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Should you train while injured?

We've all been injured before. It sucks. Often, we hear people complaining that they can't get to the gym because of their injury. "Oh, I did my ankle last week so won't be in for a few weeks." The justification being that they're waiting to get back to full recovery before they can train again. However, a lot of the time this stems from the misconception that we must stop all movement to fully recover the muscle. In the majority of cases (depending on the injury of course), there is usually always something you can do.

 

Rather than worrying about what you can't do, worry about what you can do. For example, if you've hurt your ankle, you still have three other healthy limbs you can train. Some exercise modifications often mean you can still train without exacerbating the injury in certain positions (we can help if you're stuck on ideas - after all, it's what we do). 

 

Not only this, there is good research (going as far back as 1983 from Houston et al) out there showing that training your uninjured limb can help maintain or even gain strength in your affected limb. This phenomenon is called the cross-education effect. It has been shown that contralateral strength training has carryover to immobilised limbs. For example, if we go back to old mate and his ankle, training his other leg safely can reduce the fall-off in strength, power and proprioception on the injured side. 

 

"One meta-analysis revealed that the typical magnitude of strength gain in the untrained limb is 7.6% (when compared to pre-training), equating to approximately 50% of strength gain observed in the trained limb" (Munn et al., 2004). 

 

You may not be able to help muscle atrophy (loss of muscle) on the affected side, but you can potentially enhance your recovery outcomes post-injury on the daunting rehab journey. The theory behind the cross-education effect is mainly explained by increased neural drive originating from the untrained motor cortex (Hendy & Lamon, 2017). Without getting into too much detail, the “bilateral-access” hypothesis, as a result of the increased neural drive, involves the development of motor engrams (units of cognition) following single-limb movements, which can be accessed not only by the trained limb, but also by the untrained limb (Ruddy and Carson, 2013). 

 

The main takeaway? Being injured is a setback, but we can reduce the effects of de-training by getting in and doing something. Anything. We have had plenty of ACL reconstruction clients come through our doors pretty soon after their surgery training their upper body or their healthy leg, while the other leg is completely immobilised. Whether they're sitting down on a ski erg and building their aerobic base, or pumping out some seated shoulder press, they're dedicated to getting back to their best as soon as possible. Generally speaking, it's these types of clients who end up with the best outcomes in their overall rehab journey! 

 

References

Houston M. E., Froese E. A., Valeriote S. P., Green H. J., Ranney D. A. (1983). Muscle performance, morphology and metabolic capacity during strength training and detraining: a one leg model. Eur. J. Appl. Physiol. Occup. Physiol. 51, 25–35. 10.1007/BF00952534

Hendy A. M., Spittle M., Kidgell D. J. (2012). Cross education and immobilisation: mechanisms and implications for injury rehabilitation. J. Sci. Med. Sport 15, 94–101. 10.1016/j.jsams.2011.07.007  

Hendy A. M., Lamon S. (2017). The Cross-Education Phenomenon: Brain and Beyond. Frontiers in Physiology 8, 297.  10.3389/fphys.2017.00297

Munn J., Herbert R. D., Gandevia S. C. (2004). Contralateral effects of unilateral resistance training: a meta-analysis. J. Appl. Physiol. 96, 1861–1866. 10.1152/japplphysiol.00541.2003

Ruddy, K. L., and Carson, R. G. (2013). Neural pathways mediating cross education of motor function. Front. Hum. Neurosci. 7:397. doi: 10.3389/fnhum.2013.00397