Rehabilitative Exercise:
This category of exercise is about recovery from injury and dysfunction. Most people are familiar with physiotherapy, whose practitioners specialize in helping their patients engage in rehabilitative exercise following injury. While injury specific exercise is certainly important during the acute phase of an injury, I personally believe that a good long term strategy is to incorporate rehabilitation into day to day life.
For athletes, this is relatively simple. Some of the necessary mental changes include:
-A shift of focus from competition, or performance to a concentration on improving biomechanics. Form is everything. And most sports injuries can be traced back to a problem with HOW a sport is performed, not the sport itself. And of course, athletes often get their worst injuries off the field (I once put my back out quite badly not from the personal best deadlift set I'd performed an hour before, but from hopping carelessly over a puddle on my way home!). Even so, an athlete can go back to their sport to find their way back to health. Most sports after all, can be traced back to life activities somewhere in our past and as such can be modified to help with injury recovery.
-Learning not to "finish". In this context, I'm referring to that moment of explosive force than tends to complete (or begin) an athletic action. Some might also call this "english" or "juice". In Hapkido, we refer to it as that moment of intense muscular contraction that focuses the kinetic force of our attack into our opponent. An injured body will NOT benefit from finish, so it should be avoided. Loose and easy are the rehabilitative focus.
-Range of motion is key. Short movements should be avoided. The best moves to practice when injured should be long and loose. Some sports don't have "short" movements (running, weightlifting, tennis, volleyball, etc...) in their ideal forms. Some sports do compromise full range of motion to achieve particular goals. Grappling sports come to mind as a particularly good example. Grapplers tend to be tangled up with each other and in the battle for leverage often have to struggle from a restricted or unbalanced position. While this is an accepted part of the sport, injured grapplers should avoid straining for positional change and simply tap out and start again.
-Drop the attitude. Everyone wants to win, but the injured athlete has to put that aside in favour of their own long term participation in their sport. There is a concept I came across in Chinese internal martial arts that translates as "investing in loss". While it's often thought of as a route to mastery, it can also be applied in a more short term manner as a route to recovery. Don't be afraid to give ground. Injured athletes who can't put aside their egos tend to stay injured. And if you can put it aside and accept your losses, you just might find you learn something new and expand your skills even while limited in the scope and intensity of your activity.
For non-athletes the task of rehabilitation can be even more daunting. Non-athletes are often non-athletes for a very specific reason: They don't like sports or exercise. For this reason, such patients tend to require careful monitoring, guidance and encouragement from the health professionals mediating their recovery. Now, that's a very large topic upon which entire careers are based, so for our purposes here, I'm going to try and focus on a few suggestions that an injured person with no athletic experience can try to encourage their own recovery.
-Look to life for healing activities. For example: I often tell patients with ankle sprains that balance training is important. And of course their are exercise protocols that can be performed in sessions for that. But for those that rarely keep to prescribed exercise routines, I encourage things like standing on one foot while washing the dishes or waiting for the bus. Putting on socks while standing on one foot. Washing one's feet in the shower while standing on one foot. Incorporating rehabilitative activity into daily activities that are going to be performed anyway has the potential to significantly speed up recovery.
-Learn to understand pain. This is a very complex topic, but I'll try to keep it simple. Athletes and mothers who've experience natural childbirth often have this in common: They have an internal vocabulary for their understanding of pain signals. It's very similar to the Inuit and their words for snow, though it tends to be much more individual and difficult to express in language. Pain is both your internal diagnostic system and a biofeedback mechanism. Once you can accept that, you can begin learning to read it. People who have difficulty interpreting their pain signals tend to perceive it as ON or OFF, but there is a lot more information there. Learn the difference between "good" and "bad" pain. Good pain can be though of as adaptive discomfort. It's your body reinforcing in response to positive stress. Bad pain is anything potentially destructive. Once you can learn to tell the difference between these two broad categories, further differentiation will open to you much easier.
Finally, for everyone: Take responsibility for your own recovery.
There is honestly no such thing as a mechanic for humans. We don't work that way. All health care is ultimately facilitation.
Lets take the example of chronic knee dysfunction. Over time, because of repeated injury the knee can accumulate debris that needs to be cleaned out. One recommended treatment is arthroscopic surgery to trim up ragged connective tissue and "vacuum" out floating particles (I'm oversimplifying, but I'm not a surgeon, so please bare with me). Now superficially it sounds like this is a complete solution. Unfortunately, if you were to simply go home and never think about your knee again, you are likely on a long route back to the surgeon for more invasive knee surgery in the future. It is essential for you to continue the rehabilitative process, whether that means working with a physiotherapist, or finding some other way to strengthen your knee and improve it's overall function.
No one gets off easy, and no one gets to just sit back and let the healing happen.
