T Nation

How to Rehab a Muscle

I hurt my lower back while helping unload one of those riding lawn mowers about 2-3 weeks ago. I followed misc’s advice and stopped lifting for now, but I would like to know if anyone knows how to make a muscle recover faster. Should I be doing stretches, or light exercises for the back?
Im feeling a lot better, only getting muscle pain now and then while driving, but I still dont think I should push it yet.

Cliffs

-Hurt back
-Resting it
-Wondering what else to do.

Usual progression goes something like this: get your range of motion back and reduce inflammation. Then find a weaker or painful sector and retrain the muscle fibers to fire correctly in that arc. Then restore the ability of the muscle injured to handle a stressor through a full range of motion. Then global movement patterns like squatting or putting weight over your head. Proprioception work is also nice.

With the back its a bit different as you not only need to work about muscles, tendons and ligaments but also if your spinal discs are ok too. In general once the initial phase of an injury subsides being more active and pro-active is better than sedentary. Remember when you are active is when extra blood, oxygen and nutrients are shuttled thru the affected area.

Ive asked several doctors, and nurses, and they all agree that its not spinal.
So far Im taking a muscle relaxant when the pain is bothering me, heating it when I am just sitting around, and Ive started cardio again (was bad enough to not even do this before).

Anything else I could add?

Take the Boyle approach and increase mobility in joints surrounding your low back. Wont make the muscle heal any faster, but will take some stress off of your low back muscles.

[quote]Im_New_Feed_Me wrote:
Take the Boyle approach and increase mobility in joints surrounding your low back. Wont make the muscle heal any faster, but will take some stress off of your low back muscles.[/quote]

Im_New_Feed_Me, can you please clarify what you mean by “joints surrounding your low back”? It may be dangerous and counter-productive to mobilise his lumbar vertebrae, so if you are advising this without knowing his type of tissue pathology, you are being irresponsible. You may be talking about hip flexibility though, so I wanted to clarify.

[quote]psynz wrote:

[quote]Im_New_Feed_Me wrote:
Take the Boyle approach and increase mobility in joints surrounding your low back. Wont make the muscle heal any faster, but will take some stress off of your low back muscles.[/quote]

Im_New_Feed_Me, can you please clarify what you mean by “joints surrounding your low back”? It may be dangerous and counter-productive to mobilise his lumbar vertebrae, so if you are advising this without knowing his type of tissue pathology, you are being irresponsible. You may be talking about hip flexibility though, so I wanted to clarify. [/quote]

Sorry man. I meant hip and thoracic mobility. Boyle talks about the “jiont by joint” approach.
Simply put, if hip mobility is at 80% and thoracic mobility is at 80%, then the lumbar area (meant for stability) will have to do 120% of the work to make up for the lacking in other areas.

Sometimes my brain thinks faster than my fingers can type. Stupid ADD.

Edit: Not hip flexibility either. Dynamic joint stability. Big difference.

[quote]Im_New_Feed_Me wrote:

[quote]psynz wrote:

[quote]Im_New_Feed_Me wrote:
Take the Boyle approach and increase mobility in joints surrounding your low back. Wont make the muscle heal any faster, but will take some stress off of your low back muscles.[/quote]

Im_New_Feed_Me, can you please clarify what you mean by “joints surrounding your low back”? It may be dangerous and counter-productive to mobilise his lumbar vertebrae, so if you are advising this without knowing his type of tissue pathology, you are being irresponsible. You may be talking about hip flexibility though, so I wanted to clarify. [/quote]

Sorry man. I meant hip and thoracic mobility. Boyle talks about the “jiont by joint” approach.
Simply put, if hip mobility is at 80% and thoracic mobility is at 80%, then the lumbar area (meant for stability) will have to do 120% of the work to make up for the lacking in other areas.

Sometimes my brain thinks faster than my fingers can type. Stupid ADD.

Edit: Not hip flexibility either. Dynamic joint stability. Big difference.[/quote]

Ok, thanks for the clarification!

If it is a muscle strain or ligamentous strain you can probably return to your normal workouts doing exercises that you can tolerate pain wise. Which means you can do back exercises, however, may need to use lighter weights. You will have pain, however, if it is tolerable and as you go day to day and it is not worse you can keep going.

beef

[quote]beefcakemdphd wrote:
If it is a muscle strain or ligamentous strain you can probably return to your normal workouts doing exercises that you can tolerate pain wise. Which means you can do back exercises, however, may need to use lighter weights. You will have pain, however, if it is tolerable and as you go day to day and it is not worse you can keep going.

beef[/quote]

that’s an interesting perspective.
reducing load, reducing range of motion, excellent ideas - but with the goal to move without pain.

recent work on pain/pain rehab however suggests that working through pain is not a good idea.
here’s a bit more on why

working with athletes, what we tend to see is that, if there are lots of movements/loads that can be done without pain, if no one’s holding a gun to one’s head in a life/death situation, and since there’s no restorative value to working through pain, choosing not to work through pain seems a better path - especially for the long run.

best
mc

dr mc schraefel

ps a movement assessment could be helpful too - to connect with the suggestion above about mobility work - always nice to know what needs work.

folks to look for are
ck-fms or fms coaches
z-health coaches

who are trained in doing mobility assessments and rehab from them.

alternately just working on your own dynamic joint mobility will help. eg

Assess and Correct.

