you decide to hit the weights, stick with the big primal movements at drastically reduced levels. Instead of leg extensions (which put a lot of stress on the knees, and are very unnatural motions), for example, do body weight squats and lunges. Push yourself, but only in slight increments, and be sure to report any pain to your doctor (especially sharp pains, which can be indicative of something more insidious than just dull soreness).

Swimming, Biking and Rowing

What aggravates (and, indeed, usually causes) most injuries is joint impact. Swimming, biking, and rowing are all great exercises that exert little to no stress on your joints. Truly a total body primal exercise, swimming nearly eliminates any and all impact while providing your core, arms, legs, and heart an incredibly balanced workout. Swim sprints are excellent alternatives to the land-based versions.

Another low impact exercise, biking also saves gas money (we know prices have gone down, but you know it’s only temporary – plus, think of the environment!). Biking is good for long leisurely journeys, or you can find some steep hills and do interval sprint training for a killer leg and cardio workout that won’t kill your joints.

Rowing is an extremely rigorous upper body exercise, but it’s the fluid, smooth motion that makes it work for people coming off an injury. Start off slowly (either using a machine or an actual boat) and ramp up the intensity if you’re feeling up to it.

Replacements

Can’t do Tabata sprints because of a sore ankle? Try Tabata pull-ups, burpees, or jump rope. Dislocate your shoulder, and now you can’t put up your max on the bench? Try doing four sets of 50 push-ups instead. Can’t keep up with your squat routine because of a herniated disc? Do body weight squats, or only use the bar. If you were a heavy lifter before the injury, these exercises certainly won’t make you stronger, but they will help you maintain your strength and keep you active and fit.

The idea is to accept your injury. You don’t have to like it, and you don’t have to give up, but you do have to accept the fact that being stubborn about the intensity of your workouts will only keep you sidelined longer. You can still work up a sweat and stay fit; just don’t overdo it.

Do you have a personal injury story? Share your recovery tips in the comment boards!

Further Reading:

The Prison Workout

My Knee is Killing Me… No Really.

Weight Gained During Exercise Hiatus Tough to Lose, Study Finds

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Swimming, yes. Rowing, yes. Biking, yes. And, dare I say it…elliptical machine? I know “long hours on the elliptical” is the bane of the modern Grok. But when I had knee problems, the elliptical machine provided me the alternative to at least work up a sweat on a daily basis. I think it might even be possible to do some sort of “Tabata Elliptical.” Or should I turn my back on this whipping boy contraption and just leave it for the cardio crowd?

    Joe the Tumbler wrote on January 22nd, 2009
  2. When I had surgery on both knees, once I could put weight on them, walking was the best thing I did, especially in the sand. It got me outside, raised my mood (yay Vitamin D), I got some fresh air, and I could keep a good grasp of how I was feeling so I didn’t push it.

    Holly wrote on January 22nd, 2009
  3. Bodyweight squats are a great workout. It is possible to sustain a very high level of power output with them, and I have personally worked through a shoulder injury that prevented me from squatting heavy by doing a couple sets of Tabata bodyweight squats per week. I kept nearly all my strength by simply utilizing my floor and gravity.

    The conditioning aspect of Tabata squats is great too. Not as powerful as sprints, but very taxing if you push yourself.

    Kevin wrote on January 22nd, 2009
  4. I’ve been tethered to the pool for a few weeks working out achilles problems, and have been doing a few Tabata intervals in there with everything else.

    Strap on the swimming vest (aquajogger, etc), and power through some heavy interval sessions! Its the only way to get a decent workout in the water for “regular cardio” junkies.

    Remember that your HR is lower in the pool, so you have to raise the perceived-effort level significantly.

    Here’s a wonderful training plan for when injured:
    http://pfitzinger.com/labreports/water.shtml

    Andrea wrote on January 22nd, 2009
  5. Great advice Mark. I have fortuntely been injury free for a while now… but I am awfully timid about getting hurt. It is definitely a fear of mine to be laid up in the hospital or stuck with downtime.

    The SoG

    Son of Grok wrote on January 22nd, 2009
  6. Joe, I do the elliptical too. More out of habit, as I used to be a 45-minutes-cardio-every-day girl. I’m not currently injured, so I try to keep my activities out of doors. But it’s nice to have a low impact machine to fall back on. Especially in the cold!

