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Working out with a chronic injury can be a daunting and intimidating experience. When normal everyday tasks are made challenging, maintaining a consistent fitness regimen can seem impossible. Exercising with a chronic injury is just as much a psychological challenge as it is physical. Here are 5 tips to get you started and keep you moving in the right direction.


1. Warm Up!

The warm-up is an integral part of every workout but especially for those with an injury. Warming up by increasing your heart rate before an activity will increase blood flow to help loosen tissues, ligaments, and muscles. This can generally improve range of motion and possibly pain in or near the injured site. Warming up also decreases the risk of further injury to the body. Unfortunately, we live in a sedentary society where we spend much of the day sitting, hours hunched over a desk, and not moving through full ranges of motion. This behavior increases stiffness in our joints, creates muscular imbalances, and overcompensations in the body. Over time this can wreak havoc on the body and on a chronic injury. The best thing we can do is try and “reset” our bodies before working out. A good warm-up is 5-10 minutes, increases your heart rate gradually over that time, and is followed up with, at the very least, a dynamic stretching routine to prepare for the planned activity.


2. Set Realistic Goals/Mindset

Working out with a chronic injury takes a strong mindset. There will be days where you have the best intentions to get your routine in, but the pain is unbearable, and you have to stop. This is one example of why so many give up on working out with an injury. Ultimately it comes down to your motivation and goals. What motivates you to try and rehabilitate? Is it to be able to get back to your regular activities? Is it to keep up with your children or grandchildren? If that motivation and/or goal is not important to you or altogether absent, you will not do your workouts consistently. Determine what your ultimate goal is and set smaller goals to achieve it. And let me emphasize that it is important to be realistic with your goals. If you have a significant knee injury, odds are you are not going to be running a 10K in 3 months. Start with pain-free walking for 30 mins, then increase that to 45 mins, etc. Then maybe, that turns into a 10 min jog/walk and then 15min, 20min, etc. A chronic injury is hard. It makes even the simplest tasks significantly more difficult and can prevent you from doing the things you love. It can be frustrating and debilitating mentally as well as physically. The worst course of action we can take is to feel bad for ourselves and/or do nothing about it. Working out with a chronic injury is just as much mental as it is physical. Stay positive, celebrate small successes, and most importantly stay CONSISTENT. Even if you do not make it the gym every day, you can still do an entire mobility routine in a bedroom or living room with the right knowledge as well as a variety of strength exercises!


3. Increase Mobility & Strength
Though these are paired together here they may be the most important two in producing the best results! Whether it is a knee, hip, or shoulder injury, increasing mobility and strength in and around the joints will certainly increase function, relieve pain, and improve prognosis. This may seem obvious, but consistency is key here. The biggest difference between an acute and chronic injury is that this behavior must become a habit and ultimately a lifestyle. Too often I meet with new clients dealing with chronic injury only to hear that they have never had a routine or have not been doing their strength and mobility exercises that they had been doing previously in a therapy setting. In this case, the injury has usually worsened, and the effects are radiating to other parts of the body, further affecting movement, mobility, and function. Mobility can be improved by self-myofascial release methods such as foam rolling and a unique dynamic/static stretching routine. In terms of strength, most often we want to focus on strengthening the muscles around the injury. For example, if it is a knee injury, you want to strengthen your quadriceps, hamstrings, glutes, and core. If we were to add some mobilization into the equation, we can look at a shoulder injury, where we would want to mobilize the pec muscles and upper back and strengthen the rotator cuff and your mid and upper back muscles. This is all generally speaking, however. Every chronic injury is unique and you should always consult a rehabilitative professional for guidance.


4. Nutrition

Our bodies are directly affected by what we put in them. Chronic injuries generally mean chronic inflammation and pain. What one eats can largely determine the severity of symptoms. Is your diet full of processed, low nutrient, and generally inflammatory foods? If so, you are likely to exacerbate the associated inflammation resulting in more pain and generally feeling ill. Combine workouts with this type of diet and it is likely that habit will fail sooner rather than later. Whether we are dealing with a chronic injury or not we want to always focus on intaking adequate amounts of protein to support lean muscle (1g per 1 lb. of ideal body weight is a good place to start). Look to nutrient dense foods like vegetables, fruits, and nuts. Even the best diet has nutritional gaps. Consider supplementing your diet with a quality multivitamin or natural anti-inflammatories like fish oil and curcumin. Supplements with a GMP label are your best bet as they are third-party tested for quality and efficacy since the FDA does not regulate the supplement industry. Ultimately for many lower body injuries weight can become a significant issue and make chronic issues like osteoarthritis worse. For example, every pound of extra bodyweight multiplies 4-5x that on each knee joint accelerating the “wear and tear” and being counterproductive towards your rehabilitative goals. The reality is, being overweight with a chronic injury is almost never a good thing so it is in your best interest in many cases to rehabilitate your nutrition as well, if necessary, before and/or while working out with your chronic injury.


5. Get Help
You do not have to go it alone! Today there is a myriad of professionals that can support you in your recovery or maintenance effort. From physical/occupational therapists to chiropractors, to a personal trainer certified in corrective or rehabilitative exercise. Each has expertise that can support and guide you in a unique way. Much of the time connecting with these individuals is about acquiring the knowledge to help you improve your injury. However, working with a professional on a regular basis will help you improve symptoms, consistency, accountability, and your overall outlook.  The more you can learn about your injury and how to improve it, the better off you will be. Knowledge about the body and rehabilitative procedures is constantly changing and new research and methods are regularly being developed. These professionals can help you stay current on much of it and guide you in the right direction.

Adham Ibrahim has been actively training a diverse clientele while leading and developing fitness professional talent throughout the Boston region. As a certified trainer and coach, he specializes in functional fitness, mobility, weightlifting, corrective exercise, injury rehabilitation, and general nutrition. He currently holds certifications from NASM, USA Weightlifting, MobilityWOD, and ACE. He strives for daily improvement for himself, his trainers, and his clients. As denoted via his trademark tags #neverstopimproving. He currently works at Life Time Athletic servicing the greater Boston region. To see more from Adham, follow him on Instagram: @hamfitmob #jointhemob


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