Our ability to heal is best when we are young and diminishes as we grow older. But like anything else in the body, it is based on a “use it or lose it” principle. The more we do this, the better our body gets at recovery.
Athletes and Those Who Regularly Exercise Recover from Surgery at a Faster Rate Than Sedentary Individuals
Why is this? There isn’t some superhuman gene that you are born with. This is a trained-in process that any normal person is capable of.
It starts with an understanding of the immune system. This is not a technical article, by any means, so I’m not going to sneak in any ten-dollar words to make myself look smart.
Exercise Damages the Body – In a Good Way
Exercise damages various tissues in the body. Strength training, quite literally, causes tiny tears in the muscle tissue. Outside of the gym, your body repairs the muscles, and you get stronger.
There are various words that have been used to describe the body’s process of healing itself. It is often called the immune system – collectively referring to all processes that contribute to healing the body.
So the process of healing, of repairing damaged tissue, is what we are looking at here. Your body has ways of healing itself after cuts, scrapes, burns, illnesses and hardcore workouts. It all involves the repair of tissue.
When you cough your throat raw after being sick, that tissue rebuilds. When you go under the knife to get surgery, that incision has to heal. If you roll an ankle and rip some ligaments, you have to keep that ankle still long enough for those ligaments to mend themselves.
Speeding Up the Healing Process
Depending on the type of injury, there are a few things that have to happen to bring things back to normal. You can break it down by the types of tissue that were injured. It could be skin, muscle tissue, ligament, cartilage, bone or a damaged organ.
Usually a torn ligament or muscle (torn more than the normal microtears during exercise) will cause a good amount of inflammation. The inflammation is a good thing because it brings together all of the ingredients necessary to rebuild.
The downside of inflammation is that it hurts.
Sometimes people get obsessed with getting rid of inflammation (and in some cases this may be true) but I just wanted to make a point that there is a reason that a part of your body swells up when you hit it. Sometimes it goes too far and you need to work to get it down. I’m not giving medical advice here. Ask a professional to tell you the best way to heal an injury because they can take in all factors. There is no blanket advice that anyone could give.
So this may sound crazy when I say damaging yourself is good and inflammation is good. They are just normal occurrences in a body.
The art is in how big of a dose you get.
Recovery From Exercise Is a Scale of Progression
Progression doesn’t go straight up. After a workout, you can’t lift as much as you did before. Your immune system responds by getting to work healing the torn tissue. The resources devoted to healing the tissue get overloaded for a period of time, making you slightly more susceptible to illness.
Once the tissue has been repaired, you’re stronger. You can lift even heavier. Then you go and blast yourself again and we’re back down again.
But each time, you get a little stronger and a little better at recovering.
The Correct Dose of Exercise
You do want to damage the muscles, but not too much. Some trainers have reputations of being “The most hardcore trainer in the city” or “He is ruthless.” It can be good as a sales gimmick, but rarely works out in practice. You’ll just start injuring your clients until no one is around.
The intensity of a workout should be determined carefully. Intensity is determined by how much weight is being moved, how fast and for how long.
You want to stress the body, but not too much. This is where the art of it comes in. It involves knowing your client (or yourself) well enough to know how much they can take based on tons of factors: age, fitness level, past injuries, flexibility, strength, endurance, sleep habits, diet, paying attention to what they say, paying attention to what they don’t say, knowing when they are trying to push themselves too hard or when they’re not pushing hard enough.
Here are some examples of intensity-related injuries I have seen or heard about within my sphere:
1. One man I was training had a history of surgery on his neck. He was new to me and I told him that I did not want to increase the weight on his bench press until I saw how he responded to the workout – like how sore he was or if it created a problem. He was stubborn and continued to add weight. He then felt some shooting nerves up his neck and since I was spotting him, I did most of the lifting to get it racked. He didn’t come back for weeks.
I chalk this up to my failure to get the point across. I think I should have said “I know your muscles can do the work, I want to see if the scar tissue that’s there starts pulling and causing problems.” or some such wording. Either way, I failed and he was in pain. I don’t beat myself up, but when something bad happens, I always look directly at myself to see what I could have done to prevent the bad situation.
2. One of my clients was being trained by my co-worker while I was out of town. He had her stepping up onto a box while holding dumbbells. Nothing out of the ordinary, but he had her doing it laterally and she was in her 50s. She tore something in her knee (which had already been injured years back). For some reason he thought that this was the right amount of stress on her body. It was some fancy, complicated maneuver that she didn’t even understand.
There were many failures here. The new trainer should have gone easy on her no matter what because he didn’t know her that well. He could have stuck with the program I gave him. Or he could have just not done something stupid like that. My fault is that I didn’t train him well enough.
3. Another one of my clients was being trained by a new trainer. He was getting creative with his exercises and he had her doing back extensions with a weight held against her chest. That would have been semi-okay if it was on a gradient, but he also had her twist at the top of it. She tore something and was in bed in pain for weeks. That exercise was too complex and the muscles around her spine weren’t anywhere near ready for that.
4. When I was a kid in high school I trained myself in my garage. I wanted to have big muscles so the girls would want me and the boys would be scared of me. So I did a ton of chest press every night. Like every single night. I ended up with real pain across the muscles of my chest and I had to stop for weeks before anything felt right.
For every injury that I or others have sustained, I have delivered thousands upon thousands of safe workouts. I think fitness trainers should keep a statistic of “Safe Workouts Delivered.”
As a trainer you shouldn’t ever blame the client for not telling you about an injury or existing condition. Blame yourself for having subpar interrogation skills.
Recovery from Surgery
This is a hard thing to make objective. Like “Out of all 16-year-old females who had a lateral meniscus tear, these recovered faster…” There are just way too many variables in an injury. Studies where you give a bunch of 21-year-old guys X-number of beers and observed the results are way easier. You just can’t go up to a bunch of girls and tear their lateral menisci.
What I’m trying to say is that this is more of an observed thing than a “tested” thing. I wouldn’t trust any study done because the variations in the patient, the injury, the surgeon and the surgery techniques are too much to have a controlled experiment. But, I always know that my athletic people will recover. The sedentary people I’ve dealt with always take the full time to recover and then some. They never make it back up to where they were.
The conclusions here were made by professionals working with patients who had “kind of the same situations” going on. It’s hard to do science when they were “kind of” injured the same way. That’s all I’m saying.
But exercise before surgery is catching on.
What Is Prehabilitation?
Surgeons are starting to look toward prehabilitation as a way to bounce back faster after surgery.
This is simply the process of getting someone in good shape before an operation so that the downtime after surgery isn’t so rough on their body. The idea here is to keep a person from hitting new or extreme lows of physical activity and health.
Think of it this way: if Rocky were to take a tumble down a flight of stairs, his time to recover would be less than someone who never worked out.
Ask any surgeon or physical therapist who recovers faster. They’ll tell you athletes. The answer is never “the sedentary person.” It’s always “the active person.”
So just always be as fit as possible to be prepared for the worst.