Strength Training for Pain & Injury Rehab
This is a summary from ‘Strength Training for Pain & Injury Rehab’ Paul Ingraham at Pain Science
The full article is available by clicking the main title.
It has been said that exercise is the closest thing there is to a miracle cure. “All the evidence suggests small amounts of regular exercise (five times a week for 30 minutes each time for adults) brings dramatic benefits,” we “age well” when we are active (Gopinath): less anxiety (Schuch), prevention of dementia (Smith) and a laundry list of other diseases (Pedersen), and as little as just 10 minutes per week might push back death itself (Zhao).
Exercise is Power: Resistance Training for Older Adults 11:51
But why is it so awesome? In a general sense? What makes exercise such a wonder drug?
Exercising at the right intensity + is biologically “normalising,” pushing systems to work the way they are supposed to work. Biology is all about clever homeostatic mechanisms that nudge tissue state back to average. Those systems all rely on negative feedback loops based on molecular signalling (hormonal, neurological, etc), and exercise produces a lot of stimulation … raw “data” to feed into the negative feedback loops, which is normalizing. It’s not a universal principle, and exercise cannot normalize everything. + But it does stimulate an incredible array of adaptive and homeostatic mechanisms — way more than any medicine, supplement, or superfood.
Last but not least, exercise is a classic outlet for frustration that measurably reduces stress, which naturally has many spin-off benefits. It works because stress is all about preparing the body for explosive, emergency action, and exercise simulates a “fight or flight” response. When we “survive,” it signals the end of the emergency, triggering recovery biology.
Most risks of strength training go away if you just add one simple caveat: “You can’t go wrong getting strong … with good load management.” Keep the intensity in the Goldilocks zone, no big spikes in intensity, don’t rush it, and most of what might go wrong probably won’t.
Strength training can be extremely valuable in rehab, and it can be done safely. In fact, the whole point is that it’s the ideal way to control how much tissues are challenged — to make sure it’s a “challenge” you can adapt to, rather than a harmful stress you cannot.
Although overloading cannot fix overloading, when you’re ready for it strength training can and should become a valuable component of rehab from nearly any kind of injury or chronic pain problem. It is your most important load management tool. It is extremely flexible and can be performed in a wide range of intensities, and easily customised to stimulate only what you want to stimulate.
You should do strength training when you have already paid your dues doing easier work first. You should do it to cover that last, crucial step from “recovered” to “better than ever.” You should do it to test your tissues, to reveal remaining vulnerability, to demonstrate to yourself that you really are better. It is a powerful way of demanding the highest possible function from your tissues, the most potent way of “using it” instead of “losing it.” The physiological effects are significant and numerous:
blood flow is increased far more than any massage could ever do, capillaries open up wide, the entire system mobilises resources to supply hungry muscles with oxygen and nutrients
metabolic waste products are produced and washed away at a prodigious rate, probably including old stale ones still lingering in the dregs of trigger points that you mostly (but not entirely) got rid of in earlier stages of recovery
coordination and neurological function improves with every workout as you “learn” how to actually recruit a respectable number of muscle fibres, which is responsible for most early strength gains
rusty inhibitory and excitatory reflexes are exercised, normalised, balanced, which probably provides an injury prevention benefit
Strength training does not just happen in gyms
You should consider trying to overcome gym shyness because (a) the people there are probably nicer than you think, (b) strength training is fairly efficient and you probably don’t need to spend as much time there as you fear, and (c) the precision and control of universal gym equipment has many advantages.
Nevertheless, there are some excellent, creative alternatives to gym training. Your own body weight can be more than adequate for strength training many large muscle groups. Slow deep knee bends, push ups, chin ups, and abdominal roll-ups are all good examples of body-weight-only exercises that many people cannot do many of — good places to start strength training without gym equipment.
However, it must be said that a thorough strength training program simply cannot be done without at least some apparatus. A small investment in a few barbells and exercise bands or tubing (large, colourful elastic bands or tubes) allows for an almost infinite number of strength training options.
