Injured and recovering with P.R.I.C.E

I don’t know whether it’s been the cold weather over winter or maybe the increase in exercise for the start of 2012, but there seems to be a lot of people around me that are getting injured(including myself!). Not only are there a lot of injuries at the moment, many of them seem to be injuries to the spine or pelvis. So I decided to write a blog about injuries, prevention and using the P.R.I.C.E protocol for the recovery process.

I’m using the back as an example as there are so many people with back issues at the moment and an osteopath once said to me “It’s not about ‘IF’ you get a back injury; it’s ‘WHEN’ you get a back injury!”. What he went on to say was that the spine is so complex and allows so many different movements, that without the correct posture all the time(which lets face it, doesn’t happen often enough!) it’s only a matter of time before wear and tear takes its toll and a back injury occurs. Many people lift heavy objects for a living and even those that don’t, still lift heavy things around the house from time to time, but are we lifting with the correct posture? Are we bending through the knees and not the back, letting the legs take the strain? The answer is…..generally no!!!

Many people don’t know the correct technique and those that do, rarely use it until it’s too late. That is why so many people suffer from slipped discs(also known as prolapsed/herniated discs) which can be very painful. I have added a photo of an MRI scan taken about 8 years ago of my spine, after an accident during a football match that I hobbled away from with a broken arm and two prolapsed discs. In the photo I am pointing at the two discs that have degenerative changes which can be seen by the lack of white in them compared to the rest and if you look closely, you will see the two discs protruding from the back of the spine at the curve. This caused a lot of pain down my sciatic nerve at the time and not the kind of pain that anyone would like to experience.

I do a lot of lifting in my job and even with the right technique/posture, if I don’t look after my back and concentrate on strengthening it, I occasionally get lower back pain. So if that can happen to a personal trainer, what about the people who aren’t generally as fit or strong as a personal trainer? How do they prevent this kind of thing from happening?

There are a number of ways in which we can help ourselves to prevent injuries happening like this. Unfortunately mine happened in a freak accident. I wasn’t in control of the situation and it wasn’t a direct injury from bad posture or technique at the time, but a lot of people are in control of it and neglect to do the right things. Injuries of other areas of the body can also be prevented with a little common sense and again, the right posture or technique can be a crucial part of it.

Starting with the posture, we are all guilty of slouching into comfy sofas or having the wrong posture when sitting at a desk or even when driving a car. All of these examples are things we can control. Have a look at the pictures below and see the difference in the curvature of the spine between a kyphotic posture and a neutral posture….

Is this ‘good’ posture…..

 Or is this ‘good’ posture…..

Thinking about the way we sit and trying to keep a neutral spine like the second picture, can help prevent back pain and disc problems. Another area in which we can all improve, is the way we pick up heavy objects……

Bending through the knees and picking up heavy objects correctly can go a long way to preventing back problems. By bending through the back instead of the knees, this puts a lot of unnecessary pressure on the lower back which will eventually lead to an injury and lower back pain. Both of these examples are things that can be controlled.

Unfortunately not everything in life can be controlled and therefore injuries will happen; that is inevitable, especially if you are an active person and involved in sport. Knowing what to do once you’ve got injured is the next step on the road to recovery, so here is the P.R.I.C.E protocol for you to follow…..

Protection/Prevention: Protecting yourself against further injury or preventing further damage to an area that is already injured is the first step. Strapping an injured area or using padding to protect the area is a good place to start.

Rest: Resting an injury gives it time to heal. Don’t underestimate how important it is to rest for the body to repair properly.

Ice: Icing an injury helps to reduce swelling and pain but be careful not to ice for more than 10-15 minutes maximum or it can have the opposite effect. Also, make sure ice isn’t applied directly to the skin or an ice burn can occur; keep a thin layer between the ice and skin. Ice should be applied for at least the first 72 hours after the initial injury and every 2 hours when possible.

Compression: Compressing the injured area can prevent swelling and reduce swelling that has already occurred. It also helps with the first step(protection/prevention).

