Chronic injuries suck. These aren't the kind of injuries (acute) where you get tackled in an awkward position on the football field or take a racket to the chin. These are largely issues of wear and tear, the result of poor movement patterns.. Knee pain, back pain, hip pain, shoulder pain. Every movement has a cost and HOW we move determines that cost.
The million dollar question is 'why are we getting these chronic injuries?' As a victim (or perpetrator) who has been studying this with everything I've got, my best guesses are 1) The amount of time we spend sitting and 2) A lack of adequate 'conditioning.'
Sitting is no joke! Take for instance the high degree of back pain in Western, industrialized societies vs more rural, less office dwelling groups. We were meant to move, sitting interrupts that and also as research has discovered, sitting interrupts the function of our diaphragm. When the diaphragm, one of the most important muscles in the body for pressure management, systemic health and optimal movement begins to tap out, the layers of compensation begin. Any muscle that isn't performing well will require the nervous system to recruit other muscles to try and help out. We can liken this to players on a team. If someone isn't doing their job, someone else has to pick up the slack which in turn distracts them from doing their own job. And down the slippery slope of compensations we go. This is why almost every person I know has tight hip flexors and those who don't are often hypermobile which is a different category of functioning (or dysfunctioning) altogether.
To try and tackle proper 'conditioning', I like the question, 'do you run to get fit or get fit to run?' If we are spending our days largely sitting AND not maintaining our movement abilities, we tend to lose our natural, efficient movement patterns. In other words, use em or lose em. Unfortunately after a long day at work, when we do go to the gym, our bodies might not be in a great place to deal with that workout. The second piece here is that we (as a society) have such a strong desire to push and go hard. Our nervous systems are sympathetically (fight or flight) driven. Watch any track race beyond 200m long and you will see that the athlete's form will finish worse than when they started the race. Tension goes up, smoothness goes down. Again, as certain muscles begin to tire and we reach the capacity of our conditioning, other muscles try to pick up the slack. In our day to day training, how often are we going beyond our edge and if it is often, might we actually be training our bodies to move with compensation?
For seasonal athletes, the degree to which we begin to lose our movement quality can depend on our our condition at the beginning of the season as well. Are we beginning the season conditioned or deconditioned? And if we come in deconditioned, at what point will the body get tired and start resorting to compensatory strategies and then later, to injury?
To be honest, I don’t have the knowledge or experience to say who is more likely to be injured: someone who is coming in with layers of compensation but is strong within those patterns OR someone who remains untouched by compensation but isn't strong and well conditioned. Frankly I think the research is pretty murky on this. But if we're playing the long term game, I'm recruiting the athlete who is most willing to tackle whatever obstacle is in their way. Obviously if an athlete has optimal patterns already, it’s much easier and simpler to strengthen those already existing patterns. But it’s rare to see that kind of recruit. Most athletes who have optimal patterns and aren’t strong have other issues, work ethic, mindset, etc.
To me, the coolest part is that we can remove layers of compensation. Performance = potential - resistance. Not only is it possible to reduce the likelihood of injury while improving systemic health but we can tap into athletic prowess that may be lurking beneath the surface. Once the compensations are unwound, we can enhance and strengthen optimal and healthy movement by building on good foundations.
To become well conditioned and to reset to healthier movement patterns take LONG TERM investments. We're talking about months here at minimum. That may sound overwhelming.. but when you break it down into little bit sized chunks and then you start to feel better and healthier as a human being, it's WORTH IT. It's a seed worth planting as you attempt to optimize performance but also to feel good in your body for the rest of your life. It's all about healthy functioning, less pain, less problems.