Working Out Through Injuries

The "New" Injury

So it seems that I have tennis elbow or something similar. It's frustrating because I feel like my body has been slowly falling apart since I was a junior in high school. I have chronic foot pain, shoulder pain, lower back pain, and now elbow pain. It's been a couple of weeks now that I've been dealing with this pain, so I need to find a way to get back in the gym. I can't just take indefinite chunks of time off, that's how I got out of shape in the first place. Besides, I can't just rest indefinitely until it doesn't hurt, since that can actually prove counter-productive.

However, I'm not going to simply "push through" the pain either. I'm going to attempt to actively rehab the elbow join without injuring it further. There are several rehab strategies out there for this condition, so I'm going to use some of those strategies to get ahead of this thing. Unfortunately, that means there are going to be a lot of physical limitations because I don't want to fall out of balance by training parts of my body differently.

Working Out With Tennis Elbow

What Is Tennis Elbow?

Tennis elbow is an overuse injury characterized by soreness on the outside of the elbow. It is typically caused when the flexors in your forearm become weak and the tendon breaks down. Oftentimes, the condition is brought on slowly, but sometimes it is caused by a forceful flexion or, in my case, extension.

Supplementing For Tennis Elbow Recovery

Tendons and other connective tissues take a long time to heal because they are avascular, or have a very low supply of blood to heal them. That's why tennis elbow rarely presents with swelling. Because it takes so long to repair tendons, I'm going to make sure that what little blood my body is able bring to my tendons is filled with building blocks for repair. That means I'm going to be adding glucosamine, bromelain, MSM, vitamin C, and magnesium.

There are also people out there suggesting bone broth, so I may try that as well. It kind of makes sense since you're basically eating what you're body needs repaired. It can't hurt, so what's the downside?

Exercises For Rehabilitating Tennis Elbow

I found this video below and thought it was helpful in both explaining tennis elbow and how to perform exercises to treat the proximate weaknesses that contribute to it.

How to Strengthen a Tennis Elbow -- powered by ehow

I do know from my other research, however, that it's not simply flexor/extensor weakness that causes it, but sometimes weakness in other areas of the body (like the shoulders) that causes you compensate with your forearms. My exercise program will be a little more holistic than just those listed below. I plan to take this opportunity to try and make all my injuries better. 

My Recovery Workout

The Theory

Putting a large amount of stress on the tendon is likely to result in further microtears on the tendon, so I won't be lifting heavy for this workout. Because I want to keep my body in balance, I'm also going to stay consistent with my rep ranges. One of the biggest problems with tendon rehabilitation is getting blood into the area to heal it, so I'm going to work on getting a pump each workout instead of building muscle. That means higher rep ranges and lower weights to really get the blood into those muscles.

I'll also be focusing on all of my weak points during this phase to try and prevent imbalances from causing additional problems in the future. So my hips, lower back, shoulders, and feet are going to get a good deal of work as well.

The workouts I need to be most careful with are the biceps and triceps exercises because they will put the most stress on my flexors, so I'm going to be careful with the weights and bring it up slowly, stopping if I feel more than 60% pain (pain rated a 6 on a 1-10 scale). 

Since I'm currently injured, I'm going to ease back in with a few sets of each lift, then build up to 5 sets of each lift. Below is the goal workout, where I hope to be in a few weeks. 

The Workout:

Chest & Biceps Day: 

DB Bench Press: 5x15
Cable Flies: 5x15
Cable Crossovers: 5x20
Preacher Curls: 5x15
Preacher Hammer Curls: 5x20
Forearm Curls/Extensions/Twists: 3x20 each movement

De-emphasizes presses to mitigate stress on elbows. Preachers are stable, taking pressure off the shoulder joint, enabling you to control the weight with perfect form every rep. Hammer curls are great for building up your forearms, which if not overdone, can help with the healing process. 

Back Day: 

Close-Grip Pulldowns: 5x15 
One-Arm Rows: 5x15
Wide-Grip Row: 5x15
Deadlift: 5x15


Focus on lower-back strength and mid-back development to stabilize the shoulder joints.

