I see people in my practice all the time who tell me they’re always getting injured and feel trapped in a revolving door of injury after injury after injury. They usually feel hopeless that they’ll ever break free of this vicious cycle. Understandably, this is an immensely frustrating experience. It is often helpful to know that it is also an incredibly common one – you’re not alone. Misery loves company, I guess.
Despite how prevalent this issue is, most people don’t understand why it happens. Have you ever heard the expression, “what got you here, won’t get you there”? This is kind of like that. When you try to address this cycle on your own, you approach it with the tools and knowledge you already have – which is what got you into this situation in the first place. In order to break free, it takes a fresh approach using new tools that are better equipped to get you on track to better health.
In this article, I’ll outline some of the most common reasons why people end up in this hamster wheel of pain and suffering. The list won’t be exhaustive, but should apply to most people out there. If you do find something that resonates here, don’t beat yourself up about it. We all make mistakes and just accept that you’ve been doing the best you could with the tools you had. However, think of this as a wake-up-call. Just because you may not have the tools you need now doesn’t mean you shouldn’t take the steps to acquire them. Find someone who knows how to help you stop this cycle and ask for their help! Don’t just repeat the same outworn patterns and then act surprised when you end up where you started.
The Revolving Door of injury
Here are just a few examples of things I hear from people who are stuck in this unfortunate cycle:
- “Every time I get to a point in my training where I’m feeling good and training hard, I get injured and lose all my progress.”
- “It just seems like it’s one thing after another. As soon as I get rid of one injury, another pops up.”
- “I’ve done PT and the pain goes away, but as soon as I go back to playing sports or training the injury comes right back.”
- “When I rest/take some time off of training the pain goes away, but as soon as I go back to playing sports or training it comes back.”
- “Ever since I hurt my (insert body part) (x number of) years ago, things have never been the same.”
- “I have bad (insert body part) so I just don’t do (some activity) anymore.”
- “It just seems like I can’t make any progress. I’m training hard, but I don’t seem to get stronger and I keep getting hurt.”
- “Why am I always injured? I’ve tried yoga/massage/pilates/acupuncture/physical therapy and still keep getting hurt.”
Any of these sound familiar? I’ve fallen into the trap before and so have countless others.
Why Are you Always Injured?
Alright, here I’ll briefly discuss ten of the most common causes of recurrent injury.
1. You’re Training Too Hard, Too Long, or Too Often
This one is pretty common. If you have questions about how to improve or track your recovery check out my previous post on workout recovery optimization. This is for the person who feels like they get hurt every time they start progressing in a workout program or who feels like they’re training hard, but not seeing progress. Learn to listen to your body and moderate the intensity, duration, and frequency of your workouts accordingly. This goes for sports too. Just because you want to go skiing, surfing, mountain biking, or running every single day doesn’t mean it’s good for your body.
2. Something is Missing in Your Training
If you’ve been doing the same basic workout routine for a long time or even if you’ve been changing your programming, but are still using similar movements, there’s a good chance something is getting left out. This is the person who feels like it’s just one (often seemingly unrelated) injury after another. Variety is the spice of life and the boon of good long-term training. Dismiss its importance at your peril.
A huge limiting factor here for most people is simply knowledge. Unless you have studied exercise science or worked as a trainer you likely don’t have a vast library of exercises stashed away in your brain. Sure, you can look up workouts online and cobble together your own programming. Unfortunately though, most people subconsciously gravitate toward things that are familiar and instill confidence (in other words, exercises they already know). So even if you look things up online, there’s a good chance your “new” workout will still be strikingly similar to the old one.
The value of working with a professional on this cannot be overstated. A good physical therapist, coach, or personal trainer will identify your weaknesses and build a program to address them. They will incorporate some movements you know, as well as introduce some that you are less familiar with. Not only will this keep your workout program feeling fresh and interesting, it will also make you stronger and help you avoid neglecting important muscle groups or movements. Pro tip: there’s a pretty good chance that some of those exercises you always avoid because they’re hard and you’re not good at them are exactly the ones you need more of. Working with a professional will help motivate you to do those hard things.
It’s important to note that I don’t mean that you should be constantly switching things up and doing random exercises each time you go to the gym. Rather, each time you finish a period of training that could be something like 4-, 6-, or 8-weeks long you should make sure you aren’t training in exactly the same way during your next period of training. I also don’t mean that you need to find someone who pulls the craziest looking exercises they saw on Instagram and sticks them into your training program. Find someone who is grounded in the basic foundations of training and introduces variety intelligently.
3. You’ve Been Half-Rehabbing
This likely applies if you’ve been to PT for this injury before and gotten to the point where you were feeling pretty good only for the injury to resurface when you get back to training. Typically, this happens when you quit PT once the pain is gone. The problem with this is that getting rid of pain is only the start of a good rehab program. Check out my explanation here.
Essentially, you can think of pain as the tip of the iceberg. Pain is just the part that you can easily see on the surface. Beneath the surface there are typically multiple underlying issues that together form the root cause of the pain you’re experiencing.
Pain and injury lie on a spectrum. At one end of the spectrum you are fully healthy. As stress is applied to the body, you move a bit away from that healthy end of the spectrum. If that stress exceeds your body’s ability to adapt to it, breakdown and injury begin to occur. At this point, there is often just a small injury process starting and you may still have no pain. Eventually, if your body continues down that path the underlying injury will cross a threshold that brings pain into your conscious awareness.
