Aches, pains, and injuries come with aging. Not only are these annoying and disruptive to our daily routines, they can throw our workout programs for a loop. In fact, some of you reading this may have so many aches and pains that they prevent you from exercising in the first place, for fear that you will make things even worse.
The good news is that a qualified Health Coach can help you navigate not only your return to the gym, but also put you in a position to help your aches, pains, and injuries diminish. Let’s find out how, by understanding the five things Health Coaches do to make this happen!
How to Get Back Into Working Out After an Injury
Most people asking how to get back into working out are not starting from zero motivation. They are starting from a stop. Something hurt, they backed off for a few weeks, the few weeks became a few months, and now there are two problems instead of one.
The first problem is deconditioning. Muscle, aerobic capacity, and tolerance for load all drop during time away from training, so the workout you stopped doing is no longer a workout your body is prepared for.
The second problem is the ache, pain, or injury that made you stop. Rest can quiet symptoms without changing what produced them. If tight hip flexors and weak glutes made your lower back hurt in March, those same muscles are usually still tight and still weak in September.
Picking up where you left off asks a deconditioned body to absorb the old workload while the original cause of the pain is still sitting there. The ache comes back, and the ache is what ends the return.
A return that holds does four things instead. The first workouts sit below the level you think you can handle. The corrective work aims at the cause of the pain rather than the site of it. Your symptoms after each session decide what the next session looks like. And your confidence in your own body gets rebuilt along the way, which is the whole point of the other three. The five steps below are how a qualified Health Coach walks you through all four.
Disclaimer About Health Coaches
Not all Health Coaches are created equal, and you certainly get what you pay for. You’re not necessarily looking for just any run of the mill personal trainer (as I discussed in this article: Why a Health Coach not a Personal Trainer?). Ultimately, you’re looking for someone who has a four-year degree in Exercise Science, Kinesiology, or a related area of study. This individual should also be certified through an accredited organization, such as the American College of Sports Medicine, and be currently registered on the United States Registry of Exercise Professionals. Long story short, do your homework and find the right exercise professional.
Additionally, depending on the type of ache, pain, or injury we’re talking about, the Health Coach may need to work with other qualified healthcare providers (doctors, physical therapists, etc.) to make sure your plan is appropriate as you resume activity and exercise.
Highly qualified Health Coaches typically have networks of medical and allied health professionals they work with frequently. In fact, you may have been referred to your Health Coach from one of these very professionals. Don’t only look for a Health Coach with the qualifications I mentioned above, also confirm they have an existing relationship with other healthcare providers that can assist in your care as you return to the gym.
With that understanding in place, here are the five steps a qualified Health Coach follows to get you back on track after an injury.
Step 1: Health Coaches Understand You
Aches, pains, and injuries are inherently complex. That’s because pain, in and of itself, is complex. To not get too into the weeds, everyone perceives pain differently. This is something most of us understand well.
Scientists have explored this phenomenon in research on something they call the biopsychosocial model of pain. That name says it all in terms of complexity. There are biological factors, such as the injury itself. Psychological factors, such as how we perceive pain signals in our brain. Finally, there are social factors, like what our social circle and society tell us about what pain means.
All of this to say, pain (be it chronic pain or pain from an acute injury) is very complex. Two people can have the exact same injury and report very different levels of pain and physical limitations. Because of this it is incumbent for the Health Coach to really understand you, before you ever start moving for an evaluation or exercise routine.
Common questions Health Coaches should ask in relation to your aches, pains, and injuries:
- When did this first occur? What were you doing? How long has it been going on for?
- Specifically, where does it hurt? Is it localized or radiating?
- What makes it feel worse? What makes it feel better?
- What are you currently doing to treat this issue?
- What does having this issue prevent you from doing, that you want to do?
There are certainly any number of follow-up questions that could be asked, but that last question is really the most important. The bottom line is that if your aches, pains, and injuries are preventing you from doing things you really want to do, they need to be addressed. So many people avoid activities that they enjoy (everything from exercising to playing with their kids) because it hurts to do them.
Avoidance isn’t treatment. Avoiding physical activities you enjoy is the fastest way to lead a less fulfilling and healthy life.
Step 2: Health Coaches Complete a Comprehensive Evaluation
Understanding you is just the beginning of getting you back to the gym, and the other physical activities that you enjoy. Great Health Coaches go much deeper to understand your aches, pains, and injuries. This starts with a comprehensive evaluation.
There are many different components to a comprehensive evaluation. At AFS, members of our MY180 program are assessed at the start of the program, again at the midpoint, and again at the end, so progress over the 180 days gets measured rather than guessed at.
Movement and mobility screening is the piece I want to zero in on. Movement screens are basically dynamic musculoskeletal evaluations that assess the intersection of stability, mobility, and strength. These types of assessments give Health Coaches a significant amount of important information about how to design an exercise program that is both safe and effective.
Let’s define stability, mobility, and strength in the context we’re talking about here, just so we’re on the same page:
There are some important things to highlight from these definitions.
First, stability is the foundation of movement. It doesn’t matter if it’s movement performed in the gym, or during activities of daily life; movement is actually based on stability. I know that might seem odd, so take walking as an example.
To walk effectively you need stability of your pelvis, your spine and your shoulder blades to maintain good, upright posture. Proper stability in all of these areas allows the muscles of our limbs to contract to produce forward motion. If you have issues with stability in any of these areas, not only will walking be less efficient, it will also potentially be painful. If stability is important in a simple activity like walking, it’s easy to imagine how it can be even more important during exercises you perform at the gym.
