Overcoming Injury

Overcoming Injury

By Peter Shaw
02/02/14

Dedicated to my best friend Jonny Byrne. RIP my friend.

Firstly, I would like to thank Des Shaw and Shaw Sports Performance Solutions for asking me to write on such a relevant topic in modern day sport. For anyone who knows me that reads this post, they will already know that I have a lot of experience with this subject (my friends probably think I hurt my finger writing this).

Man is now at rest more than ever and this leaves us more susceptible to injury. Over my short career I have pulled hamstrings, compound fractured my collarbone in four places, fractured my talus bone, fractured my right ankle, fractured my right wrist twice, undergone a hip arthroscopy surgery, undergone a sports hernia operation, tore my anterior talofibular ligament in my left ankle twice, been placed in a brace for two days as my vertebrae was out of line and have had many more less significant injuries which could fill up this whole article. I spend a substantial amount of my time rehabbing rather than training and one might say I am dysfunctionally functional as an athlete. My main sport is hurling but I also play Gaelic football and have played soccer at a very high level in my early teens but this has taken a back seat now to my hurling endeavours. My objective here is to give advice, both mental and physical which I feel worked for me in overcoming injury. The number one goal when injured is overcome the injury and come back stronger. Here is my perspective based on my experiences with injury.

Prevention

Recently the majority of my time spent in the gym has been what many people would consider strength training and a few years ago I would of too. However I feel now that it’s now morphed into more of injury prevention and a prehab strategy. Currently I allocate a lot of my time to foam rolling and doing self myofascial release (SMR) which is basically a form of self massage and a great tool for athletes to identify muscles, or muscle groups that are adversely tight. My hips are a priority area because they become very tight and they need extra flexibility work to mobilise them. I also use large resistance bands to distract the hip joint, a technique introduced to me by my physiotherapist Damien Sheehan and this has vastly improved my hip flexion, extension, internal and external rotation. Because I spend so much time sitting in college and watching tv etc. my muscles tend to ‘shut off’ and not produce the desired muscle contractions when I’m training or playing. Using SMR and hip distraction with resistance bands has helped this problem greatly.  Physical therapist and author of “Becoming a Supple Leopard” Kelly Starett’s body of work in the area of mobility has impacted greatly on me and I recommend everybody to check his work out here at http://www.mobilitywod.com/. Glute activation or lack of more to the point was a major problem of mine and was the reason for a lot of my early hamstring problems and hip instability. I use exercises like glute bridges, band walks, crab walks and unilateral strength exercises in my routine to develop better glute activation and this has also helped me drastically in my injury prevention strategy.

Knowledge of the Injury

The first thing when you get injured I suggest you to do is be evaluated by a physiotherapist, GP or in extreme circumstances a specialist. They will do an initial assessment and develop the course of action(s) from this. Generally most injuries will require treatments such as massage, trigger point therapy, ultrasound, laser treatment etc. but some may require referrals for CT scans, x-rays or MRIs to diagnose correclty. Some may even send you to have an evaluation by an orthopaedic surgeon depending on the severity of the injury. So when you are in the presence of these injury specialists it's important that you ask lots of questions regarding the injury like:

·        What is the diagnosis?

·        The recovery time for the injury?

·        What treatment is required?

·        What to expect during rehab process?

·        What exercises/workouts can I do while injured?

·        Is there anything I should avoid doing while rehabbing?

Your knowledge of the injury is very important. If you understand it a little better you can engage in a more effective rehabilitation programme. If you feel any pain during rehab and you should stop, you know your body better than anyone and its better to be slow and steady when rehabbing. Remember tomorrow is a new day! Far to often players fail to ask what workouts they can be doing while injured and just stick to rehabilitation exercises given to them by physiotherapists and are missing a great opportunity to improve other areas. Being injured is the best opportunity to come back stronger. A good example is Roy Keane, whilst injured he used this time to build his upper body strength whilst having a lower extremity injury. There is always something you can be doing to get better whilst injured but always remember to ask the injury specialist before conducting any workouts.

Developing a Relationship with Your Injury Specialist

One of my biggest failings when injured was my willingness to change physiotherapist based on my fellow teammate’s recommendations, ‘Oh this guy is great he’ll sort you out have you back in no time.’ or other times I was pushed towards certain physiotherapists by my coaches and this creates a vicious circle of never actually developing a relationship with the one physiotherapist. While I was suffering different injuries, I was travelling around to different medical professionals and all of them had varying opinions and methods of treatment. Some would look to treat the area of injury and I would be back on the training pitch quickly but these never get to the root of the problem, whilst others looked at the bigger picture assessing my movement patterns and but this meant longer rehabbing times and more corrective work to be completed. Being a typical competitive player and wanting to get back as quick as possible, the quick fix was usually the choice. However this led to further injuries down the road and it’s can be hard for a player to choose the long term option and have faith in someone when there is no relationship built up.

