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FeedDown (But Not Out)
Injury doesn’t have to mean the end of an active lifestyle.
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When John Holzer injured his back in a fall six years ago, doctors put a rod in his spine and fused several vertebrae together. Both physicians and therapists told him he was lucky to be able to walk.
Holzer, however, wanted more. A lifelong runner, he’d already started tapering down his routine after a pulled hamstring. But the notion of never being able to run again was difficult to swallow. “Eventually, I found the pool,” says Holzer.
Whether you’re a marathon runner, a gym rat or a golfer, exercise can be addictive. Given its health benefits, that’s a good thing. But if an injury prevents you from returning to a normal exercise routine for weeks, months or even longer, the effect can be physically and psychologically devastating.
“I’d never encourage someone to stop exercising altogether,” says Dr. William Emper, an orthopedic surgeon at Bryn Mawr Hospital.
Still, many of his patients have to completely rethink their fitness routines. Water exercise—whether it’s swimming or aerobics—is easy on joints and bones, and can be a great first step back to an active lifestyle. Waterproof casts make it even easier.
For others, bike riding (stationary or otherwise) is another means of aerobic exercise. An upper-body ergometer—found in most gyms—can also provide a great alternative workout.
Despite myriad options, convincing anyone who is partial to high-impact, high-adventure sports that a walk, swim or modified gym workout is an adequate substitute can be tough. “It’s especially difficult with runners,” says Emper, who treats many hardcore athletes. “There really is no substitute for that wind-in-your-face feeling.”
Nonetheless, a key part of the recovery process is accepting one’s limitations and learning to enjoy new routines. Of course, those routines must be developed in consultation with a doctor and a physical therapist. The risk of re-injury rises exponentially, and great care must be taken to protect and strengthen the body after injury.
The first one to two days after an injury are critical. There should be no “getting back to exercise” or “working through the pain” during this first stage of healing. “We like to refer to R.I.C.E.—rest, ice, compression and elevation,” says Caroline Hughes, a physical therapist with Main Line Health. “For the first 24 to 48 hours, you want to reduce inflammation and become exactly aware of what the injury is. That’s where a physician steps in.”
Once the injury moves more fully into a recovery stage—when swelling lessens and the pain begins to subside—the patient needs to seriously assess the situation and develop a proper recovery plan. Often, people can start some form of physical exercise two to three days after injury (depending on the type)—usually of the non-impact variety, such as swimming or biking or chair aerobics.
“This is where people tend to either want to go right back to where they were and over-train too soon, or they decide they want to rest more than they need to and lose some ground with their fitness level,” says Hughes.
