Athletes get hurt all of the time, especially when they are in season.
My job usually consists of getting a training effect for them without making the injury worse.
When this is the case, there are a couple of steps that we need to go through to determine the right course of action.
I am not going to pretend to be a PT and the textbooks would say if someone is hurt, refer them out. I agree that strength and conditioning coaches should not be playing doctor or performing rehab on their athletes without the right qualifications.
We can, however, train around the injury.
For the sake of simplicity, I am going to use the shoulder for most examples. This is something I have had to deal with a lot lately with my hockey players.
The first step in this process is to figure out what hurts.
Does the shoulder hurt to go overhead, out to the side, etc.? Is the pain a sharp, burning, or pinching pain?
When this is the case the best scenario is to train the lower body without compromising the shoulder. If it hurts to set up for a back squat, then no back squats for that day. We can instead try goblet squats with a kettlebell, front squats, or split squats with a weight vest.
There will always be some variation the athlete can perform pain-free.
Second, how did the injury happen?
It is important to know the difference between an injury that happened over time and someone whose shoulder hurts after they got hit into the boards.
In the latter scenario, the athlete needs time for the injury to heal. Performing the safest shoulder exercises will probably still hurt.
The former situation is a little bit more confusing. The athlete would probably describe that kind of injury as tight or achy instead of sharp. This could be due to alignment, overuse, or imbalance and could be trained. Just remember not to blur the lines between rehab and training.
It is always a safe call to have a professional work with the athlete when in doubt.
Lastly, is the injury going to affect both sides of the body?
A hip is a good example here. If the right hip hurts, it makes sense that we can train the left leg right?
The only issue with this logic is that the pelvis moves as one, not independently. If there is an issue lying in the pelvis, then lower body work cannot blindly be considered acceptable.
This is where a good relationship with a PT can help because they can explain which movements are and are not recommended.
Once these questions are answered we can move into the actual training. There is always something that can be trained on a given day.
It never makes sense to sit at home with an injury once the acute phase of it has passed.
The 2 main things we can do with an injury are as follows.
- Train the opposite part of the body.
I am currently working with a kid who has an ankle injury. The solution is to train the upper body and core hard.
He can still get a training effect, he will still work hard, and moving around will actually help the healing process.
Sitting at home would provide no benefit.
- Train the good limb
The human body is much smarter than we give it credit for. Blood and nutrients still have to go to all parts of the body regardless of an injury or not.
As a result, training a non injured shoulder (while doing nothing on the injured one) will still get some benefits to the afflicted side.
Dan John wrote about the time that he was in a cast on one arm. He only trained the good arm and the broken side came out of the cast stronger.
The injured limb is always going to become weaker due to an injury. It doesn’t make sense to also allow the good side to become weak.
Train the good limb to maintain strength and potentially reduce detraining in the opposite side.
The whole key here is to train around the injury especially for acute pain.
When there is sharp pain and a definite event that caused it, avoid that limb like the plague. It must heal first.
There are still 2 legs, 1 arm, and 1 core that can be trained with a shoulder injury.
Remember to be smart and work closely with the proper professionals to best help the athlete.