The word “rehabilitation” means the restoration of good health and the resumption of normal functioning. The word “conditioning” refers to challenging or stressing something in order to strengthen it. The approach to the workout that is appropriate for healthy people is at the opposite end of the fitness spectrum from the approach for injured people. One group needs vigorous conditioning and the other requires gentle rehabilitation.
While you are healing, your body is more fragile and has self-protective mechanisms that block any possible danger of reinjuring itself. After you’ve suffered an injury, your muscles should not be challenged. We have to temporarily forget about getting into shape, which can come once we have healed. The goal of any exercise is to increase the rate of healing.
At first glance, the ESSENTRICS healing workouts might seem similar to conditioning workouts, as we are using many of the same movements, exercises, and techniques. However, upon examining both types of workouts, you will notice that the conditioning routines challenge the muscles while the rehabilitation routines focus on blood circulation and relaxation.
Maximum blood circulation keeps injured tissues well fed and oxygenated. On its way out of the heart, blood is the carrier of all the healing nutrients; on its return journey, blood acts as the garbage removal system. To ease circulation and encourage blood flow, we simply have to relax our muscles as much as possible and move through the exercises like a rag doll, while breathing deeply. Years of experience working with injured people has taught me that the more the clients relax in a workout, the faster they heal. This consistent, gentle movement is all that is required in the healing phase of rehabilitation.
I have seen both personal trainers and clients become so frustrated by tight muscles that they stretch aggressively in a vain attempt to force the tightness to loosen up. But the body has natural defenses aimed at protecting the muscles against further injury. You often end up with the opposite effect: The reflexes go into protection mode, making the muscles even tighter and more contracted, and the injury is worsened rather than healed. Strength training, which is supposed to increase power in healthy muscles, has the opposite effect when used on injured muscles.
To speed healing, you can also use another very important trick: avoidance. For example, if you have an injured knee, you work every group of muscles in the body except the knee. You relax the injured knee while gently stretching and strengthening the ankles, calves, quadriceps, inner and outer thighs, hamstrings, gluteus group, and so on, working every muscle except the knee itself. Not going near the injury while releasing tension in all the peripheral muscles has the effect of taking the strain off the injured area. Doing a full-body workout is the most effective way to heal a local area, as long as you keep the injured area relaxed.
The amazing thing is that you can do ESSENTRICS even when you are injured. Often, students will join a group class when they are suffering from some minor pain or injury and they have no problem participating in class as long as they do the workout in “relaxed healing mode.” At the start of the class, I remind them, “Anyone who is injured, just do the same workout—but be lazy in your execution.”
Once you have a doctor’s permission, I encourage you to exercise when you are in rehabilitation—but be sure to carefully monitor yourself to make sure you are not working. You will recover far more rapidly if you don’t put any effort into the movements. If you’re used to thinking of exercise as a means of getting into shape, you may resist the idea of being told to be lazy. But trust me: After doing one workout like a rag doll, you’ll change your tune. Most of my injured students smile with relief—they tell me they feel better and are actually capable of moving more freely than they were prior to the class. To me this is the magic of the human body: Your body knows how to protect itself and how to heal.
HEALING GLOBALLY IS HEALING LOCALLY
Injuries are never local and the healing of injuries should not be local either. To prevent injuries, all 620 muscles in the body must be equally flexible and strong. To heal injuries, the injured muscles must be returned to an equal balance of strength and flexibility with the rest of the body.
THE ROLE OF AWARENESS IN INJURY PREVENTION
A major part of injury prevention is awareness, the link between the mind and the body. Awareness in ESSENTRICS is the conscious and deliberate alignment of all joints: knees, hips, and spine. Awareness is being sensitive to when a movement feels wrong, feels awkward, or is putting an unhealthy strain on muscles. The more aware you are, the better any movement is performed, and the better the results will be.
Body awareness is the integration of several objectives into one. First, you develop an awareness of your body and its movements, which helps you strengthen the muscles to support and correct the change. In ballet and modern dance, students are trained to know exactly which muscles to use in order to execute a movement. But this awareness does not come naturally to most people. Without dance training, many people have trouble isolating specific muscles, which I believe is critical to staying safe and getting the maximum benefits of any fitness program.
In fact, most people are unaware of how they move in most everyday activities, such as sitting, standing, or walking. Regardless of whether we are conscious of them or not, these movements actively train the body—correctly or incorrectly. Poor posture is an example. Habitual poor posture develops the muscles accordingly—the pectorals begin to shrink, the back muscles weaken, the shoulders round, and the neck becomes overstretched. Many people’s body awareness is so poor that they can stand with poor posture feeling as though they are standing correctly. It’s only when they see themselves in a mirror that they realize how bad their posture actually is.
When someone becomes accustomed to poor posture, correct posture feels uncomfortable and wrong. You will need time to reprogram your mind and strengthen your muscles to achieve good posture and feel comfortable with it. During the transition period from bad to good posture, you have to be motivated and committed to making the change or you will quickly revert to bad posture.