The operative words in the definition of mobility above are “while producing force.” We want to be mobile in a functional sense. This requires both great range of motion, and force production, at the same time. Being flexible for the sake of being flexible isn’t very functional during daily life. All activities and exercise we do require flexibility (range of motion) and strength (force production). You can’t disentangle the two functionally, so they must be evaluated together.
Finally, every activity or exercise we do has its roots in our muscles’ ability to produce force. Even cardiovascular activities like running or biking occur at some low percentage of our muscles maximum force production capacity. The higher that capacity, the easier it will be to perform, because it occurs at a lower percentage of maximal muscular effort.
Using a comprehensive movement screen allows for a systemic evaluation of stability, mobility and strength.
Step 3: Health Coaches Provide Exercises to Address the Root Cause
The interesting thing about most lingering aches, pains, and injuries is that the site of the pain and the cause of the pain tend to be two different things. Certainly, if you roll your ankle, the site and cause of the pain is your ankle. This tends to not be the case with chronic aches, pains, and injuries.
The site of the pain
Where you feel it, and where you point when someone asks. With an acute injury like a rolled ankle, this is also the cause.
The cause of the pain
What produced it, which with a chronic ache is usually a joint or two away and is the thing a corrective exercise routine has to reach.
A common area of pain and injury for many people is the lower back. In fact, according to the CDC, 39.0% of adults reported back pain in the three months before they were surveyed in 2019.
Although the pain occurs for most people in the lower back, the cause of the pain can be a result of:
Qualified Health Coaches, performing the appropriate movement and mobility screening can start to ascertain some of these potential root causes, and establish a corrective exercise routine to address the root cause. When done correctly, many of these aches, pains, and injuries occur less frequently. I go through the deep core side of this in detail in Train Your REAL Core to Banish Lower Back Pain, and the same site-versus-cause thinking applies at the shoulder.
At this point, it’s also important to mention (as I alluded to above) that great Health Coaches also understand their scope of practice very well, and know when to collaborate with other healthcare providers. None of what is discussed in this article is rehabilitative in nature, that’s what physical therapists do. What we’re talking about here is after an injury has been adequately addressed by a qualified healthcare provider, and you’re looking to return to exercise.
If anything, great Health Coaches will communicate directly with your healthcare providers to keep continuity of care. This also establishes lines of communication in case something goes wrong when you’re returning to exercise.
Step 4: Health Coaches Monitor & Modify
All aches, pains, and injuries are unique like a snowflake. Although presentation of symptoms and the actual injury itself might seem common, return to exercise is anything but common. This is where a highly qualified Health Coach comes in.
Monitoring your symptoms after each workout (even after every rep or exercise, in some cases) is critical to a successful return to exercise. Doing a comprehensive movement and mobility screening, and prescribing exercises to address underlying causes is a great first step. From there it’s important to understand how your body actually responds to your workouts.
Fundamentally, a great Health Coach will “start low, and go slow.” This is a commonly used adage when exercising with aches, pains, and injuries.
Start Low, Go Slow
Two halves of the same adage, and they control two different things.
Start low refers to starting with lower volume (sets, reps, duration), intensity, and technical complexity, meaning easier movement patterns than the ones you were doing before the injury.
Go slow refers to how those three move upward from session to session. If symptoms re-emerge, the coach scales back or modifies the program rather than pushing through.
The goal of following this adage is to “first, do no harm.” Indeed, the most precarious part of exercising with aches, pains, and injuries is just getting started. Great Health Coaches know how to start you at a level that will not cause anything to flare up. From there, they’ll carefully monitor you to see if any symptoms re-emerge. If so, they’ll scale things back appropriately or make programmatic modifications.
Great Health Coaches know how to make modifications and keep you moving towards your goals. They’re skilled at how to modify speed of movement, range of motion, load/intensity, volume, and other factors in your program to keep you exercising, even when issues arise. This might be the most valuable assistance Health Coaches provide. They help you solve minor aches and pains that occur as you resume exercise, to keep you going when you may not have the confidence or knowledge to do so on your own. That week to week check-in is the same mechanism I describe in Accountability is Calling: Five Ways Health Coaches Keep You on Track.
Step 5: Health Coaches Restore Confidence & Empower
With everything above withstanding, ultimately what a great Health Coach does is help restore confidence in your body and empower you to do the things you want in life. Fitness gives you the ability to fully engage with everything in life. Aches, pains, and injuries take that engagement away; anyone who’s ever had a significant injury knows that.
Everything that I’ve described above is just essentially a process through which a Health Coach takes you through to regain confidence in your body’s ability to perform activities that are meaningful to you. This confidence brings a sense of physical empowerment that allows you to feel in control of your own health. Nothing is more valuable than this. Sadly, when aches, pains, and injuries occur most people become passive participants in the healthcare process, and they don’t have to. There is nothing more disempowering than feeling like you don’t have control over your body and the things you want to do with it physically. This doesn’t have to be the case.
Working with a highly qualified Health Coach for guidance on how to resume the activities you enjoy provides a level of empowerment and freedom that everyone deserves. If you want to take control of your health while dealing with aches, pains, and injuries, find the right Health Coach. You deserve it!
Something Hurts. You Still Want to Train.
MY180 pairs you with a Health Coach, a Registered Dietitian, and an Exercise Physiologist working from one plan for 180 days that fits your life, your schedule, and the aches you are working around.
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Sources
- Lucas JW, Connor EM, Bose J. Back, Lower Limb, and Upper Limb Pain Among U.S. Adults, 2019. NCHS Data Brief No. 415, CDC National Center for Health Statistics, 2021.
- European Pain Federation EFIC. What is the Bio-Psycho-Social Model of Pain?
- American College of Sports Medicine. ACSM Certification.
- United States Registry of Exercise Professionals. USREPS registry.