Injuries are common and we take it to be the norm when choosing to live active lifestyles. Truth is, that isn’t how it’s supposed to be. While muscle soreness is a given, injuries, especially repetitive injuries are an indication that there is something wrong.
I’m writing this article to help you understand why injuries happen in the first place, shed some light on the most overlooked causes of injuries and empower you with information to prevent these nagging aches and pains – greatly reducing the probability of suffering from an injury once and for all.
Types of Injuries
Injuries can be categorized to two types; process injuries and direct trauma. The latter is usually easy to diagnose, treat and recover from, while process injuries are a result of repetitive micro traumas over a long period of time. Process injuries are therefore far more complicated, and commonly misdiagnosed, not to mention that most direct trauma injuries are a result of process injuries.
Our body’s are designed to be mobile and will go to extreme measures to maintain mobility as it sees it to be a critical factor for survival. Moving efficiently and safely however, requires a very specific balance between mobility and stability. Any disruption to that balance will cause your body to alter the way it performs every day tasks. This disruption, coupled with added loads (resistance training / endurance training) creates the perfect recipe for injuries to occur.
Tennis elbow (elbow tendonitis) for example is something that many people believe they have to live with for the rest of their life. Actually this is simply a result of an imbalance in the forearm muscles and can be fixed in less than a month of adequate exercise programming. I have been able to get many clients suffering from tennis elbows to train pain free in 45 days when they’ve lived with months of painful training and wasted hours of physiotherapy sessions.
While you may think that elevating your arm is only specific to your shoulder, it is actually an integrated movement that occurs through a series of events all the way down to your feet. This integration is known as the Kinetic Chain of the body and any dysfunction within the chain will lead to abnormal compensations, that over time will result in injury
The Injury Dogma
When it comes to injuries, people (doctors included) tend to isolate the injured area from the rest of the body. While it’s critical to do so, failing to understand that the body works in harmony will lead to a longer recovery period, if not worsen the injury or cause it to recur.
That said, you can begin to understand that an injury in the knee for example may be brought on by a disruption in the kinetic chain somewhere else in the body; such as the ankle or hip. So while the injury is to the knee, there may be nothing particularly wrong with the knee itself. This is known as a referred injury or referred pain (usually overlooked and misdiagnosed in majority of injuries)
Our body is connected from head to toe by a series of overlapping segments (our joints). Each segment is designed with a very specific function, all-working together to form a linked interdependent relationship known as the Kinetic Chain. Picture an orchestra. While each member has a separate function, they all work together to produce a harmonic symphony. If any member fails to play his part perfectly, it causes the symphony to be off tune. That is exactly what happens with any disruption to the kinetic chain.
Disruption in the body’s kinetic chain can be caused by a number of reasons such as:
- Poor lifestyle habits
- Incorrect form during exercises
- Inefficient workout program
- Previous injuries
All the above lead to muscle imbalances, which are the underlying cause of injuries.
It All Starts With A Muscle Imbalance
Muscle imbalances refers to the strength / mobility / length of one muscle group compared to its corresponding opposite muscle group (agonist / antagonist muscles). This is the pinnacle cause of injuries.
For the sake of clarity, I will take the example of an imbalance caused due to stronger quads compared to hamstrings (aka quad dominance).
The quadriceps muscles makes up the front of your leg muscles and attach to the front of your pelvis (Hips) with the lower portion attaching to the top of your knee. They are responsible for extending your leg at the knee; raising your legs as well as extending your knees.
The hamstrings cross and act upon two joints – the hip and the knee and are responsible for flexion of knee and extension of the hip.
So as you can see, the quadriceps and hamstrings are opposing muscles as they are responsible for counteracting each other’s functions. Now given our imbalance (stronger quadriceps) lets see what this does to the kinetic chain.
The stronger quadriceps will over power the hamstrings and pull your pelvis forward and down, causing excessive curve of the lumbar spine (lower portion of the spine). At the same time this stretches and tightens the hamstring muscles, which will inherently affect the knee.
The above will alter the functions of the spine – as it needs to become mobile (versus stabilizing) to counteract the altered pelvis position – while the knee is placed at a mechanical disadvantage. With the latter occurring and as you unknowingly continue to will cause micro trauma to your joints and place stress on your muscles eventually leading to injuries down the line.
In this case our subject with the above imbalances will most likely develop trauma to the knee. As a result a doctor visit will indicate inflammation and possible damage to the knee. Surprisingly 90 percent of orthopedics will overlook this imbalance and prescribe anti inflammatory medication, followed by cortisteroid injections with the least option leading to surgery. Funny enough, none of those remedies will fix the underlying cause of injury and will eventually result in the injury to recur once the subject has healed and returned to training.
Shoulder injuries – another common problem in the fitness world is mainly caused due to a dysfunction in the kinetic chain that causes the shoulder to be misaligned. Given our current lifestyles’ (hunched over positions at our job, driving, texting) our chest muscles become shortened and tight, while at the same time elongating and weakening our upper back muscles. This, in addition to long seated hours causes our gluteus muscle to become inactive (causing the knee to rotate inwards). The latter will result in altered biomechanics (as the body will override its normal motor recruitment to achieve movement) and eventually result in injury.
So as you can see, most injuries, even though are caused by direct trauma (during a specific exercise) will in most cases be a result of a disruption in the body’s kinetic chain. I’ve had many instances where clients suffering from month-long injuries were cured in a few sessions by working on a completely different area I the body. In essence, contrary to common belief, most people need to be following an unbalanced training program to address their imbalances. A balanced training routine will only make their imbalances more apparent and lead to more injuries down the line. This also applies to recuperating an injury. Solely isolating the injured area and working on a tight muscle (especially stretching) will only lead to more complications down the line.