What other factors can prevent recovery from an injury?
If I have learned anything from this journey, it is that obstacles are plenty and forgiveness is slim. It seems that everything can be going well and one wrong move can send you tumbling back to the starting line. The good news is, unless you experience a complete relapse (i.e. re-tear the same tissue), you are never as far back as you think.
The kinda-good-news is that for all those that work with me directly, I always frame this from a long term. We set the expectations low and durational — nothing gets achieved overnight. It helps endure the long process of getting back to 100%.
So what are those things that seem to impede progress when everything is going well?
Diet and Nutrition
While it is tempting to zip right to “inflammation”, really the biggest culprit is building blocks. If you are in high demand of the pieces of the puzzle to facilitate healing and you are not providing those things, healing will be delayed. What are those things? Collagen and protein. There are a handful of vitamins and minerals that show some evidence of assisting, but ultimately its regular old food that will get you the best benefit.
Alcohol
I’ve got some bad news — alcohol is pretty much antagonistic to every physically productive thing you want to do in life. The most relevant detail here is protein synthesis. Alcohol disrupts protein synthesis in the near term (i.e. while you are drinking) but studies also show that there is a half-life of this that can last up to 72 hours. Which means if you drink on Friday, then again on Sunday and maybe a glass of wine with dinner on Wednesday, you’ll have inhibited ability to repair for the entire duration — even if you abstained completely on the other days.
Compounding of Stimulus
When you are compromised, so is your ability to handle general outside stimulus. If I am shy a good knee/elbow/foot that means I will disproportionately rely on the others for help. I don’t have data on this, but anecdotally the number of people who report their OTHER GOOD LEG starting to hurt after an injury is staggeringly high. The first 30 days are the most critical. It would be my advice to avoid that extra hike, round of golf, house cleaning marathon or building that Ikea bedroom set until you are a bit further in the process. These may all seem like rather innocuous activities (and perhaps even necessary to get done!), but it only takes one funky move for you to have two bad elbows instead of just one.
Interpreting lack of pain as 100%
Speaking of the above, 30 days in and you are feeling great! The pain is all but gone and you feel light as a feather again! The problem is, you aren’t quite there. I use 90 days as a minimum guideline for a new injury from date of incidence to ability to contemplate. If you had ACL surgery, it is more like 12 MONTHS. This will vary tremendously. But for your garden-variety “dang, that really hurt!” but no medical interventions are necessary, 90 days is a good guideline.
One of the upsides of ability training is that we can put this to the test. Let’s say you have a bad knee that starts to feel better. Well, can we MAKE it feel bad by loading the tissues further? If I can reach maximum effort without pain (that is, a 9/10 of effort, pain free) then things are looking good. If “ordinary daily activities” are pain free but we load it to a 5/10 (using our 9/10 on the good leg as a control) and that produces pain, then we are not yet out of the woods.
Too much “testing”
I don’t know what it is, but human beings are obsessed with testing. We want to know how we are doing! The problem with excessive testing is that “the test” and “the training” are two different things. Imagine you take the SAT. Then, you take it again in hopes of a better score. And again…and again. Well, due to simply getting better at the test, you will likely make some marginal improvements. But does this represent better capacity? I’d say no. Whereas, if you stopped testing, trained the basics, got smarter and then 6 months later took the test again, you’d have an indicator of capacity that was also part of a measured process. Testing is always pushing the boundary. Training is operating within a known boundary. If you are ALWAYS testing the boundary, the chances of you accidently going over it increase.
Slacking on the little things
The unfortunate reality of recovery is that it boils down to the little things. Did you do your homework? Did you do your mandatory warmup? Did you do your cool down? Every day? Every rep? Perfection isn’t required, but slowly slipping away on the basics is a surefire way to encounter many of the above pitfalls — testing it before its ready, misreading a lack of pain for being 100% and simply missing the 1000s and 1000s of reps your tissues need to make long term, sustained changes.
It’s not all doom and gloom! Most of these things are not arduous asks, here would be a summary of how to be proactive in recovering from an injury
Eat a nutritious diet
Avoid consumption of alcohol
Be mindful in the first 30 days not to pile on too much
Be mindful in the first 90 days to not get too confident
Embrace the process and avoid testing it excessively
Find a routine to get your homework done
That doesn’t sound too bad, does it?!