Elevation: Elevating the injured area above the level of the heart(if possible) reduces the amount of blood which flows to the area and therefore prevents more swelling. It also helps the lymphatic system flush the swelling away with the aid of gravity.

By following the P.R.I.C.E protocol, it can make recovery time much less than without the knowledge of what you are supposed to do. This protocol can be followed for any injury, not just the back that I have used as an example in this blog.

I hope this blog has been useful in teaching you what to do in the event that an injury has occurred. I also hope that by seeing a real MRI scan and hearing how easy it is to injure your body just from incorrect posture, that you think about your posture more each day and where possible you use the correct techniques to hopefully prevent an injury that is very common and one that I’m seeing a lot of lately.

Thanks for reading and good luck in taking good care of your body!

Exercise: Back to Basics!

Recently I have heard a few people say “Don’t you have to be quite fit to have a personal trainer?” or “I need to get a little fitter before I have some personal training.” and my answer has been…..”NO, not at all! Every single one of us is an individual and our bodies work in very different ways. We all have to start somewhere and what better way to start than have professional advice from the beginning, rather than try when you don’t really know what you are doing!”

A friend of mine sent me some fitness blogs a few days ago and although most of them were a good read, there were points I disagreed with, one point in particular stood out in my mind and I would like to give my opinion to it. Here is the quote……

“Never do cardio right before weight training, doing cardio uses up your stored glycogen which will greatly compromise your energy level during weight training. On the other hand, doing weight training first will use up the stored glycogen then the body will look for fat to burn as energy.”

As I said above, every individual is different and has different goals. It is true that if you do cardio before weights, you will generally feel more tired during the weights but there is no reason why you can’t burn fat during a weights session too! Also, it completely depends on what is more important to you as an individual to what you do first. For instance, if you want to burn fat and gain general fitness, I would suggest the cardio comes first as it is more important for your overall goal, whereas if you wanted to concentrate more on building muscle or toning up, then the weights section would be more important and should come first, whilst you are fresh and can perform to your best. The other reason why I disagree with this statement is that when doing cardio, if you keep your heart rate to the correct zone, burning fat as an energy source rather than glycogen is easily done. So, like I said, we are all different and it’s about finding out what works for you.

Exercise is like trial and error, as long as the basic guidelines are followed and you are exercising in the correct manner and performing exercises safely(with the correct posture), the rest is about what works for you. You might find that a friend tells you to try something that has got them great results and when you do, you achieve nothing. This is because your body is not the same and will respond differently to some exercise than others.

What is important is consistency, will power, a positive mental attitude(PMA) and belief that with hard work you CAN……be what you want to be, work towards the shape you want to be and become a fitter healthier person. So, with this in mind, I’ve come up with a few pointers that might work for you and help you in the right direction to living a healthier lifestyle:

