Fitness Makeover: Staying fit when injury takes you out of commission

Credit: Matthew Stockman/Allsport
Steve Childers from Hudson, Ohio, is Octobers Fitness Makeover subject. An avid swimmer and sometime triathlete, Steve had the misfortune of fracturing a bone in his elbow (making matters worse, it happened on a recent vacation!).

Although broken bones are thankfully not prevalent in the swimming community, this is an important subject for a column because all of us have at one time or another been immobilized unexpectedly. Broken bones aside, swimmers and traithletes can find themselves in a frustrating bind should they suffer from swimmers shoulder (rotator cuff inflammation) or particularly severe road rash (from a nasty cycling spill).

Not ones to sit on the sidelines and remain sedentary until their injury heals, these diehards look for creative ways to stay in shape. Thus it is important that they find the right exercises to ensure speedy recovery while avoiding re-injury.

Having only recently freed his elbow from a partial cast and sling, Steve remains unable to utilize his arm to full effect and would like to know ways to stay conditioned while he heals. With the mishap a month behind him and (according to his doctor) full recovery about a month away, what can he do to avoid going stir crazy and prevent lethargy from taking over his active lifestyle?

Given that his doctors orders are to avoid putting any type of strain or weight on his arm at all, one would think that Steves choices for satisfactory exercise are limited. But there is a lot he can do, and a lot he should be doing, if hed like to maintain good conditioning in anticipation of his recovery when he can finally hit the road (and the pool) again.

Most importantly, Steve should stimulate as much circulation to his arms as possible. Increased blood flow sends valuable nutrients to broken limbs that can aid in the recovery process, and it keeps surrounding muscles from atrophying at a rapid rate. One way to stimulate blood flow to the arms is through mild shoulder-rotation exercises. Such drills also keep shoulders from tightening (especially when they are supporting an arm in a sling) and increase their range of motion.

Also, regardless of whether a swimmer has full use of his arms or not, shoulder-motion exercises are essential in helping to lengthen and maximize the stroke by developing the all-important shoulder roll.

With his arms relaxed at his sides (or in a sling, it doesnt matter), Steve should begin moving his shoulders forward in a circular motion, 10-12 times. Then, reversing the motion, he should do 10-12 more backward rotations. He should repeat this set a few times each day.

In a few weeks time, he can hold small weights at his side during the drill, which will help lengthen his already-increasing range of motion (hence lengthening his stroke when he returns to the water). Caution: Adding heavy weights to this exercise may strengthen shoulders and add bulk, but it will have contrary effects to flexibility and range. Never use more than 10-pound weights, and start out with 3 pounds.

Another great way to strengthen shoulders is to practice holding drills. For instance, hold a pencil in front of you at eye level with both arms extended. Hold it for a minute, relax for 10 seconds, and repeat. Work your way up to doing this five or 10 times, then replace the pencil with a 1-pound weight.

In time your upper arms will strengthen to the point where holding a streamline position off the wall when you flip-turn, or keeping your stroke long and smooth when youre fatigued, will become second nature. You are strengthening a small group of muscles that are often overlooked, but if theyre developed they can work wonders in perfecting, and salvaging, your stroke.

Another holding drill is to simply hold your arms extended above your head, as if you are streamlining off the wall in post-push-off position. After about a minute (maybe less), you will notice the strain it puts on your upper arms. The longer you can hold this position, the better off you are in maintaining proper technique and form in workouts and races when shoulder soreness sets in. Repeat the drill in varying intervals and attempt to best yourself each day.

The above rotation and holding drills are great exercises to try if you find yourself with an immobilized arm, because they do not involve weight or repetitive movement. But they are also great ways to broaden your range of flexibility while strengthening overlooked muscles that you rely on daily in your swimming.

Incorporating these drills into your pre-workout stretching and warm-up routine will only help you become a more efficient swimmer, whether you are injured or not.

Another obvious response to Steves upper-body handicap is to focus on conditioning his lower body in low-impact ways (the repetitive impact of running can result in further elbow trauma). I covered vertical kicking in a previous column on hotel-pool workouts, and this is still my favorite and most challenging drill.

With his arms crossed over his chest and his body vertical in a deep body of water, Steve can flutter-kick for a minute, keeping his head above water and taking short, fast breaths (deep breaths will cause him to sink in the water as he expels air). Then, after a 30-second break on the side of the pool, he can try again. And again. By the third minute, Steves quads will be burning and his heart rate will be pounding.

What makes this drill more beneficial than kicking horizontally with a kickboard is that there is no easier downkick. When your body is horizontal, you raise your leg back on the upkick and let gravity take care of the downkick, creating whitewater and hopefully propelling you forward ever so slightly. With your body vertical in the water, your legs are faced with equal underwater resistance in both the upkick and downkick directions, while having to keep your gravity-prone body afloat.

After mastering this drill, complete with the aforementioned rest breaks, Steve can intensify the leg workout by switching to breaststroke or egg-beater kick during the rest periods (thus switching from passive to "active" rest). This can easily be the most challenging 10 minutes of a swimmers workout, if done correctly. Not only is this a great leg workout, but its also a terrific cardiovascular challenge that has the same effects as a sprint set of 50s or a small group of fartleks.

I am also a proponent of one-arm drills, which are basically swimming with one arm stationary at your side. In Steves case, he can do only a left one-arm drill due to his injury, but swimmers who would like to perfect their technique should exercise both the right and left arms equally.

By swimming with only one arm, one can concentrate on that particular arms underwater recovery. If the submerged recovery is correct (an s shape and its mirror image, depending on which arm), the body will roll forward with each stroke. If the recovery is incorrect or the shoulder-roll not complete, the body will fishtail and struggle awkwardly in the water, indicating bad technique.

Just because Steve is nursing a fractured arm, it does not mean he has to remain sedentary. In fact, this is an ideal time for him to master a few important drills that he should continue doing even after he recovers. Conversely, just because you may be healthy and intact, it does not mean you shouldnt bother with shoulder-rotation exercises, vertical kicking, one-arm and holding drills.

While they may not be loads of fun or the way youd like to spend your training time, they are important exercises that not only strengthen oft-neglected muscles, but also help ensure proper, more efficient technique.

And who can do without that?

If you are interested in being the subject of a Fitness Makeover, please e-mail your questions to Alex, and include a phone number where you can be reached upon your selection.

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