At the beginning of March this year, I got an email from a guy asking for help, let’s call him Bob. In his email, he mentioned that he was deadlifting at Christmas and injured something in his back, which led to him struggling to both row and go about daily life. He said a friend of his at one of the top programs in the country recommended me to him, because his pain was debilitating and he wanted to do everything he could to race at the Head of the River.
He wasn’t based in London, so we started with an initial free, information-gathering call to talk about his back pain and its origins. This is the first step of my online rehab process with any client, in order to determine and categorise symptoms from mild to severe. It also allows a client to get to know me and see if we are a good fit to work together.
Here’s a summary of Bob back in March:
The injury occurred after deadlifting at Christmas as part of his school’s strength and conditioning testing. He experienced lots of symptoms like stiffness, tightness in his back and hips and reported a high level of pain, 7/10. He was also regularly going for sports massages to help relax the muscles in his lower back. There was some positive effect, but he said it was very short term and pretty minimal.
We did a thorough assessment, completed capacity testing, and used video analysis to looked at how he moves. All this information combined gave us a clear picture of his situation and what he can and cannot do and how much the pain was impacting him.
The plan was simple. Start with getting him to move again in his comfortable, pain-free range, and focus on symptom management. The aim was to get him confident to move his spine, hips and pelvis again. In the first two weeks, Bob had a lot of small wins, which boosted his confidence and set a good foundation for us to build on later. We also placed a big emphasis on making sure his day to day life was helping him, not hindering him.
Gradually, we began to add in more challenging movements, such as moving through a greater range of motion at each joint, and progressing some exercises. Pro-rehab tip: using breath work with tentative movements can help to relax the body.
Throughout working together during Bob’s rehab, we spoke about a few topics, one of the most important was how his lifestyle was secretly hindering his rehab. For example, his sleep schedule was an easy area for improvement. By getting an extra hour of sleep before midnight, this improved his recovery and lowered his stress. Another huge win was splitting up rehab into small, manageable chunks throughout the day, rather than all at once at the end of the day.
We kept challenging him in the gym, making sure he stayed fit by swapping to the static bike. Now his symptoms were under control and he had very little pain, the next stage was all about making him stronger. We used the capacity testing to highlight his areas of improvement and tailored a part of his strength and conditioning (S&C) program around it.
Bob’s S&C program started off with very simple exercises, and was different to his normal program to keep it entertaining and challenging. The focus was on his movement patterns, movement quality and enjoyment.
Week on week, we were seeing lots of improvements in the weekly check ins. Bob’s consistency was paying off and he could quite literally feel his rehab paying off. Now the momentum was high, we started to transition to more rowing specific movements and set a goal to row at an important national event for schoolboys in May; I’m sure you can guess which one.
Bob’s dedication and consistency with his rehab was seriously impressive. His S&C made him stronger and, gradually, his pain and symptoms became less intense and flare ups were less common. He completed the capacity testing again after six weeks, and the improvements were phenomenal. This objective data was great to see his improvement and that rehab (and getting stronger) really pays off.
We kept going with regular S&C and gradually started bringing back rowing on the ergo. We started with small intervals and gradually built up to 30 minutes over the course of five weeks. The next natural progression was trying longer intervals and a key marker was spending 60 minutes on the ergo doing UT2 (aerobic zone) with no pain during or after. This was a huge win.
He then went rowing in a boat and had no issues: another huge win. Fast forward to the big race in May, and he won silver in the championship coxless four.
This was a massive win for him, his crew and his team.
This story is about how frustrating it is to be injured and how important it is to get assessed and have a clear, objective and personalised rehab process. By being committed, resilient, and trusting the process, the hard work in rehab will always pay off.
Sophie Hudson is a registered and chartered physiotherapist.
If you are suffering with an injury, contact Sophie through her online form: https://docs.google.com/forms/d/e/1FAIpQLSfbeTKdxcyirVbTvQIzUs7KAuas6r4wuiYE4ZI65Hffhom38A/viewform