  • When starting to exercise for the first time or starting up again after a long break, don’t be stubborn and push it too hard too soon. Listen to your body and what it is telling you. If it has a few aches and pains, acknowledge them but don’t ignore them. If you try to push through them you are likely to injure your body by putting it under too much stress before it is ready.
  • Don’t neglect the boring bits! What I mean by this is the warm up and cool down before and after each session. These are not there just to make you look like you know what you are doing, they are there because you DO know what you’re doing! A warm up and cool down will get the body ready to exercise and also bring the body back to a resting state afterwards. Imagine your muscles like an elastic band; if an elastic band is left for too long in a draw and then taken out and stretched immediately, it is likely to snap. The idea of a warm up is to get the muscles warm and more flexible so they aren’t overstretched straight away and tear like the elastic band! Dynamic stretches(stretches on the move) are a big part of a warm up. It is also there to increase the body’s circulation and dilate the blood vessels ready to deal with the body’s need for oxygenated blood when exercising more vigorously. A cool down is just as important to flush away the lactic acid build up in the muscles to reduce stiffness/soreness in the body over the following few days. Static stretching is a big part of a cool down so that the muscles don’t tighten up and shorten after exercise. Keeping the muscles supple is a major part of any exercise programme.
  • Rest is just as important as exercising itself! If you continuously put the body under stress you are actually making micro tears in the muscles of the body. Without sufficient rest to recover, these tears will not repair right and an injury is on the cards. Scar tissue build up is very common from overworking without enough recovery and this can lead to a bigger muscle injury preventing you from exercising all together for weeks on end. Again, listen to your body and it’s aches and pains and if you feel like you need a day of rest and recovery, you probably do BUT this shouldn’t be used as an excuse to get out of exercising. Be honest with yourself because consistency is key.
  • Keeping your body hydrated is a must! Many people neglect the correct fluid intake which can be a bad mistake. The fluids lost from sweating whilst exercising means they are in constant need to be replaced. A dehydrated body will lead to fatigue and the muscles don’t perform as they should causing muscle pulls. It is important to prevent dehydration by continuously topping up your fluid intake before, during and after exercise to replace the lost fluids and body salts. A hydrated body will perform better and is less likely to have muscle injuries, which means regular exercise can continue consistently.
  • Lastly, many people struggle with knowing how many times a week and for how long they should exercise. There is no right or wrong(within reason!) but there are some good guidelines to follow. When starting up, try building up the time of the session gradually starting at 15-20 minutes and over time increasing it to roughly an hour maximum. Also, start with one or two sessions a week and add more as and when the body starts to recover quicker and you feel ready to exercise again. Three sessions a week is more than adequate to maintain a good fitness base but if you want to exercise more, there is no reason why you shouldn’t as long as you give yourself a day or two to rest every so often. Exercising five to six times a week is the maximum I would advise purely so there is a day or two to break the week up for a recovery period.

I hope this blog has given you an insight into a few basic pointers, to help get you on track for starting on the first rung of the ‘fitness ladder’. Remember, you know your body better than anyone else, so make sure you treat it with respect, listen to it and learn from it, and it will take care of you and reward you with the success of achieving your goals.

Consistent or Consistently Inactive?

The Findings:

After recently returning to full training from a calf injury, that meant not running for 25 days, I have witnessed first hand(again!) what a break in fitness training can do! The great thing about technology is being able to compare data and doing exactly that has shown me in black and white the differences between regular, consistent exercise, to irregular, inconsistent exercise. After seeing what it can do to someone like myself that is in the fitness industry for a living and loves to keep fit, I thought it might be a great idea to share my comparisons with others that exercise a lot less, to show the effects it can have on the body and change a few people’s mind sets towards regular exercise.

The facts:

I run 10 miles at a time 2-3 times a week with 1-2 resistance training sessions in between, consisting of full body weights and core exercises. The last time I ran(when fresh) before getting injured, was Sunday 10th July. Since then I have not been able to do any impact exercise so I’ve been limited to CV on a bike and weight training. Because of this I knew my fitness would suffer but I wasn’t sure how much until I returned from injury. My first run back from injury(without pain) was on Thursday 11th August, 32 days apart. The differences in pace, time, and most importantly heart rate are quite amazing!

Here is the comparison(make sure to click on ‘more detail’ for a thorough comparison):

http://connect.garmin.com/activity/comparison?activityId=105655672&activityId2=98138179

If you look at the difference in max and average heart rate between the two, the latter run was higher by 12 beats per minute, making the heart rate zone much higher and the body having to work much harder even on a flatter course. If this is what can happen to the efficiency of the heart of a personal trainer in 32 days, whilst continuing other forms of training in that time, imagine what it can do to the average person that neglects their body and the exercise they do to keep it in shape over months or years of irregular, inconsistent exercise. If the heart takes that short a time to become that less efficient, take a moment to think about the strain it will have on other organs of the body and the body’s performance as a whole. Even the smallest jobs could seem epic if the heart has to work so hard to make it happen, so here are a few tips to make sure you keep your body working as efficiently as possible.