Lifestyle Exercise:
There are two basic ways to engage in lifestyle exercise.
The first is doing any activity that can be considered "practice for living". Now while any sport can potentially be adapted to fit this model, some have evolved specifically for it. The best examples I can think of are hiking, traditional dance (I'm thinking of east African dance as I write this), yoga, pilates, tai chi and aikido. Close seconds (and they don't make it into first because of their tendency towards competition) are eastern martial arts (karate, judo, wushu, hapkido, tae kwon do, kali, muay thai, etc), weight lifting, ballet, endurance running, cycling, and climbing. Feel free to add any others you can think of down in the comments section... These kinds of activities can help to polish your mind and body in preparation for daily life. Just practicing breathing alone has the potential to give you more energy and a better outlook on life simpy by increasing the oxygen supply to your brain. It's tempting to look for a metaphysical explanation as to why these things can be so good for your way of living, but it's not necessary. Just looking at what we know about these activities is enough. They help your body become stronger, more flexible, and energy efficient. And that means everything gets easier and more enjoyable in the rest of your life too.
The second is finding exercise in life. The best way to describe this is to use the example of my father, Paul Blacker. He's worked as a tool and die maker for all his adult life, and even in to retirement he still takes contracts and seems to enjoy it. As far as I know, he's never played a sport or worked out in a gym. Exercise for him has always been working at a physical job, and finding ways to make it physically challenging or mechanically efficient depending on his needs in the moment. I can remember him having a chin up bar between his workshop and the garage/storage area. He'd walk under it and either hang, or do a few chinups on his way from one area to the other. Because his job requires him to move various quantities of metal from one place to another, he seems to delight in finding ways to move even the heaviest of pieces by himself. And when he felt he needed a break, he'd often go for a walk (ok, ok, and a smoke. He's given that up in recent years), instead of just sitting and staring into space...
Now, not everyone works in a labour intensive job suited to incorporated exercise. Sitting behind a desk for most of your day may not lead you to be the most active worker. Nevertheless, there are several ways to optimise your activity level. Probably the best way is right at the start of the work day: Don't drive. Walk, cycle, even run to work. Worried about getting to work sweaty? Well, lifestyle exercise isn't about intensity, it's about movement. So you don't have to push yourself while commuting, you just have to leave yourself enough time to get where you're going without arriving dripping with sweat. You could climb stairs instead of taking escalators or elevators. Sometimes it might mean making things less efficient and making things harder than they have to be. For example, moving boxes or water bottles in your arms instead of finding a dolly.
Ultimately the key here is intention. You have to INTEND to exercise.
To put the term in context, I'm not referring to planning. I'm referring to mentally engaging active participation in exercise. I suspect it's the reason why when you look into a construction site, you'll generally be able to divide the workers into two groups: The strong and robust, and the overweight, out of shape and broken down. The first group engage in positive self talk: "I like being active and outside" or "This job helps me stay fit". The second group engage in the opposite: "When is this day going to end..." or "Only ten more years to retirement..." or "My back hurts... again... I wonder if I can get on disability?".
Performance Exercise:
This one is about goals and competition. It's the engagement in an activity or sport with the intention (there's that word again... I have a sneaking suspicion I'll be doing a blog specifically about that topic at some point!) of pushing personal, societal and athletic limits. The central concept is achievement.
There are just so many more qualified people out there writing and speaking about human athletic performance, what it is and how to achieve it, that this is going to be a surprisingly short section. Rather than giving in to the temptation to go into great detail, I just want to say this:
The pushing of your limits is a commendable goal, but you may not be leading yourself to optimal health. The world of sport is littered with record holders with broken bodies. For every world class athlete who retires into a healthy active life, there must be hundreds of others who spend the rest of their lives with compromised mobility and pain.
A common gym mantra is "no pain, no gain" and while certainly true, it needs to be taken with perspective. As I said above, there are different types of pain, and it's essential for anyone intending to push their limits to develop an internal dialogue with their pain. This is a very personal opinion, but I feel that you should embrace pain and fear. They tell you useful things about what you're doing and how you're doing it. Ignoring them may lead you to stratospheric levels of performance if you're lucky enough to get there without a career ending injury or psychological dysfunction, but it seems highly likely that you'll be left injured, and probably unhappy with the remainder of your life now that you can no longer look forward to new achievements. Personally I'd rather take longer to go through the crucible and come out stronger, than force my way through and come out broken.
I'm not an Olympian or any kind of champion, and not a trainer of them either. But I do like to push myself and reach higher. And I like to help others do the same. I think that to strive for achievement means being not only the short term goal of that heavier lift, or that more challenging competition, but also the long term goal of health and happiness.
As always, feel free to comment, correct or criticise. Hopefully it won't be another year before my next entry!
No comments:
Post a Comment