“Too much, too soon, after too little for too long.” – Scot Morrison
This quote perfectly sums up a large majority of the injuries that we see as
physiotherapists. Whether we were forced to take a break from our activities (likein our current circumstances), or we tend to only do activities during certain times of the year (anybody else only run in the Summer?), it is important to have a plan in order to safely return to the things that we love without causing any problems in our muscle, joints, or other soft tissues.
The human body is amazing. It is constantly changing and adapting according to the information that we present it with. If you consistently give your body a specific stimulus at the right amount, your body will adapt to it. If you give it too much at once, it may cause a problem. An easy way to imagine this is picturing the difference between a callus and a blister.
Small amounts of irritation to the skin over time causes your body to adapt to that irritation and make a tougher layer of skin in that area in order to protect itself, a.k.a. a callus.
If you irritate that area of skin more than it was prepared for, you may get a blister. Which is red, painful, and tender to touch. This same concept can be applied to almost any tissue in the body.
So how do we go about safely returning to an activity when we have no idea how much of that activity we can handle? By looking at our acute and chronic workloads.
Your chronic workload is how much of that activity you have done, on average over the past month (4 weeks). Your acute workload is how much of that activity you have done, this week. When your acute workload is MORE than 1.2x your chronic workload, we start to see problems and an increase in injury risk.
Let’s use running as an example. We’ll say you were running 10km, three times a week by the end of last summer. The weather is getting nice out now, so you decide to get the running shoes back out. How do you decide how far to run? Do you go back to 10km because that is what you were doing last time you ran? This is what most people do. But what is your chronic workload? Because you haven’t ran in months, it is essentially zero.
This means that the tissues in your hips, knees, and ankles are no longer prepared to take the forces that they will endure over 10km, which may cause irritation and pain. “Too much, too soon, after too little for too long.”
So where should you start? If you have not been doing that activity on a regular basis, I recommend that you start at about 50% of what you were doing last time you were doing the activity regularly.
In the running example, keep it to 5km. Then see how you feel over the next couple of days. If you have no issues, run another 5km. Then see how you feel over the next couple of days.
The goal is slowly build up your chronic workload over time, in order to give the tissues time to adapt to the stress you are placing on them.
If this is something you need help with, schedule an appointment with one of our physiotherapists so they can help you come up with a plan specific to you and your activities, to keep you pain-free and moving. Remember; make calluses, not blisters.
PT, DPT, CMFA, CF-L1