Successfully Return from Injury with THIS Fundamental Progression...
You sustain an injury.
You go receive help from your therapist.
You finally are out of pain, and your physical therapist says "just ease back in and you'll be fine"
You're excited that you can finally start working out again.
You get to the gym and....you realize you have no idea how to simply ease
back into training.
You don't want to do the workout as prescribed or go heavy on your snatches. I mean, you haven't snatched or done a pull ups in about 8 weeks. You don't have pain, but your ________ still feels a little weird. You don't want to go back into working out full force because you know you'll re-injure yourself (you may know from personal experience). But you also don't want to go at it too slow because you really want to workout again!
So how do you progress back into training systematically, effectively, and efficiently?
You need to progress yourself back into training by slowly adding complexity to your movement, then stacking speed, load, and intensity on top of foundational movements.
The first thing you must progress back is the complexity of movement. Dr. Kelly Starrett has done an excellent job of categorizing the movements to make this concept easier to understand. He talks about this concept in his book Becoming a Supple Leopard. I will be quoting his definitions of the different categories of movements in this post. I highly recommend checking out the book for yourself!
The first category of movement you need to remaster is: Category 1 movement. What are Category 1 movements?
“All these exercises share a common sequence: They start in a position of high stability (PHS)—a braced neutral position from which you can maximize torque in your hips and/or shoulders—and maintain that stable position throughout the entire range of motion. This is how you classify a category 1 movement.”
Movements which fall within the Category 1 movement category are your basic squat patterns, hinge patterns, press patterns, lunge patterns, pulling patterns, rotation patterns, and simply carrying objects. Examples of these will be your back squats, front squats, goblet squats, deadlifts, good mornings, glute bridges, split squats, bench press, pull up, ring row...etc. These movements are fundamental and are the basic foundation for ALL the movements you perform in life.
How do I do this?
Regain these movements by linearly progressing this movements in pursuit of your prior function. Start with a simple linear progression on tempo. A progression which clinically works great is starting with 3 sets of 15 reps on tempo (4 second eccentric, 4 second isometric hold at bottom, 4 second concentric, 1 second between reps). The limiting factor will be the movement itself and your ability to maintain the prescribed tempo. The LONG time under tension will enable you to build stability within the pattern, and build strength and capacity in your connective tissues,
You will then progress from 15 reps, to 12 reps, to 10 reps, to 8 reps, to 6 reps. You will naturally be able to move more load as the reps decrease. In the beginning your loads will be light but it will be very challenging! Eventually your loads will approach your normal training weights from before your injury. When you get to this point your tissues will be ready for the loading and intensity that you wish to throw at them, your body will feel great, and your movement patterns will be BETTER than they were before.
The next category of movement which you need to reestablish are Category 2 Movements.
You begin with a“Position of High Stability (PHS): A braced, well-organized position that allows you to create and maintain maximum stability through your hips and shoulders. [•Connection in starting position: Maintaining a torsion force through the entire range of motion while moving at a slow speed.], you then remove the connection by removing torsion force or adding speed, then you spontaneously stabilize your spine and generate torque to finish in the same Position of High Stability." The starting position and the ending position are the same.
Movements which fall under the category 2 umbrella are wall balls, kettlebell swings, jump squats, box jumps, jumping lunges, running, rowing, snatch balance, kipping pull ups, Kipping handstand push ups, plyo pushups.
How do i do this?
Once you have built the foundation by retraining foundational movements (category 1), you then introduce category 2 movements to the equation. You progress category 2 movements by starting with lighter loads, lower volume, and in a non-fatigued state. You then progress these into higher loads, higher volume, and performing while in a fatigued state.
The last category of movements are Category 3 Movements.
“Category 3 movements closely resemble the actions of sports: You move fast, combine multiple archetypes into one movement, and change direction rapidly—for example, going from a pull to a press (as in a muscle-up), cutting, jumping, and then landing in a different position. Formally defined, a category 3 movement starts in one position, removes the connection (torque), and arrives in a completely different position. Put another way, you need to be able to spontaneously generate stability while transitioning from one archetype to another."
Movements which fall in category 3 are often those performed in sport. Snatch, Clean, Kettlebell snatch, med ball toss, lateral cutting and jumping, muscle ups, swinging a baseball bat, throwing a football are all examples of this. When you get to this category of movement you are most likely feeling great and in the final stages of regaining your prior level of performance.
How do I do this?
Just like you progress category 2 movements, you progress category 3 similarly by starting with lighter loads, lower volume, and in a non-fatigued state. You then progress these into higher loads, higher volume, and performing while in a fatigued state and a higher cognitive load.
The progression is Category 1 --> Category 2 --> Category 3. However there WILL be overlap between categories AND different movements may actually be in different categories throughout the rehab process. This is where it is very important to have the guidance of a rehab professional who knows your injury, knows your sport, and understands the process to most efficiently return you to your previous performance. Your rehab needs to be challenging and your rehab should be specific to your current needs. Having a rehab professional there to guide you through the process, inform you of whats normal or abnormal to feel during the process, and tailor the process to you specifically is crucial for returning to your prior level of injury as quickly and efficiently as possible.
How long does this process take?
Well, this depends. There are a lot of factors to consider and it's an impossible question to answer correctly. Every individual is different. But, the process works!
If you are returning from an injury, find a clinician who understands the rehab process and understands your goals to help you get back to the activities and sports you love. They will guide you along your journey, let you know what's normal and what's not normal, and they will get you back to the things you love in the quickest most efficient manner possible!
Here at Ground to Overhead Physical Therapy, we help athletes all over the country return to the sports they love. We do this with in person appointments for athletes local to our clinic and remotely we help athlete through individualized training-rehab programs. We coach the athletes through electronic communication, video analysis, and video calls; guiding them step by step along the process of their rehab process.
Questions about the content within this post?
Interested in how you could regain your prior level of performance without re-injuring yourself?
Contact me by clicking here!
Send me an email at Tancini@groundtooverheadphysicaltherapy.com .
I'll be happy to help!