Best manual out there on self assessment, IMO.

[quote]Im_New_Feed_Me wrote:
Assess and Correct.

Best manual out there on self assessment, IMO.[/quote]

ah that’s interesting. Eric and Mike are awesome, and based well within physio; vgood price.
May i ask, what is in the list of your comparisons of self-assessment approaches that this one has come up on top?

thanks
mc

Mostly Gray Cook’s functional movement screening. After Boyle’s first Functional Strength Coach dvd set, I used that for a few years before Assess and Correct came out.
In my opinion, anything produced by Boyle, Robertson, Cressey and Hartman is gold. A bit of it is over my head, (especially Cressey’s shoulder stuff) but I am learning.

thank you.
so you’re saying the guys of inside/out and related. ok.

forgive me for pressing but i’m keen to understand how folks come to their assessments here:
what does “mostly Gray Cook’s functional movement screening” mean?

thank you again
mc

I’ll tell you a little about myself if you are interested.

I am by no means an expert, but I am very much into the movement aspect of exercise. I am certified as a personal trainer and as a post rehab conditioning specialist through the AAHFRP. I consider Mike Jones to be a VERY smart man as he is sort of “bridging the gap” as he calls it, between physiotherapists and personal trainers.

I first got introduced to Roberton, Cressey and Boyle through this site and a few of their articles on joint by joint approaches and foam rolling techniques. I started following them almost exclusively (I know, kind of stupid, but I’ve branched out a lot since then) and really got into the “Magnificent Mobility” and “Inside Out” dvds. I began to use these as assessments for my clients to test the range of motion around their joints. (ie - stabilizing joints and mobilizing joints) I quickly became known as the mobility guy at our Studio and started to really fall in love with that aspect. I was learning so much and helping a lot of people, it was very rewarding.

From there, I started watching Coach Boyle’s “Functional Strength Coach” dvds and was put onto Grey Cook’s functional movements screen, which I thought was incredible. As I am relatively new to personal training (3 years) I was really excited to know that through a series of movements, or tests, I could quickly gauge my clients mobility, and address their problem areas.

From there, I followed Robertson mostly (Indy Seminar, Bulletproof Knees, Building the Efficient Athlete) and loved everything he and Cressey came out with. So when Assess and Correct came out, I knew I had to get it.

Now, maybe it’s just me not knowing as much as I should, but I love this manual. It has helped sooo many of my clients with their pain, and they have referred friends and family to me and I am swamped with clients, which I love, as our Studio is a pay as you go type Studio with no membership fees so you have to wow your clients every time to get them to come back.

If you have any opinions, or ideas as to where I can find something better, I would love to hear them. Like I said, I am still new to this, but I know this is where my heart lies, and I need as much help as I can get.

Thanks!

thank you

still don’t quite get what happened with the gray cook stuff - you thought it was incredible and then what happened?

did the other stuff feel more accessible? with cook, you go on a cert to get the info, practice and so on. but it’s more expensive. robertson and co - you can get on dvd’s for much less - was that a factor in your decision of what you pursued?

So, ya i can mention all sorts of things, like i think if a course/cert is too expensive, or you don’t need ceu’s for your own certs, then a dvd like the essentials of elite performance mini dvd course (http://tinyurl.com/2dyte3e) is great for the kind of stuff i talk about here
http://www.tmuscle.com/free_online_article_issue/issue_631#cool-nervous-system-tests

BUT
main thing is mastery - getting with something that you find works for you, that you have the resource to get into deeply - that’s really important.

i know lots of folks who try everything - and trying everything is great; take as many courses as you can; read as many books as possible, but have a base, so you have a really good lens through which to assess other stuff.

and do you have a community of peers within that space for working through issues.

thanks for sharing. wish that this forum had sig files so we could have a bit more about ourselves persistently available.

best
mc

Really the only reason I didn’t keep with the Cook stuff is because in the dvd, it was only 6 movements, if I remember correctly. That was as far as my knowledge took me. I actually had no idea there was a certification for it until you said so now. It’s something to look into for sure.

I am going to check out this Z-Health, I’ve heard about it once or twice before and it seemes very interesting. Man, I love my job.

Thanks for the advice!