The benefits of using your awareness to correct a lifetime of bad habits (bad posture, heavy walk, or any other mechanical action that can lead to injury) cannot be overstated—you will easily develop a more attractive body, or attain greater success as an athlete, or simply learn to appreciate the power and the glory of your own body, no matter how old you are.46
Injuries may seem local, but often the actual damage or trauma may be caused by tension or weakness in another part of the muscle chain to which the injured muscles are attached. For example, a knee injury could be caused by tightness in the hamstrings or calves. Back pain could be caused by tight hamstrings, and neck pain could be caused by atrophy in the feet.
When someone has tight or overbuilt muscles, tension is created in the muscle chain and pulls on all the muscles along that chain. The extreme tension leads to a tearing of the most vulnerable muscle along the chain. The injury is caused by a chain reaction, but the initial tension might be somewhere else in the body.
The number one way to prevent injuries is to keep the full-body muscles equally strong and flexible. When people do a lot of strengthening and very little to no dynamic stretching, you will find muscle tears, sprains, and injuries. If you have tight or overbuilt muscles, your entire body is an accident waiting to happen.
Athletes often suffer from muscle tears and injuries. I’m not talking about athletes bashing into one another and getting injured—I’m talking about injuries resulting from just doing a noncombat movement in a sport. Injuries from overbuilt muscles are also very common in the aerobics and running worlds, when muscles become so tight from years of impact that the body cannot sustain the tension. Something has to give and usually does. It could be a back, groin, calf, shin, Achilles tendon, or hip—somewhere along the chain of muscles, the tension builds until the weakest point gives out.
DON’T BABY THE INJURY
Overbuilding and too much tension in the muscles a
re the main causes of injuries and pain. But after the injuries have healed and it is time to rebuild the body, many people make the mistake of overprotecting the previously injured area. This leads us to the next problem: atrophy.
People often make the mistake of protecting or isolating a previously injured area by depending on braces, orthotics, or bandages while training the noninjured part. Whenever a muscle is restricted from movement, it will inevitably weaken and atrophy from lack of use. Being overprotective of the original injury virtually guarantees that you will develop a chronic lifelong weakness in the area instead of just recovering from something that hurt you once and then was gone from your memory!
THE 20 PERCENT RULE
Athletes get much more out of ESSENTRICS than just increasing their flexibility. The workouts cover a broad spectrum of techniques and objectives that athletes need, from active, ballistic, and eccentric stretching to alignment, injury prevention, and body awareness. To get the best results, I always recommend the 20 percent formula: Athletes should devote 20 percent (one-fifth) of their total training time to ESSENTRICS. In practical terms, that means an athlete who does 20 hours of training weekly should put aside four of those hours to do this program. Or an amateur athlete who does five hours a week should put aside one hour for it. Athletes who follow this formula have consistently experienced fewer injuries and much improved performance.
Most athletes assume that a stretch program is solely intended to improve flexibility—so their logical question is “Why should I do it if I don’t need flexibility?” Who doesn’t need flexibility? In my experience, these same athletes often have a grocery list of aches, pains, and injuries!
Ultimately, all sports require speed, and locked joints restrict speed. Even the smallest degree of added flexibility can help any athlete increase his or her speed—every little bit brings athletes closer to the podium!
Over the years I have seen this temptation to overprotect our weakest muscles in the healing processes of everyone from injured athletes to people with congenital diseases. Both groups, in my opinion, are overly dependent on braces, orthotics, or other athletic “support” devices, which keep their injured areas weak. While these types of support can be beneficial in preventing further injury, I believe they should be used as little as possible, because the more we depend on them, the weaker the muscles become. Muscles need to be moved and engaged to gain strength, and as long as they are being restricted from movement, they cannot strengthen.
When I first suggested to Robert, a teenage client of mine who suffers from a condition associated with cerebral palsy called triplegia, that he stop using the braces on his legs, his family viewed my advice with some skepticism. He was then 15, and he had been using leg braces since birth. His doctors had said they could no longer do anything for him. In desperation, his parents turned to me. I will be totally honest: I know nothing about triplegia or how to treat it. But I do know a lot about the nature of muscles and atrophy.
When I first met him, he couldn’t walk up the stairs to my studio; he was always falling down. His parents and four siblings were his constant caregivers, picking him up and helping him maneuver around their home. I gave him some basic exercises to do but the most important advice was to take off the braces as much as possible.
The next year when Robert returned, he was able to walk up the stairs on his own and stand by himself without falling down. A year after that, at Robert’s annual hospital visit, the size of his calf muscle had grown by three-quarters of an inch! Needless to say, he and his family were beaming with pride. Robert and I continue to work together, each year adding more complex exercises. We have even done the fox-trot together!
Not fully rehabilitating is a mistake that many injured people make. Previously injured muscles get weaker from lack of use, so the problem is aggravated by atrophy and an imbalance. This leads to a lifetime of pain. I can’t tell you how often I hear people talk about childhood injuries that are still causing pain 50 years later.