My advice is to find a qualified and experienced physiotherapist. They should a good reputation for their precise rehabilitation techniques and assessing the bigger picture and also for constantly keeping up to date with new proven methods of treatment.  Once you find this person stick with them. They will build a profile of your body type, your dysfunctional movements and injury history which makes it easier for them to diagnose you correclty. Moving from one physiotherapist to the next will mean starting this process again each time. My current physiotherapist is able to tell me my complete injury history, the exercises I struggled with during rehabilitation, my trials and tribulations with rehab and the times I lay on the physiotherapist’s table disillusioned with the whole process. Building this type of relationship with my physiotherapist I feel has benefited me greatly in reduction of injuries and also has helped with reducing rehabilitation time when injured. 

Fitness While Injured

A problem I had with my long layoffs was when returning to full training I had a poor fitness base behind me. I recall during the late stages of my collarbone injury, doing wall squats, lunges and interval sprints on a spinning bike and this work proved to reduce my muscle atrophy and allowed me to focus more on strengthening the shoulder muscles when the sling was removed. Too many times I had been injured, returned to training and my hamstring would cramp or worse my back would spasm because of returning to training with a poor fitness level. Try to work on your fitness and do lighter versions of your regular training before you return to full tilt training. My belief is the only time you shouldn’t train is when you are sick. You can always be working on something to prevent a decline in your fitness levels. A video I seen recently exemplified this belief, it showed a professional rugby player was doing seated intervals of boxing pads while he had a knee brace on for an MCL injury. My advice is speak with your physiotherapist and they can advise you best on what strategy you can adopt to keep your fitness levels from dropping too low whilst rehabbing your injury.

Positive Mindset and Support System

I can admit during my hip injury in particular that I was in a dark place at times. After being injured for so long and being diagnosed some many different times with varying opinions, I became very frustrated. It was very difficult to remain positive when medical professionals didn’t quite know what the root of the problem was. It took me two and a half years, 6 medical professionals, over 30 appointments and who knows how much money to find the root of the problem. My first Hip Arthroscopy for a Femoral Acetabular Impingement didn’t rectify my injury. Eight weeks later I underwent a sports hernia surgery and this all during my final year in second level school (leaving cert).

It took 23 weeks in total to return to full training and competition. Remaining positive proved arduous during this long rehabilitation but I was determined to get back better than ever. Initially, during the rehabilitation process I was enthusiastic and looking forward to getting back training. But when the exercises are very monotonous; such as lifting your leg while lying down or squeezing a small ball lightly between your knees, my attitude quickly changed to one of apathy. Setbacks caused me to become disillusioned with the whole process and a comeback seemed further away than ever especially when i was told I had a small chance of making it back to competition and possibly only a few years before impending retirement because of my hip injury by one medical professional.

What helped me greatly in staying positive was having a strong support system. My physiotherapist, coaches, friends and family were pivotal to helping me keeping a positive mindset. The constant reiteration that I would make it back from these injuries kept my spirits high through my rehabilitation. I found comfort in talking with other players who have come back from serious injuries before and this proved invaluable in staying positive during my darkest days. Getting their perspective and advice was instrumental in giving me a keeping me focused to get back to my best. Also viewing motivational videos (there are loads to choose from online) lifted my spirits when I was getting very disillusioned with my progress. Also reading about sporting greats who had previously had injuries and made full recoveries gave me hope too such as Ray Lewis (Baltimore Ravens Linebacker) returning from what was believed to be a season ending triceps surgery to win an superbowl and lift the Lombardi trophy.

Goal Setting

This is vital in the rehabilitation of any injury. Goal setting will provide you targets and timelines to achieve which will hold you accountable. I would set goals to do a certain amount of reps of an exercise. For example, I couldn’t do 10 bodyweight rear leg elevated split squats. Goal setting changed my attitude right around, I developed a tireless work ethic which involved doing strength work before I would go to school. Then I would do core strengthening and hip flexibility at 4:30pm after school.  My thought process was not a rehabilitation programme, it was more like an American footballer in pre season and I used the rehabilitation process as a strength programme. It was determined to be the strongest I had ever been. I developed on to doing rear leg elevated split squats with 20kg dumbbells in either hand and a 10kg weighted vest for 8 reps. Developing simple goals in conjunction with you physiotherapist, that are specific, measurable, achievable, realistic and time oriented will help you get back on course to full fitness and competition.

From my experiences with injuries I have had, I feel that these are the major areas which I found most important in the journey back to full fitness & competition. I have over time, improved these areas greatly in order to make sure that I reduce my chances of acquiring future injuries and also to reduce the amount of time I am removed from competition when injured. I hope this article can help some athletes out there who are currently injured, in despair because of the potential long layoffs and rehabilitation I also hope it will act as a guide for athletes in the event of future injury. Remember there is always someone who has had a more severe injury than you, constant reoccurring injuries or been to a darker place than you. If they have made it back, so can you! Remain positive and work hard with your physiotherapist and you can be back stronger than ever!

Peter Shaw


About the Author
Peter is currently studying for a BSc in Strength and Conditioning at Limerick Institute of Technology in conjunction with Setanta College. He comes from a Gaelic Athletic Association sporting background. He is currently a member of the Carlow senior and U21 hurling teams and also a member of the Carlow U21 football team. He has also competed at a very high level in soccer on FAI emerging talent squads, regional level in cross country and basketball while attending Knockbeg College (2007-2013). He has three years coaching experience with underage GAA teams and is about to undergo his GAA level 1 coaching qualifications.