    Sandy wrote on January 22nd, 2009
  7. After my 3rd degree sprain in my right ankle and after the doctor “okayed” me to do some working out, I jump roped. I started with just jumping on my left leg, and then slowly but surely added pressure to my right, which increasingly built the strength back up in that ankle. I was careful to wear my air cast every time and stop when it got too sore, but if definitely helped.

    Jane wrote on January 22nd, 2009
  8. I broke 2 different vertebra in 2 places a few years back, which pretty much took me out. I just told my physical therapist that I was seeing 4 times a week that I wanted to stay in shape and they gave me other exercises to do while I was strengthening my back/core. Almost like getting a personal trainer… ;)

    H. Smith wrote on January 22nd, 2009
  9. Tennis elbow and golfers elbow. I’ve had both on different arms. Probably due to my silly days of isolation exercises.

    What worked for me was to rest for a couple of days – then every day starting with a dumbell with no weights do 25 wrist curls palm up, then 25 with the palm down. If the pain doesn’t increase, slowly increase weight. Once you get to a decent weight, lower reps.

    Jonny wrote on January 22nd, 2009
  10. “copious amounts of vegetables” amounts of veggies hurt my tummy-wum-wum. I agree with the fat and protein, of course. And small amounts of veggie do have their place, so long as they are…small.

    Ilgo Fungi wrote on January 22nd, 2009
  11. “copious” amounts of veggies hurt my tummy-wum-wum. I agree with the fat and protein, of course. And small amounts of veggie do have their place, so long as they are…small.

    Ilgo Fungi wrote on January 22nd, 2009
  12. If you injure one side, work the other. It has been known to save the muscle and strength on the opposite side.

    Zen Fritta wrote on January 23rd, 2009
  13. Trust me, something you DO NOT want is to ingrain your muscle imbalances resulting from or causing injury.

    Injury + haphazard strength training = chronic pain.
    Working unilaterally is poor advice in most cases dealing with injury or pain IMO.
    Ever hurt your ankle and a few weeks later your back hurts?
    http://www.musclebalancefunction.com/
    http://www.solution4pain.com/index.html

    Chris wrote on January 23rd, 2009
  14. Serious or permanent injury may not have been a death sentence for Grok. Shanidar I (a Neanderthal, not one of our direct ancestors) managed to live a long life, in spite of suffering some serious trauma. http://en.wikipedia.org/wiki/Shanidar#Shanidar_1

    SN wrote on January 23rd, 2009
  15. A timely post from my perspective! I am just a week “post-op” for a ruptured quadracep tendon. A seemingly minor slip on the ice on a Christmas ski week, and there I was…doing “snow-angels” waiting for the ambulance!
    Apparently the rehab for this type of injury is really long, due to the lack of vascularity in the tendon. This is really devastating for me as it happens that I have recently lost over 30lbs and was within striking range of my goal weight. Fortunately, I have hope that the PB behaviours that I have recently adopted will sustain me through this.
    As you know, Mark, from the old days in LG, I am an endurance “junkie”. I want to ride double centuries this summer, and fully intend to meet that goal…… using smarter PB type high intensity interval work rather than chronic cardio madness!!!
    Anyway, Ill hop on my crutches and hop into a big salad!

    Tim wrote on January 23rd, 2009
  16. How timely…… I’m three days into enduring a herniated disc which has paralyzed my foot and made my lower leg numb. I went from running intense sprints, dropping 3-4 pounds per week, to hobbling around with the aid of a ‘walker’ and being high on morphine just to keep it bearable. I am on the verge of depression. I truly am addicted to the post-workout endorphins and am going through serious withdrawal. Wwwaaaaaahh!
    And I was all geared up and on track to meet my final fitness goal by my birthday this spring.

    Ultimately, I know I’ll be fine, but I am struggling right now. Your encouraging words and suggestions are what I needed. I think I’ll re-read the post and look forward to getting back into action…someday….sigh…

    new_me wrote on January 27th, 2009
  17. I have had to many bad injuries, that I have tried training through, I know that it was my own fault as I was pushing myself too hard.