Addressing the pain alone only brings you back to the point in that injury process just before the pain started. This means that the underlying issues are still there! They may have been partially addressed, but certainly not eliminated. If you stop rehab at this point, it’s highly likely that you will again cross the threshold into pain.
4. You Expect Rest to Heal Your Injury
This if for the people who say they’ve taken time off, the pain’s disappeared, but then when they go back to training it comes right back. While some rest may be a necessary part of injury recovery, it is never the answer in isolation. The reasons for this draw from numbers 2 and 3 above. If you rest until the pain goes away, you’ve done absolutely nothing to address the root cause that brought on that pain in the first place. When you go back to training, the pain is all but guaranteed to come right back. On top of this, whatever you’ve been doing in your training thus far is what got you into this mess in the first place. Going right back to that same training and expecting a different outcome just doesn’t make sense.
5. You Let Old Injuries Limit Your Future
If you ever say that any part of your body is “bad” (i.e. “I have bad knees”) this one is for you. Labeling some part of your body as bad signals multiple things. One, you’re subconsciously telling yourself that a particular part of your body is inherently bad or weak and that things will always be the way they are. Second, you’re expressing hopelessness and giving up on trying to find a solution. Now, before you take offense to those statements hear me out.
When you’ve dealt with pain and injury from a particular area for a long time it is 100% understandable that feelings of hopelessness may creep in. That said, giving up hope is never going to help you move past this issue. Even in cases of injuries that truly will never be the same, there are still lots of possibilities for growth and modifications that can allow you to do the things that you love. Animals (including humans) are resilient. If you’ve ever seen a three- or even two-legged dog that should be all the evidence you need. What’s more, labeling a part of yourself as “bad” will only make you feel bad. That body part is still yours and it still has value. Just focusing on the positive and lifting yourself up rather than putting yourself down can make all the difference.
Sometimes healthcare providers are to blame for this mentality. If that’s the case, move on! Find a provider that helps you feel hope and gives you solutions rather than condemning you to failure. More on this here.
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6. You Have Old Injuries/Imbalances/Limitations That Were Never Fully Addressed
Did you have some injury in the past that just never seemed to fully go away? If so, that’s a sign that you may have never fully addressed that injury and the underlying issues that caused it. Stop living with that injury as if it’s a fact and instead start looking for solutions.
7. You Don’t Cross-Train Well
Smart cross-training addresses the same thing discussed in number 2, above. You can cross-train in the gym or through sport. The exact modality you use is not important. What is important is that your cross-training uses muscle groups and movements that are neglected in your primary activity.
8. You Keep Trying the Same Things
You can insert many treatment modalities here, but some examples could be massage, yoga, pilates, acupuncture, physical therapy, or chiropractic. I’m not knocking any of these professions. They are all fantastic and many of my clients get amazing benefits from them. That said, any one in isolation is not as strong as multiple in combination. Massage and acupuncture are passive modalities. They can influence many things like relaxing your nervous system, boosting immune function, improving circulation, and many others. What passive modalities cannot do is address active mobility or strength – two of the most important components of injury rehabilitation. Chiropractors sometimes do work on these things, but often do not.
When properly taught and practiced, yoga can be excellent for addressing mobility, mindfulness, breathing, and relaxation. Yoga does not, however, build strength. Furthermore, if practiced or taught poorly yoga can exacerbate mobility issues, create hyper-mobility, and irritate the nervous system.
If you’ve tried certain approaches before without finding a solution, consider trying something new. Also keep in mind that not all providers are equal. If you’ve worked with one provider and not seen improvement it doesn’t necessarily mean that their treatment modality is ineffective. It may simply mean that the individual provider is ineffective for you. Keep testing new treatments and different providers until you find your all-star team.
9. Nutrition, Sleep, Hydration
Without these three pillars, your body simply CANNOT function well. Consider getting some bloodwork and working with a dietician to make sure your nutrition and hydration are on point. If sleep is a problem for you, start working on finding a solution. Sleep is something I have personally struggled with, so keep an eye out for a future article on sleep.
10. You have an Unaddressed Underlying Health Condition
Make sure that you are taking care of your overall health. Work with a physician you trust to address any health conditions. Your body can only handle so much stress and any unaddressed health issues will limit your body’s ability to handle the additional stress of sports and training.
That’s All Folks
I think almost everyone can find some of themselves in the examples above. Even if you haven’t had recurrent injuries, there’s a good chance that any injury you have had can be traced back to one of these sources. One of the most important take-aways from this is that solutions are out there. You just have to find the right person to help you and then ask them for help! Yes, it will likely cost you some money, but think of all the quality time you’re losing by not finding a solution. Ask yourself how much it would be worth to you to break free of this cycle of injury. Think of it as an investment in an injury-free future.
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Health Advice Disclaimer
This article provides examples that are applicable to many, but not all people. They are based on typical presentations seen in my personal clinical practice. This information represents common findings in the population discussed, but can in no way take the place of professional evaluation and treatment by a licensed medical practitioner. It is impossible to provide 100% accurate diagnosis or prognosis without a thorough physical examination and likewise the advice given for management or prevention of any injury cannot be deemed fully accurate in the absence of this examination.
If you are currently experiencing any pain or injury, seek professional evaluation before undertaking this or any exercise program. Ensure that you are medically cleared for exercise before undertaking any exercise program. Significant injury risk may occur if you do not seek proper evaluation. No guarantees of specific outcome are expressly made or implied in this article.