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The Large Professor Rehabs, Pt. 1
A peak into JB's training log -- rehab phase

By Dr. John M Berardi, Ph.D.
First published at www.johnberardi.com, May 21 2004.

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On The Shelf

Well, the inevitable has happened. The Large Professor’s 11 years of heavy weight-training have caught up with him. That’s right, JB is on the shelf. Sort-of.

To be honest, I’m a little bit embarrassed to admit my litany of injuries, which include serious knee pain and inflammation, an inflamed biceps tendon, and a lower back that’s not allowing me to sit for any extended period of time without a dull ache. After all, the current trend in strength and conditioning circles is to mock the injured for their training indiscretion. As a matter of fact, I think I’ve even read some strength coaches claim that most injuries (even to team sport athletes on the field) are caused by improper lifting form.

So you can imagine my dismay in finding myself legitimately injured and sidelined with not just one problem area, but with three significant areas of concern. In baseball, I’d be heading back to the dugout. But after coming to terms with my not-so-minor aches and pains (drinking heavily helps) and after talking with some other training veterans, I’ve come to realize that injuries are inevitable. The man who has trained hard and heavy for over a decade without any injuries is a lucky man indeed.

Of course, the focus on injury prevention of many modern strength and conditioning coaches is important. And sure, many injuries do come as a result of postural problems, improper lifting form, poor recovery, etc. But are all injuries the result of training stupidity, as some suggest? Clearly not. Common sense dictates that if your forcing anatomical and biochemical adaptation with constant training overload, you’re walking a tightrope between progress and overuse. And once in a while, you’ll accidentally step over that line.

Time Off?

Let me clue you in on my basic training philosophy: I never take extended periods of time off from the gym. Sure, if I’m over trained, I’ll be sure to take a week off and ease back into the gym, working systems of the body that will allow me to expend energy without taxing my recovery resources. For example, if my CNS is fried, I’ll take a week off and then ease back into the gym with hypertrophy type training that won’t overload the nervous system.

This philosophy is in place because, like most of you, I love being lean and muscular. So fatigue, injuries, and overuse are not excuses for staying completely out of the gym and, as an effect, letting my conditioning slip away.

This philosophy has served me well in the past. When in pain, I’d mostly find movements that didn’t hurt the injured body part or I’d lighten up the load on movements that did bother me. And most often, the injuries would usually disappear after just a few weeks or months.

But recently a new factor has entered the picture. I’ve become a sedentary guy. Now that I’m out of university and am taking this year to focus on writing and consulting, most of my day is spent in a desk chair. And part of me suspects my new sedentary behavior, coupled with heavy training, is the #1 cause of my injury-plagued body. This was confirmed recently as I decided, for the first time in my life, to see a therapist. In the past, if it remained undiagnosed, in my mind, it wasn’t a problem. So it took me a while to actually build up the momentum to see someone.

Diagnosis

Fortunately I picked the right guy. I was referred to Rory Mullin, now a part of the Science Link team, by my good friend Matt Nichol (the head strength and conditioning coach for the Toronto Maple Leafs). Rory did an initial postural and movement analysis probed around my knee and back and came up with a first line rehabilitation plan. At the beginning, we employed a system of myofascial stretching, ART, acupuncture, and other more conventional athletic therapy techniques. We learned that my back and my knee responded well to manual therapy. Within 2 weeks of therapy and stretching (2x every day), I was able to squat heavy again. I easily worked up to 450lbs pain free whereas I was only able to use 135lb just a few weeks prior. And dead lifting was going quite well also.

Unfortunately, right around this time, I began working on a new writing project and was spending at least 8-10 hours a day sitting at my computer. This was bad news for the knees and back. All the sitting, coupled with the heavy squats and dead lifts, brought about a resurgence of the pain. Great, back to the drawing board. Unfortunately though, the stretching and rehab weren’t getting the job done any longer. Curious, Rory brought in a posturologist by the name of Yves Ethier. Yves is a strength coach and posture specialist from France and is one of a few specialists (Guy Voyer and Michel Joubert being others) who decided to bring their techniques to North America. On one of his trips down from Quebec, Yves did a full analysis of my posture and found a number of inhibitions starting with my feet. It appears that sitting all day was making me tight in certain areas. This tightness (which wasn’t completely eliminated by stretching) was causing subtle deviations in my lifting form. This created a feed forward system of muscle tension and a slow degeneration of some of the soft tissue structures of my knees and lower back. As I’d train, these tissues would get aggravated and inflamed. This pain led to a gradual compensation by other muscles of the body and these became tight too. As you can see, unless I break the cycle, I get broken myself.

As a result of Rory and Yves’ expertise, we’ve got a full rehab plan. First, I’ve had to get new lifting shoes (Olympic style), flat insoles for these shoes, and orthotics for everyday use. In addition, Yves discovered a pelvic imbalance that Rory and I are currently working on with stretching and manual therapy. Finally (this being the worst part), I’ve had to eliminate squats and dead lifts from my routine for the time being. Talk about sticking a dagger in my heart! Instead of bilateral movements involving the legs, I have to use unilateral for a while. And the loads are dramatically reduced. However, with these steps taken, I’m certain we’re on the road to recovery and I’m certainly improving.

Rehabilitation

Although squats and dead lifts are out, I’ve found ways to work around my knee, back, and biceps injuries and continue training pain-free. In the interest of demonstrating how it’s possible to work through injuries and rehabilitate at the same time, I’ve included my current training routine.

A huge part of my routine currently involves stretching – both dynamic and static. If you’ve got nagging injuries and aren’t stretching pick up a book on stretching and get started. Science of Flexibility, by Michael Alter is a good start.

In addition, I’d like to give special thanks to Rory and Yves for their expertise. I’m redefining my body right now and while this is a difficult process (because of my impatience and years of learned habits), I’ll be better off in the long run.

Honorable mention also goes to George Morrison for providing the X-Vests for this training phase. Here at our Toronto facility we’ve been using the X-Vest, with great results, for everything from loaded walking (to increase fat loss) to chin-ups and plyometrics. It truly is an amazing product! It’s been essential in my own rehab, allowing me to safely load exercises that would be difficult to do otherwise.

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