    Tom wrote on January 29th, 2009
  18. This is an old blog, I can see that from the dates. But I am going crazy, I wanted some advice or even help. I have been on my PB diet for 4.5 months and I am doing great 23 pounds down. I run 3 times a week (5 miles each time)and love how I am lighter and fitter, then suddenly. Two weeks ago 5 miles away from home,on one of my runs, my knee just decided to hurt and lock. I managed to walk home in a fashion, and with great pain. Swelling and pain took over. I did not twist or jar my leg at all and I had a smooth run, so I could not understand what had happened. To cut a long story short, two weeks have gone by, I have seen the doc, I am on medication and my knee is like a balloon. The doc thinks it is just wear and tear? I can only walk for while, but my leg is strapped up and I have to elevate it. I cannot run, or twist my leg in any way, I cannot do any bending of my knee. So cycling, swimming and any rowing are out of the question. I am following my usual PB diet, but crave more carbs. My weight is rising I am 4 pounds heavier and I am afraid I will put everything I have lost back on. I know it is only two weeks so far but I feel as though this is going to be a long drawn out affair. You are my last resort Mark, so I hope your advice sees me through this.

    Charmaine wrote on May 25th, 2012
    • Im not expert but I’d be ignoring the cravings for carbs. Recognise that cravings go away if you ignore them.

      Jane wrote on May 25th, 2012
      • I think that the craving and possibly giving into more carbs is because I am not doing much with my knee injury. It is my fault for not being stronger willed, I suppose. When I am busy and running etc. I think more about my food a fuel, but at the moment it is filling in a empty space where I would normally run. I am going to try hard to ignore the cravings and hopefully it will subside and try to find something else to fill the space in my day.

        Charmaine wrote on May 28th, 2012
    • Remember, 80% of body composition depends on what you consume, only 20% on working out.

      I noticed that I put weight back on when I was not paying attention to how much I was eating, especially those delicious, calorie-packed nuts (almonds, Brazil, macadamia). A food diary helped me IMMENSLY.

      Nicole wrote on May 25th, 2012
      • I have found that I want more, nuts and also I have wanted milk! I am not into milk very much normally but I do eat quite a few nuts. I already keep a food diary, I have noticed that I am eating more of the things I have avoided for the last few months. I am determined to keep the weight off and off my feet :)

        Charmaine wrote on May 28th, 2012
  19. I used to be a fencing athlete, then practiced Wushu for 4 years. Finally dropped out of everything because of a tendinopatitis on both knees. After I switched my training to boxing to keep doing martial arts but trying to spare the knees, injuries on my shoulders started developing, and my doctor could not find any plausible reason for my pain, as every exam showed it was fine. So he just told me that I have “loose ligaments” naturally and will have to take it easy forever. My trainer, though, told me that it is just a matter of building enough muscle to hold the joints.

    A while after I quit Wushu I found out I was lactose intolerant, and in fact giving up on dairy relieved not only the pain and inflammation on my joints, but also my chronic rinitis and health in general. I tried phisiotherapy, light weight training, no results. Two years of “recovery”, still no sports allowed.

    Then I moved to Japan, tried a vegetarian diet, put on a bit of weight, lost lean body mass. I was so bored of pulling rubber bands at home that I tried learning to dance and it all went down on a particular day that I worked so hard I could not stand up. I almost crawled home and spent two days laying down, with acute pain with every move of my knees. I stopped all the modalities and kept only the weight training, bud had to keep it light.

    This year I changed my training and slowly recovered my ability to walk more than 1km without feeling pain. After I found out the Paleo Diet, I managed to drop the body fat percentage to 20% and I almost stopped feeling pain. Still, any extra effort awakens the pain, and it is especially frustrating (though not unexpected) after 4 years of suspention in “in recovery” status. The thing is that I am very very anxious to go back to sports, to build more body mass, and to run. I can’t help but to have high hopes for the diet.

    Alena wrote on November 24th, 2013
  20. I will be having shoulder surgery in 2 weeks and am wondering what I can do other than walk, especially for upper body and core. I am new to PB and am loving it, but now I’m getting worried -

    Diane wrote on January 6th, 2014

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