The Tips:

  1. When starting to exercise, try to get into a routine that the body recognises. Build it up so that you workout at least 2-3 times a week for an hour at a time.
  2. Everyone needs a rest to let the body recover and as I’ve mentioned before, the rest is just as important as the actual workout, but don’t leave it too long between workouts. As you can see from the stats above, if the gaps are too big between exercise, the body’s fitness will suffer and you will feel like you’ve taken a step backwards every time you start exercising again.
  3. Lastly, keep things fresh by mixing up what exercise you do, this way you will be less inclined to put it off as you are bored of your routine. By doing this you will keep your exercise routine fun, consistent and your body working efficiently for as long as you put the hard work into it.

I hope these three tips help you keep your body fit and healthy. If you have come across the same break in exercise and experienced the same fitness struggles, please leave your stories and let me know if this blog has helped you!

No Pain, no gain?

Throughout my football career I put on a brave face through many injuries, some minor and some more serious, but in a competitive sport like football, it is important to play through what you can so you don’t lose your place in the team………or is it? I believed, when I was young, that I would be frowned upon from pulling out of training or competitive games because of an injury. Unfortunately, there were times when this was true because some of the managers in football only want one thing……to win! Most only care about what happens right now and don’t really worry about what an injury might mean to your future.

The more injuries I had and the older I got, the more I realised it was up to me to protect my body when it needed protecting, or my career would not last the distance. Unfortunately, the damage was done in my early years, by putting my body on the line one too many times for people who weren’t concerned with my future and in the long run I paid the ultimate sacrifice, an early retirement. The injuries I sustained over the years were just too much to continue playing a professional sport and that is why I am where I am today. Hopefully my experience of injuries and playing through the pain of broken bones, cartilage tears, arthritis to name a few, can help others not to make the same mistake. So, there are times when the saying “No pain, no gain!” couldn’t be further from the truth.

This picture shows a head injury that has left me with a scar across my forehead for the rest of my life! I was also playing with a broken hand!

Recently I’ve had a few people ask for my advice about injuries they are having problems with. It seems that a lot of people don’t know the basic protocol after the initial injury, so this blog will give you all you need, to help you speed up the recovery period of less serious injuries, such as sprains and strains(if in any doubt over your injury, medical advise should be sought).

Here are a few simple pointers that will help speed up the recovery process. When ever possible always follow the PRICE protocol:

  • P = Protection. Protect yourself from injury as best as you can (eg. wearing shin pads etc) but if the damage has already been done, the same principles apply; Protect the injury from further damage by stop playing or using padding to support the area.
  • R = Rest. Being brave and playing on is not always wise! Rest is important to let the injury heal no matter how big or small it may be. This can be the difference between a speedy recovery or making the injury worse and adding weeks or months to the recovery period.
  • I = Ice. Applying ice to an injury reduces pain and inflammation/swelling. It should be performed for 15-20 minutes maximum every couple of hours. Be careful not to ice for longer than 20 minutes as it can damage the tissue further rather than help it. Also, it is advisable not to put ice/ice packs direct to the skin to prevent ice burns which can be very painful! The next two steps can be performed at the same time as icing an injury to aid recovery.
  • C = Compression. Keeping an injury compressed with bandages will reduce swelling or prevent the injury from swelling further, if swelling has already occurred. You can compress at the same time as icing for added benefit. If the compression causes pins and needles, throbbing or cuts circulation as it feels too tight, take the bandage off and compress the area again but not as tight.
  • E = Elevation. By keeping an injured area elevated above the level of the heart as much as possible, it reduces swelling and lets any swelling already built up in the area track away to the nearest glands making the area less stiff and helping recovery. Again, it is a good idea to elevate an injury whilst icing.

This is a sight no one wants to see. One I can't actually remember!

So there is the basic protocol. Obviously more serious injuries will need medical treatment but this protocol will always be used along the line at some point.

Remember, no pain, no gain is not always the answer when it comes to injuries. Pain is your body’s way of telling you something is wrong, so ignoring it can only make an injury worse. Don’t let a pain you have ignored turn into an injury that can cause more serious problems later in life!