The Mysteries of Injuries

As a professional dancer for 10 years in New York City, I've had plenty of injuries. It's a long list. As a retired chiropractic orthopedist, having practiced for many years in New York City, I've treated lots of people with a very long list of exercise- and sports-related injuries.

As a life-long athlete, I'm well aware that a person with an injury has many questions.

When can I get back to my sport? is the most common and most immediate question. This is relatively easy to answer.
What can I do to prevent this from happening again? is another common question. Often, the answer is relatively straightforward. But for some, injuries continue to happen.

Which leads us to the key question -

Why did this happen to me?

This is the hardest to answer. Sometimes, stuff just happens. As a physician, you may need to look a person in the eye, shrug your shoulders, and say exactly that - sometimes stuff just happens. But it's very important to continue to attempt to discover likely causes.

I believe there are three main sources of training injuries -

Under-preparation
Over-training
Lack of focus OR not paying attention

Under-preparation means doing things you're not ready to do. In Manhattan, I often worked as an aide at the finish line of the New York City Marathon. After a while, I was no longer shocked by the numbers of people who were absolutely falling apart at the aide station. Once a person was able to speak coherently, I'd ask them about their marathon training - how did they prepare?

The ones who were in the worst shape were the ones who prepared the least. Obviously. Well, obvious to the docs, but not obvious to the person attached to the I.V.

People who have never done aerobic exercise go out and try to run five miles. People who have never done strength training go to the gym and try to use heavy weights. People who have never taken a yoga class go to one, like it, and then go every day for a week.

Oy.If you're 16, you can go crazy. Sometimes, even if you're 26. But if you're 36 or 46 or 56 - or 66, 76, or 86 - you've got to train on a trajectory. Start slow, start with the basics. Have rest days. Build up your strength and stamina. Get used to the new form of physical activity, and build on your base. Doing too much will send you straight to your doctor's office - or to the hospital.

Over-training means doing too much. Most of us are guilty of this. I know I am. Ego gets in the way, you think you're tough, invincible, and you exceed your physical limits of the moment. For example, you love to run, you build up your weekly mileage, and all of a sudden you've got a stress fracture in your fibula or tibia [or a bad strain of the posterior tibialis [which feels almost exactly the same as a stress fracture].

There is another side to this, and none of us wants to baby ourselves. I mean, how many runners haven't had lingering calf pain or a chronic stress reaction? Most of us have had this at some point.

What I want to emphasize here is to train SMART, and to look out for the possibility of over-training. It's always a temptation, and the result is never good. The short-term gratification is completely outweighed by the frustration and deconditioning resulting from injury-enforced down-time.

What about focus and paying attention? I'll propose that many injuries happen during normal training because your mind wandered off. People are paying more attention to the TV screen or to the music on their iPods than to their rep of the moment. What happened to present time consciousness? This powerful Zen concept offers tremendous value for people who exercise. Focus provides immeasurable value, forging powerful brain-muscle connections. And, focus - present time consciousness - causes you to be right in the moment and doing your exercise properly.

I'll make the bold statement that you're very unlikely to sustain an injury during normal training if you're completely focused. I can look back on so many of my own injuries and point to wandering attention as the immediate cause. Now, it's challenging to focus all the time, right? Yes, it is. Maintaining focus is part of the discipline of training. It's a Zen thing, packed with powerful rewards for a person.

But aren't there underlying issues that may predispose a person to injury even if they're doing all the right things? The easy answer is "yes". The hard part is to accurately assess and possibly diagnose such issues.

Underlying causes often involve complex biomechanical imbalances. Most often, these are not easy to correct. A person may spend vast amounts of precious time and money in trying to find effective therapy. She may visit chiropractors, physical therapists, orthopedic surgeons, massage therapists, and assorted "natural healers", and still not achieve a permanent solution.

What to do? I believe knowledge is power. A magnificent book - really, the seminal work in the field of biomechanics - is The Thinking Body by Mabel Ellsworth Todd.

The Thinking Body was written in the 1930s. It's a slow read, but will definitely reward you by helping you get your head on straight [literally] about human biomechanics and physical performance.

More to come about biomechanical imbalances, how to begin to restore efficient form, how to regain performance levels, and how to prevent recurrence of injuries.

David Lemberg

25 years experience in fitness, exercise, health, wellness

Author, speaker, educator

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