Shoulders & Triceps Day: 

DB Shoulder Press: 5x15
Reverse Flies: 5x15
Forward Rotation: 5x15
External Rotation: 5x20
Single-Arm Triceps Pull-down: 5x20
Skull-Crushers: 5x30 with light weights in comfortable ROM

Shoulders get great anterior and lateral work from presses, so I use the reverse flies to balance out shoulder development. Plus, reverse flies are great for scapular muscle development if proper form is maintained. Emphasis is placed on rotator cuff strengthening to rehabilitate that injury and prevent future elbow problems arising from compensation.

Single-arm triceps pull-downs are easy to control my movement with, so any triceps strengthening can be done with perfect form. Skull-crushers are risky because they're part of how I injured myself in the first place, but I think they can help rehabilitate as well if I'm careful with weight and practice good form. It allows me to gradually build up a better ROM and prevent future injuries to the elbow tendons. I increase the volume so that I can try to get a good pump.

Leg Day: 

Front Squats: 5x20
Step-Ups: 5x15 each leg
Side Lunges: 5x20 each leg
Hip Adductors: 5x20
Hip Abductors: 5x20
Hamstring Curls: 5x15
Seated Calf Raises: 5x15
Balance and toe-curl movements to strengthen arches: variable and to exhaustion

I could probably do a normal leg workout, but since this program is focused on injury rehab/prevention, I'm focusing on hip development (hip ab/ad, step ups, side lunges) and reducing stress on my lower back (front squats). I add hamstring curls because front squats and step ups hit the quadriceps much harder than the hamstrings, and I don't want to go out of balance. The balance and toe curl movements are designed to help strengthen the arches in my feet, which I'm hoping will help me with the chronic pain there. They'll not need too much because the other leg exercises will wear them out some, but I think they can use a little extra work.

Cardio: 

Since I'm doing higher-volume and not focusing on muscle development for the foreseeable future, I may as well start a cutting phase and get rid of my excess body fat. That means adding lots of cardio to my weekly program and changing my diet. Typically, you don't need to change your lifting routine for a cutting phase, but in this case, my lifting routine is changing anyway.

Doing cardio after lifting burns twice as much fat, so I figure I'll mostly do sustained steady rate cardio after my lifting sessions. I'll try to do what Layne Norton suggests, which is to burn about 350 calories from cardio each session. He suggests cardio 3x/week, but I may do it more frequently to cut faster. Probably not more than 4 or 5 times though.

Diet: 

Layne Norton, a pro natural bodybuilder and PhD in Nutritional Sciences, has devised some handy guidelines for macronutrient intake during a cutting diet. The goals are to spare muscle and lose fat. Everyone has a different body, but there are three main body types: ectomorph, mesomorph, and endomorph.

Ectomorphs have very fast metabolisms and typically have difficulty building muscle or fat. They are usually slight of build. Think Kevin Durant.

Endomorphs are roughly the opposite of ectomorphs, they build muscle and fat quickly. Most endomorphs are naturally heavier and have difficulty losing fat. Think Buster Douglas.

Mesomorphs are somewhere in the middle, and they are genetically rare. They have naturally hard bodies and have an easier time building muscle. Lebron James is probably more mesomorphic than most, as would be someone like Mike Tyson.

It's also possible to have a mix of the mesomorph and one of the other body types. In my case, I'm naturally muscular like a mesomorph, but I overproduce certain hormones like cortisol, so I would be a mix of endomorph and mesomorph.

In my case, I'm going to balance the mesomorph and endomorph recommendations from Layne Norton's guidelines. See my dietary breakdown is below:

Total Caloric Baseline: 3150 (calories to maintain my current weight) - 600 (enough to lose 1.2lbs/week with diet alone) = 2550 calories

Protein: 315 grams (1.5g/lb), or 1260 calories from protein

Carbohydrates: Whatever is left, (2550 - 1260 - 612) = 648 calories from carbs, or 162g of carbs

Fat: About 23-24% of my caloric baseline, 2550 x 0.24 = 612 calories from fat, or 612/9 or 68g of fat

Frequency: I should be eating every 3.5 to 4 hours and consume about 35% of my calories shortly before my workout.

So each day my goal is to eat:
315g Protein
162g of Carbohydrates
68g of Fat

Let's Get Started

I'm going to get started today with the Chest & Biceps workout, since that's where I left off after the initial injury and progress through them in the order listed. I'll check in tomorrow and let you know how it goes. I'm hoping I don't make the pain more severe. Today I'm going to do no more than 3 sets of any exercise and avoid failure entirely. I think that's best since it ensures I won't be losing good form at any point.