Why that injury won't go away, and outsourcing your health.

To understand this, we first need to group injuries into two categories.

The first is some sort of trauma to a body part, like twisting your ankle or breaking your wrist from falling off your bike. We know how these injuries happen, we know which muscles, joints, ligaments, or tendons are involved, and we have a pretty good idea of where we need to get them back to.

The second type of injury is one that doesn’t have a traumatic event, builds over time, or just starts to hurt for no real reason.

Traumatic injuries actually make rehab a bit easier. Once the damage is diagnosed, you can focus on that body part and getting it back up to strength.

Non traumatic injuries are trickier. You need to work out whether the painful area is the problem, or the solution.

Let me explain with an example.

A runner comes to me with hip pain on the right hand side after building up his miles. When I ask about injury history, he tells me he had a right knee injury six months ago and regularly rolls his right ankle.

It might be that he built up mileage too quickly and his hip couldn’t cope. Or it might be that the hip is overworking, making up for the knee and ankle muscles that aren’t doing enough of the work (underworking).

You see, when you have an injury your body reduces the amount of force a muscle can use, it's a protective measure. If you’ve rolled your ankle for example, you wouldn’t be able to hop on it, your body won’t allow it. That’s a protective mechanism where the body limits the output of the surrounding muscles, so you can't physically do it no matter how hard you try. For the running example, his injuries may have reduced the output of the muscles around the knee and the ankle, and therefore the hip needs to take up the slack and do the work for them.

In this case, the hip is the solution, and the knee and ankle are the problem.

So, where should we focus our energy in the rehab process? If we load up an already overworking hip with more exercises, I’m not sure that will go well.

We focus on the problem.

I know a few physios follow this newsletter, so here’s a relevant study showing this hip ankle relationship in more detail:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3418949/pdf/i1062-6050-46-5-461.pdf

How Do We Solve These Issues and Fit Them Into a Programme?

First, we need to take a deep injury history. I ask people to start from the bottom of the body and work their way up, listing every injury they’ve ever had. Then we build a timeline. Which were the injuries that happened just before the current injury, do they give us a clue? Are there any injuries near the current injury site that may have a direct effect (knee and ankle to hip), do they give us a clue?

Then we get our Sherlock Holmes hat on and try and solve the mystery.

Instagram and LinkedIn will tell you that 'if you do these exercises it will solve your pain', but as I hope you can see, your pain will be different to other people's because you have completely different histories. You will see testimonials of how these exercises have helped people, but remember, a stopped clock is right twice a day, and if someone with 50k followers has 2 testimonials, it is because the clock was right twice.

When the pain has been resolved, we make sure those old injury sites are being worked consistently and progressively in the programme so the injuries don't come back.

Then we look at their current training and ask: is anything missing? Where do we need to focus during the gym sessions? What is their mileage like, are they increasing load too quickly?

By load, I mean weekly volume. A runner increasing their load might mean increasing their miles.

We plug the holes in the programme, progress the running safely and gradually, and we move forward.

Sounds simple, right? Rehab is never simple, but hopefully this gives you a new lens to look through. If something hurts, think about what hurt before that, and start there.

What’s Happening at Razor Performance

We had our first marathon completion of the year last weekend, amazing. This one was unique. They were unknowingly signed up to the marathon by their fiancée and came to me 2.5 months out, feeling stuck. With ski trips, holidays, and hen dos coming up, training wasn’t going smoothly. We completely overhauled the plan, built in progressive strength work, structured nutrition, and scheduled long runs. Mission complete.

We’ve got someone competing in their first Hyrox next month. After four weeks of prep, we’re now heading into a tough phase. He wants a sub 1.20 finish, so there’s work to be done.

A client messaged me yesterday to say she ran four miles because she “wanted to.” When we met, she was recovering from a serious hip operation. With a young son and busy job, she worried she’d never run again, or keep up with him. I still remember her saying, “I don’t need a cheerleader. Just tell me what to do and I’ll do it.” From that point I knew we would work well together.

It’s a great place to be when your body just lets you go and do what you want, and now she can.

One of my newer clients is about to return to running. Over the past 2.5 months, we’ve built a solid gym routine, dropped 4 kg, and now it’s time to head outside. His goal was a stretch when we started, now we’re laying the stepping stones to get there.

London Marathon is coming up. Two brothers aiming for PBs. One client hit a 150 kg deadlift despite knee pain. Another is making their return to running after hip issues.

Lots going on.

Let’s Talk About Outsourcing

I usually mention the clients chasing big goals, but that doesn’t tell the full story.

Many of my clients simply outsource their health to me.

My programmes start with a 3 or 6 month commitment, and after that, clients can continue month to month if it fits.

I’ve got a brilliant client who travels relentlessly for work. Does he have time to check the hotel gym and plan every session? Or is that time better spent earning or seeing his kids? I’ll let you decide.

One of my good rugby mates, former PT and pro player, has trained with me for 18 months. He’s run a marathon and is in the best shape of his life. He knows exactly what to do, but he doesn’t want to think about it. So I do.

Plenty of others just want to stay strong, injury free, and feel good.

People outsource their finances to advisors and accountants. Why? Because it saves time, makes them money, and they’re better at it.

After that initial big goal, many of my clients choose to outsource their health to me for the same reason.

Props to those on my programme who keep showing up, week after week, hitting the small targets, and becoming fitter, stronger, more capable people because of it. This is actually more difficult to do than the big goals.

The newsletter will take a break next week as I’m off for Easter. I have someone finishing next week so I do have very limited space for coaching, but don't delay.

If you are frustrated with your training, or you just want to get some advice, I offer all of my new connections and subscribers a free 30 minute training audit. No sales, just an offer of value. If you need help implementing it, that's another conversation.

Link to book: https://calendly.com/razorperformance/30min

See you after Easter.