About the Author: Eric Bowman is a Registered Physiotherapist in Ontario, Canada who works in the areas of orthopedic physical therapy and exercise for people with chronic diseases. He’s also intermittently involved with the University of Waterloo Kinesiology program and the Western University Physical Therapy program. He also competes as a powerlifter in the Canadian Powerlifting Union and has completed the CPU Coaching Workshop and Seminar.
If you’re a serious athlete – at some point you’re likely gonna get hurt. It’s part of competitive sports regardless of whether you’re in a strength sport like powerlifting or weightlifting, an endurance sport like running or cycling, or a contact sport like football or rugby. Competing at a high level isn’t healthy, and the efforts needed to be a high level athlete can break the body down over time.
As a physiotherapist who competes in powerlifting, I see many athletes – ranging from teenagers trying to make a college team, to weekend warriors, to retired professional and strength athletes. They each have their own story and their own goals … but over time I’ve found many common themes to be present across the rehab process for athletes and for people in general. Here are five tips for the athlete going through the rehab process.
Tip #1: Make sure it’s a good time for you to start rehab
I’ve seen many athletic and non-athletic people struggle to make progress with rehab due to external factors that interfere with the process.
The first problem with this is that time, family, work, and athletic commitments can make it difficult for a client to do rehab exercises and optimize all the necessary aspects of successful rehab – such as proper sleep, training program design, and psychosocial factor management. If you’re in the process of moving, going through a divorce, or taking university classes while working full-time, how much time do you have to do rehab?
The other issue is that these factors can prevent you from making the necessary activity modifications to recover from a pain episode. If you’re moving and have to lift furniture all day, how is that going to help you recover from an acute, inflamed shoulder? Is playing multiple basketball tournaments every week the best for your patellar tendonitis?
I’m not saying you should shy away from the rehab at the first inkling that life isn’t perfect – as it never will be. But you should ask yourself honestly if you are in a good position to put a reasonable effort into the rehab process. High quality rehab is expensive – and if you put the money into it, you want to be in a good position to get the most out of it.
Tip #2: Stay off the forums and social media threads
I cringe whenever I see a strength athlete asking for medical advice on Facebook or on a forum. It makes me shake my head – they’ll put tons of time, effort, and money into eating, sleeping, supplements, coaching, and training – but they’ll cheap out on finding a good rehab professional.
At the end of the day, most strength coaches – unless they’re Charlie Weingroff, John Rusin, Dani LaMartina (Overcash), Stefi Cohen, Scotty Butcher, Zach Long, Quinn Henoch, Christina Prevett, or myself (among others) – likely don’t have the requisite training to diagnose and treat musculoskeletal pain conditions. Most importantly, the biggest reason to stay off the internet medical community and see a proper professional is to make sure your pain is the only problem, and isn’t secondary to another medical condition – like cancer, a fracture, or an infection.
Tip #3: Find a good rehab professional who you click with
I wrote about this in more detail on my own site last year. For the Reader’s Digest version, some traits to look for are:
- They don’t run you through an assembly line – 40 minutes for assessments and 15 minutes for followup treatments are my bare minimums.
- They understand pain science and the biopsychosocial model – which I intend to write more about in a future article.
- They don’t need to be an elite athlete but they should understand lifting and athletics.
- They ask you about your general health.
- They take the time to listen to and communicate with you.
- They value continuing education and self-improvement.
- While I’ll get some flack for saying this one… they give you exercise, education, and self-management strategies, and not just make you dependent on hands-on therapy and modalities.
Sites like Clinical Athlete are good ones to go to if you’re looking for a rehab professional who fits the bill in these areas.
Tip #4: Be patient and don’t ride two horses with one rear end
As Stan Efferding said in one of his may recent podcast interviews (paraphrased), you need to give yourself the freedom and time to get yourself healthy before chasing high performance goals.
Many athletes, myself included, are impatient and eager to get back on the horse – whether it’s due to the love of the game, fear of losing performance, or both.
For most people – if you’ve built a good base of strength, conditioning, and skill for your sport, it shouldn’t take long after the rehab process is done to build back up to peak performance. But conversely, trying to rush the rehab process and cycling back into extreme pain can delay your recovery by months or years.
Tip #5: Look at the rehab process as an opportunity
This time is a chance to enhance general physical preparatory qualities and to optimize other contributors to peak athletic performance.
A good rehab professional should give you a list of activities that you CAN do to maintain (and even improve) your fitness while recovering from your issues. In addition, a good therapist will likely give you novel exercises to help with strength, endurance, hypertrophy, mobility, and/or motor control in areas that may be lagging.
This should be seen not as rehab purgatory (to quote John Rusin), assuming it’s done properly, but rather as a means to improve general physical qualities such as mobility, strength, and movement – which may enable you to improve your overall performance in the long term.
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Optimizing Rehab and Performance
Also, as I said in my podcast interview with Travis Mash earlier this year, there are many commonalities between optimizing rehab and optimizing performance. Some of those areas include:
1) Optimizing sleep: Poor sleep is a big risk factor for sports injuries, chronic pain, and impaired performance. However, the methods to improve sleep are straightforward and include
- going to bed and getting up at the same time every day.
- preferably waking up naturally without an alarm clock.
- minimizing, if not eliminating, caffeine and alcohol consumption after mid-afternoon.
- having a sleep environment that’s cool, dark, and quiet.
- minimizing, if not eliminating, screen time before going to bed.
If these strategies don’t help with sleep, then it may be worth trying to get in to see a specialist – especially given the high number of larger athletes (i.e. powerlifters, strongmen, football players) who have sleep apnea. The symptoms of sleep apnea can, although not always, be minimized and potentially eliminated through losing weight and aerobic exercise (interestingly regardless of weight loss). Some athletes may not always be able to do that, potentially due to performance demands, and may need other professional options to improve sleep.
2) Psychosocial factors: high levels of stress, anxiety and depression can put you at risk of sports injuries, chronic pain, decreased performance, and decreased recovery.
Simple steps to improve these issues can include
- eating right, exercising, and getting good quality sleep.
- learning to say NO.
- staying organized: I use Google Calendar and a To-Do-List app (todoist.com) to keep track of everything I need to do and schedule it accordingly.
- getting enough down time and time with friends and family.
- taking part in relaxing, low-stress activities (i.e. 10 minute walks after 2-4 meals a day or leisure bike rides) depending on your training needs, goals, and tolerances
Beyond that again is where you may need to seek other professionals, especially if these are impeding your performance and/or your recovery from a pain episode.
Recovering from an injury is not always fun, but these tips can make it easier to go through the process and also make it more rewarding for you and your athletic career in the long run.