HEALING AN INJURY
We need to keep the pace of rehabilitation slow enough that the muscles surrounding the injury don’t need to learn new tricks. In time, the injured muscles will heal and strengthen, picking up where they left off.
Injuries are, by definition, points of weakness, and there is a natural temptation to continue to protect these weaker body parts so as not to cause more damage. A fear of reinjury becomes a psychological challenge in the healing process. Favoring the healthier, stronger muscles is always easier than using the weak ones, but that is a common and dangerous mistake. Let’s review the steps in healing:
Step 1: In pain, relax
The more relaxed your muscles are while you are exercising, the more rapidly you will heal. This is true for two reasons: Relaxation helps increase circulation and relaxation does not trigger the protective reflexes that seize the muscles and stop them from moving. Stay relaxed while exercising until the pain has totally gone away.
THE HEALING FORMULA: 10 TIPS FOR RAPID HEALING
When you are healing:
1.Focus on increasing blood flow to the entire body in order to bring healing nutrients to the injured areas.
2.The muscles need to be relaxed the entire time you are exercising. While it may take several days or several weeks, please wait until the pain goes away before changing from healing mode to training mode.
3.Never go to the end of a movement; always hold back from going to your limits.
4.Movements should be small, not large.
5.Use circular movements.
6.Work slowly.
7.Work in a “lazy” manner.
8.Always do a full-body workout.
9.Breathe deeply throughout the workout.
10.Do not focus on the injured muscles more than any other muscle group.
Injured muscles need the natural healing medication carried in blood cells. Blood cannot flow as effectively into contracted muscles as it does into relaxed ones. So stay relaxed if you want to heal quickly!
If you have a type A personality, you might find it frustrating to be forced to slow down and relax while exercising. Don’t look upon it as exercising; tell yourself that you are doing therapeutic movements.
Step 2: Once the pain is gone, it’s time to strengthen your muscles
Once the pain is gone, you can start to rebuild your muscles’ strength and dynamic flexibility. Slowly increase the intensity of your workouts one day at a time. This step doesn’t take long—muscles are designed to be strong and flexible.
However, be careful not to overexert them: Overexertion can reinflame the injury. When weak, injured muscles are challenged before they are fully recovered, protective reflexes kick in and block any advancement. You don’t want to teach the muscles the wrong lessons. Rebuilding injured muscles to their original size and strength takes time, depending on the severity of the injury.
During the rebuilding process, don’t focus too narrowly on the injured muscle. Owing to the injury, the muscles will have shrunk. If the injured area has been restricted in a cast or binding, you will also have some degree of atrophy. In order to reverse the atrophy and rebuild the muscle, the area needs to be equally stretched and strengthened on a daily basis. Strengthening alone will leave the muscle tight and unbalanced, making it susceptible to future injury.
Do a full-body ESSENTRICS workout (30 minutes every day) to keep your body balanced with equal strength and range of motion, along with any strengthening that your therapist advises. You will be like new in no time.
Step 3: Once the muscles are strong, return to a normal training schedule
After strengthening the injured muscles, get back to business and continue a regular fitness routine for the rest of your life. Without regular exercise, injuries and pain may return and the body will age more rapidly. ESSENTRICS is an ideal program for maintaining a strong flexible body that heals quickly and is resistant to injury.
HEALING SPECIFIC CONDITIONS
Most inju
ries and chronic pain are caused by compressed and unbalanced joints. Conditions in this category include osteoarthritis, frozen shoulder, plantar fasciitis, chronic inflammation of the groin, shin splints, hip and knee degeneration, osteoporosis, and chronic back pain. Unless we correct the cause of the problem and heal the original injury, we will be forced to live in chronic pain, suppressing it with medication, and bandaging over the symptoms with temporary solutions such as heat, ice, and massages. ESSENTRICS is so successful in healing injuries and reducing chronic pain because its primary objective is to simultaneously lengthen and strengthen the muscles; this directly relieves compression and rebalances the muscles surrounding the joint.
The following section gives a brief overview and description of some of the most common medical conditions and injuries that ESSENTRICS has had success in relieving and healing. Some of these conditions cannot be fully reversed but can be prevented from progressing further. Others can be greatly improved and sometimes healed completely. (Note: These descriptions are not to be used for self-diagnosis. If you require a diagnosis for one of these conditions, talk to your doctor.)
Every case is unique and depends on many factors, such as age, previous level of fitness, and weight. Your degree of pain relief and injury healing will be as individual as you are, but I can promise you that ESSENTRICS will help you feel better, now and in the future.
Arthritis
“Arthritis” is sometimes used as a catchall term to describe any condition that results in damage to the joints. Arthritis is the leading cause of disability in people over the age of 55, but many young people have arthritis as well. There are many different forms of arthritis, each having a different cause. Physicians often recommend ESSENTRICS to people suffering from osteoarthritis, because the stretching and strengthening help to relieve pain caused by compression and grinding of the joint head due to damaged cartilage.
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