Looking back at the time since my injury, I feel like this
has been one of the areas that I have learned the most about – and so I wanted
to share it with you.
In training, I think that you are always looking for that
‘Goldilocks zone’ – where you are stretched and make progress, but not to the
level that it breaks you and forces you back. So that across your week’s
training it is not too easy, and not too hard, but just right to get the
adaptation that you are looking for.
When injured, this zone is even harder to find because there
are no benchmarks. Indeed all of the normal benchmarks that you have are based
on your previous, un-injured self and lead you seriously astray! It can be so
hard to leave your ego behind in terms of what level is worthy of effort and
exhaustion. An additional difficulty is that my sense is that the gap between
stretch and stress is much narrower when you are injured, so you need to be
more precise and wary of the smallest signs of over-reach, before the body
stops you in your tracks. And these ‘tells’ may be completely different from
those that you got when you were in full-on training and the onset may even
come hours later (especially in the case of nerve-pain).
My own search for Goldilocks was a long one! In spite of
constant commitment and tracking, I had a very long period where week after
week I failed to get through the ‘simple’ exercises that were set – sometimes
collapsing or passing out with the pain, sometimes just completely seizing up
and suffering for the rest of the day and night before my next attempt. So managing
to do the prescribed exercises consistently for the whole week between
appointments really was a big deal.
I had no idea how much it had been torturing me. Realising
this issue and actually managing to do seven days in a row of completing the
prescribed exercise and actually managing to progress the reps, I now feel so
much lighter in mood and belief. I start to believe that I am starting to
recover and starting on my way back to life. Even though I know that these
exercises are easier than a good proportion of my previous exercise sets,
completing them means so much.
Why the breakthrough?
I still have a file of all of the exercise sheets that I
have failed to make over the last 18 months (a few of them across 2-3 months of
appointments with constantly trying and failing, and almost all of them still
beyond me today). I should probably have put them in the bin, but have been
keeping them for the day when I improve enough to get through and make the
progress to be able to underpin the basics that could mean a return to life and
sport. Looking back over them compared with what has worked for me over this
last week, these are the things that stand out as differences:
- This exercise routine is broken down into a
daily gentle mobilisation routine and the progressive part of the set is only
every other day to allow for a recovery day. Many of my other programmes were
up to 3-5 times per day, and always daily, which seems to have been an
intensity that my body could not cope with.
- The first few months of the programme are all
bodyweight movement exercises and only progress to include weights once I have
built up to that.
- There is a ramp into the reps and sets, as the
body adapts – with the first set very easily within my current capability.
- A golden rule is to always stop with at least 2
reps still in the tank. And never, ever going to the point of failure – as that
can put the body into a state of alert and lead to more ‘guarding’ behaviour
from the muscles (which can take weeks and months to then unlock).
- Every single exercise has one or more regressions
to make it easier, in case the pain gets worse and I start to struggle – so I
can do drop-sets, or easier sets. I have learned that every exercise has
regressions, and what a difference that makes! Previously the exercises had
been much more binary – it was do the exercises and if you fail early, then
- We have gone through all of the key form points
and gone to the point at which compensation sets in. For the compensations that
we went through, I have a physical cue to keep the body on form (such as a
roller balanced in the small of the back, a strap to keep under tension at all
times, or the knees in contact at all points of the move etc)
- There is a clear goal to be able to breathe
deeply and calmly throughout, not straining or bracing, or pushing through pain
(but it is OK for the muscles to get tired or ache, as they used to when
training). This is really useful, as there have been so many different views on
whether you ‘push through the pain, as it is just guarding behaviour’ or ‘stop
and respect the pain, as it is there for a reason’.
- We’ve got a clear commitment between us to keep
to the recovery interval, reps and form precisely, even if that means a ‘fail’
– as this helps us to get to the root of the issues quicker and more
accurately. This makes it feel like a partnership where we are both working on
the problem together, rather than me feeling that as the patient I am the
- The programme follows a clear and specific order
of releasing overactive muscles and gently activating the specific muscle and
then integrating it into the wider movement. This does make it a longer
programme and means that there are no short-cuts, but really makes a
difference. It also only works at the end-range for a short time, as this is
very demanding indeed.
is a path forward with really small increments for the progression, such that
there is a clear glidepath for progress, with check-steps and alternatives to
take a different approach to address lack of progress. This fits into an
overall ‘treatment’ plan that looks like a training plan, complete with blocks
each with their own objective, quantitative progress testing every 2 weeks and
a clear functional progression thread underlying all of it. Naturally every athlete wants to know ‘how
long until…’ but I have really learned now to trust the process and just to
focus on the progress in each of the 2 week testing blocks and making fast
interventions when something happens that is not what we expected.
Why did not managing
to complete the exercises come to have such a big meaning for me?
I have to admit that I am only just starting to pick away at
and release the layers of blaming myself that I feel for letting everyone down,
not managing with the basics of life, and for not recovering as expected. This
is all psychologically very difficult.
As an athlete I had always believed that consistent and hard
work would be rewarded. And that in a recovery context this meant doing always the
exercises from the physio – no ifs and no buts. Early in my recovery a friend
who is a physio told me that the level of adherence to exercises from the
physio is only thought to be about 20% (and actually admitted that even when
she goes to see a physio herself, she rarely does the exercises!) I vowed never
to be one of those 80% not doing their exercises.
So when pain overtook me over and over again such that I
would collapse weeping with the pain and retire to bed or lying on the floor to
recover, I felt that I was letting myself and everyone else down. That I did
not deserve to recover.
But that is all in the past now! And I think that if I had
known the questions to ask (based on the 10 bullet-points above), I could have
got there more quickly.
So what should you do
if you are currently struggling?
Even if not injured, I think that we are all in search of
the Goldilocks zone and can apply these principles in our training to get to
the stretch zone, but not the stress zone! In rehab we probably need to dial it
even further back – to ensure that we are progressing, but not getting into the
Having now spent a lot of time studying corrective exercise
and reading a lot of books, and doing online study, I have learned that there
is literally no exercise that cannot be made more basic – moving it right back
into exercises lying on the floor and building from key underpinning exercises
of the correct muscle recruitment in breathing. So always ask how to regress
(and progress) an exercise; you also learn a lot in the process too! I realised
that I did not ask this enough – I would tell the physio how I had got on and
we would either just try again the next week without changing anything, or they
would tell me to stop doing anything for a week.
And when doing the exercises, always focus on form and the
correct rest interval – stopping as soon as the form slips. This ensures that
you get the real benefit. Plus see the sense of achievement with the
progression. This does mean becoming more of a Strength & Conditioning
(S&C) student than ever before! Watching athletes do S&C I’ve seen that
strong athletes’ bodies often (effortlessly) find another way around by using
the synergist muscles rather than activating the main muscle – so knowing the
cues and checks is important. Things that your body could get away with before
injury can put you deep into pain post-injury and relying on dominant muscles
misses a lot of the benefit of the exercises!
Finally, I would say that often the focus is on strength
(which is about the muscles) but can be about the recruitment (which is the
messages from the nervous system). So it is worth understanding which of these
it is, as that should change the pace and type of movements in the exercise
Good luck in your search for Goldilocks!