In Pain? How to Assemble a Winning Team for Your Rehab
You wake up in the middle of the night and your shoulder is screaming as you lie on it. In the morning, you can barely bend over to put your Stance socks on after that heavy squat session yesterday. Box jumps and double-unders are impossible because of your heel pain. You’ve rolled, smashed, broke out the bands, taped, and enlisted a “super-friend”. Nothing works.
What gives? Is this the life of a CrossFitter?
Pain Is Not a Side-Effect of Training
It shouldn’t be. Athletes are known to think musculoskeletal pain is a normal side-effect of training hard. MobilityWOD and the new kid on the block, ROMWOD, have helped many functional fitness athletes move better and prevent injuries. But if you’re injured, these programmes were not designed to substitute the advice of a health professional. Knowing when to seek advice and who to go to is critical.
Are you uncomfortable? Or are you hurt?
Pain is there for a reason, and you need to listen to it and go for help when you’re hurting. Read through the list below for common examples of when help is needed.
- Sudden Onset of Pain - You turn over a heavy clean and feel a pop in your wrist. You know immediately something is wrong. On your next attempt, you can’t even clean an empty bar.
- Pain Travelling into Your Arm or Leg: You show up to the box late, and deadlifts are on the whiteboard that day. You skip the warm-up and rip the bar off of the floor. Suddenly, a pain shoots down your right leg.
- Worsening Pain: Weeks ago you noticed tightness in your posterior shoulder whilst finishing a snatch EMOM. Lately, the pain has gotten worse and is affecting other movements. You’ve had to scale your WODs and weights as a result.
- Pain That Does Not Go Away: Over the past couple of months, you’ve noticed elbow pain doing pull-ups and muscle-ups. It doesn’t stop you, but it annoys the hell out of you. You’ve taped it up and taken some ibuprofen, but it won’t go away.
After you’ve established what type of pain you’re in, it’s time to seek help from the appropriate practitioner. The choices for which musculoskeletal (MSK) specialist to see can be confusing. If you want me to tell you who is better between a physiotherapist, osteopath, or chiropractor - I’m not going to. There are varying levels of education, experience, and skills between practitioners. The trick is to take the best from all them and put together a winning team for your rehabilitation.
How to Assemble A Winning Team for Your Rehab
Osteopaths, Chiropractors, and Physiotherapists
Physiotherapists, chiropractors, and osteopaths are regulated by government-mandated bodies and are trained to diagnose and get you back in action as quickly as possible. If you have an active injury or pain that is not improved by mobility work, massage, or sport therapy, you can receive diagnostic work and focused treatment from these guys. When your injury is sudden or gets progressively worse, finding the source of your problem is important.
Physiotherapists in particular are skilled in identifying the mobility issue causing your pain as well as handling acute and chronic injuries. They will evaluate your condition and come up with the best plan of attack to get you under that bar again as quickly as possible. Their strengths lie in soft-tissue treatment methods, joint mobilisation, and, most importantly, rehabilitative exercise.
I've seen everything from fractures, to sprains, dislocations, and contusions in CrossFit competition.
Chiropractors and osteopaths are similar in their philosophies and treatment methods. If you are suffering with lower back or neck pain, they are your go-to musculoskeletal professionals and are particularly skilled in spinal manipulation. Annie Thorisdottir had both an osteopath and chiropractor as part of her treatment team following her well-documented low back injury a few years ago. Many sport chiros and osteos also utilise rehabilitative exercise, soft-tissue therapy, kinesiology taping, and dry needling.
Sport Therapists and Sports Massage Therapists
Sport therapists and sport massage therapists are accomplished at recovery, maintenance, and preventative work. Qualified and experienced sport therapists are also skilled in utilising functional movement screens in order to diagnose mobility limitations and develop the appropriate soft-tissue intervention and mobility programmes. Little niggles and minor injuries can be managed effectively by these therapists. They tend to have high proficiency in deep tissue massage and other soft-tissue techniques to aid recovery.
General Practitioners and Emergency Doctors
In rare cases, musculoskeletal pain can disguise more serious medical conditions. If pain is worse at night, accompanied by fever, night sweats, nausea, or fatigue, it is critical to bring up the pain to your GP. Granted, he or she may send you away recommending you avoid the gym for a bit and take some anti-inflammatories, but it’s important to get in the queue in the event imaging or a consultant referral is needed. Reputable chiros, osteos, and physios should liaise with your GP about your treatment and make these referrals as necessary.
"Your ideal MSK practitioner will be familiar with functional fitness protocols and will work with you to get you back to the gym as quickly and safely as possible."
If you hear a “snap” or “pop” with a sudden on-set of pain or wounds that won’t close, go to your local emergency room. It’s vital to rule out fractures, put joints back, get wounds closed, and get head injuries evaluated properly. I have seen everything from fractures, to sprains, dislocations, and contusions in CrossFit boxes and competitions.
Don't Forget Your Coach
Your coach is the glue that holds your team together. Give your physio, chiro, osteo, sport therapist, or massage therapist permission to talk speak directly with your coach, so they can work together. Your coach will ensure you continue to move with proper mechanics consistently and add in the appropriate load and intensity as recommended by your team of practitioners.
Individual Treatment Means Better Function
Whilst foam rollers, lacrosse balls, and kinesiology tape can be beneficial for general recovery, additional help is needed when you’re in pain. Get help from the appropriate professional, talk to your coach, and scale your workouts appropriately. Your ideal MSK practitioner will be familiar with functional fitness protocols and will work with you to get you back to the gym as quickly and safely as possible.
MobilityWOD and ROMWOD can aid in general recovery, but professionals can direct you to the exact mobility exercises and programme for your specific problem, enhancing your function and performance in the long run. Your injury is just an obstacle, not the end of the world. Follow these guidelines, find the right practitioner, and you’ll be smashing your WODs and lifts again in no time.
More Like This:
- The Missing Link of the CrossFit Athlete: Treatment
- 4 Things You Thought You Knew About Kinesiology Taping
- The 2 Missing Pieces of Pain-Free Performance
- New on Breaking Muscle UK
Photo 2 courtesy of Robert Crowley.