The Top 9 Biggest Rehab Mistakes Crossfitters Make: Part 1

barbell fail The Top 9 Biggest Rehab Mistakes Crossfitters Make: Part 1





I think it’s awesome that people are out there trying to troubleshoot their own injuries and get back on their feet.  

This is what my website is all about.  From a physical therapy perspective, people begin getting better once they understand that they are in charge of their pain and injury.   The amount of effort you put into your rehab is going to have a direct effect on whether or not you get better.  It’s not as easy as someone just laying their hands on you.
That being said, I still see a lot of mistakes out there.  Here are a few to try and steer clear of.
9) Assuming that mobility is the magic bullet to fix all issues
I see this one all of the time.  Someone hurts their lower back and then gets advice from his or her friends.
“Mobility, mobility, mobility.  You should know better,  You’ve got to stretch”.
Was it the lack of mobility that caused the problem?  Well, maybe.  Or it could be that you’ve been doing an intense olympic lifting program for the past 3 months and you’ve hit heavy squats two days in a row.  You’re back is pretty much fried and eventually something gives.   Maybe you went too heavy on your last set or two and your technique gave way.  Maybe it was a combination of everything.  What I can most certainly say is that mobility will not be the cure-all.
When your body gets into a poor position during an exercise, it could be because you lack flexibility or because you aren’t strong enough to stay in a safe and efficient position.  You won’t fix this by stretching.
If you pay attention to the research at all you’ll see that flexibility is a really poor way to decrease injury risk in athletes (1).  Unfortunately, static stretching has also been shown to decrease performance when done before competition (1).
On top of that, flexibility by itself does not change the way we move (2).  You heard me, if we just stretch something it won’t magically improve our technique.  If we really want to improve our technique, it’s going to take a combination of stretching and then hammering technique once we get the range of motion we need.
Let’s not throw the baby out with the bath water though.  Mobility has its time and place and is vitally important.  However, it’s just a piece of the puzzle.  The pendulum has swung way over to the mobility extreme.  If you want a more in depth explanation of this you can listen to Dr. Brian Strump and I talk about this HERE:
8) Misunderstanding why your technique falls apart and what that means for your joints.
As described above, when you’re technique falls apart it isn’t just because your mobility is sub-par.  Your body can also adopt a poor position because you lack the strength and stability to get into the correct position.  Basically your body moves into a poor position because it’s trying to gain extra stability.  This ends up stressing structures that shouldn’t be stressed.  For a more in depth explanation of why this happens and why it’s bad click HERE:
In my opinion, the most promising injury prevention studies in the sports world are coming from neuromuscular training programs which emphasize learning how to move better(3) (More specifically how to land and change directions with the study I cited).
This is going to take a combination of stability to maintain the correct position, mobility and then drilling the technique until it’s made permanent.
Atleast in the ACL population, these athletes don’t see the benefits of injury prevention programs until about 6-8 weeks.  To me this means that you’ve got to spend some serious time learning how to move properly.  Especially given that most people aren’t practicing each movement on a daily basis like in the above study (3).
7) Assuming that perfect technique will fix everything
Perfect technique is very important to stay injury free.  However, do you think the human body was designed for high intensity exercise week in and week out for years on end?  Were 7 sets of snatches at 85% of my 1 rep max part of our survival as a species?  Well, only if your technique is correct (That was a joke).  Just because we clean up our technique doesn’t mean that the stresses on our body disappears.
The point here is that even if our technique is spot on, there are still very real stresses on our bodies.  A deep squat is still going to stress the knee to a large extent and the stress on the lower back goes up quite nicely when we attempt a 1 rep max deadlift.
Our shoulder “impinges” every time we put our arms overhead.  If we go overhead too often, we’ll end up with shoulder issues.
I don’t mean to make the point that all of crossfit is stupid and dangerous, I just want to make the point that fixing technique is also just another piece of the puzzle.  There are other extremely important variables that also need to be addressed, like programming and individualization.
6) Exercising through pain
Pain is a very powerful stimulus for a change in the way you move.  If you’ve got pain when you exercise, your body will do its best to move differently so that it doesn’t hurt as bad.  On top of that, you’re body will build a new motor pattern (new way of moving) in that funky technique you adopted in bench press because your shoulder hurts.
Guess what?  If you never break that habit, you’ll have funky technique on your bench press for the rest of your life, even if the pain goes away.  Hopefully that funky new technique doesn’t cause another problem (Note the sarcasm).  I banged up my shoulder pretty well polevaulting in college.  Of course I could not suppress my primal meathead needs and had to get back to bench pressing ASAP.      That ended up having me press with one elbow way tucked to the side and the other flared out wide.  Now my right pec muscle is tiny compared to my left.  Weird.
Alright, that’s it for this week.  Next week we’ll count down the top 5.  Hopefully you guys have gotten some good take-away points, especially if you’re currently working with an injury.
My shoulder hurts should I do muscle-ups?
Contributed by: Dr. Dan Pope, DPT
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References:
  1. Paradisis, Theodorou, Pappas, Zacharogiannis, Skordilis and Smirniotou (2013) Effects of Static and Dynamic Stretching on Sprint and Jump Performance in Boys and Girls Journal of Strength and Conditioning 
  2. Moreside, McGill (2013) Improvements in hip flexibility do not transfer to mobility in functional movement patterns, Journal of Strength and Conditioning Research
  3. Gilchrist, J., Mandelbaum, B. L., Melancom, H., Ryan, G. W., Silvers, H. J., Griffin, L. Y., Watanabe, D. S., & Dick, R. W. (2008). A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. The American Journal of Sports Medicine, 36(8), 1476-1483.
  4. Scott, Docking, Vicenzino, Alfredson, Zwerver, Lundgreen, Finlay, Pollock, Cook, Fearon, Purdam, Hoens, Rees, Goetz and Danielson (2013) Sports and exercise-related tendinopathies: a review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012 British Journal of Sports Medicine
  5. Cook, Purdam (2013) The challenge of managing tendinopathy in competing athletes, British Journal of Sports Medicine

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