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Training Around Injuries #1: Hand/Wrist

As I've gotten older as an physician, coach, athlete, and human I have learned and unlearned many things. Science is constantly in flux, and what was correct 5 years ago may now have strong data showing that it wasn't quite as certain as we thought. However, there is one thing I know for sure: if you train and compete long enough, you will get hurt. This is as inevitable as death and taxes. I've talked before about training around injury in a general sense, but it's time to get into a little more specifics. Over the next few posts, I'll talk about what you can do to stay strong despite injury limiting your options.

There are a countless injuries to choose from, but let's start with one that a weightlifter recently consulted me about: the wrist. I'll include the hand in this discussion as well, because the question is “what do you do to keep the upper body strong when you cant hold anything in one hand?” This athlete is currently in a cast, and is worried about shoulder and upper arm atrophy during the recovery process.

The answer to this not overly complex, but does come with some nuance and precautions. First, as always, make sure that you have been fully evaluated by a licensed provider and have a good diagnosis prior to starting any of this. Furthermore, check in with this provider about the specifics of your injury and how any movement of the arm could affect them. Obviously if you're in a full-arm cast, you're out of luck and need to wait until cleared to do anything. And if you have any pain in the injured area during any of the following suggested exercises, stop immediately.

Now that we've got that out of the way, let's talk about how to reduce strength loss and atrophy when you essentially don't have a hand to work with. It's actually doesn't require as much fancy equipment as you might think. If you're at a Globo-gym, all you need is a cable tower and an ankle strap attachment. If you're at a box or garage gym, you can do the same thing with some bands. Let's break it down by muscle group:

  • Biceps: loop the ankle strap and velcro it around your arm just distal to the elbow. You may have to play with the angle, but you've now got a lever to do bicep curls just like you would if the weight was in your hand. You can use the cable or wrap a band around a power rack for resistance.

  • Triceps: attach the strap in the same manner as above to give you the ability to perform tricep pushdowns and overhead tricep extensions. Again, you'll likely have to play with the angle to find the right stimulus.

  • Shoulders: attach the strap proximal to or on the elbow joint. Using the band or cable, you can perform front, lateral, or rear delt raises. If the band or cable is long enough and you angle it right, you also have the ability to do some overhead pressing and upper trap work.

  • Chest: attach the strap proximal to or on the elbow joint. As you might guess, now you can do some chest flyes and presses. These can be performed lying or standing.

  • Upper back: attach the strap proximal to or on the elbow joint. Without involving the biceps, grip, or any other factor, you're now able to perform rows, pulldowns, etc. This might actually be better than the traditional exercises in some cases, as many people have difficulty activating the muscles of the upper back, instead relying on their biceps to do the work.

As you can see, there are many ways to train without the use of one hand. Yes, the levers and fulcrums will be different than the traditional lifts, but you can still get an excellent stimulus. Try to focus hard on the quality of the movement, the muscle contraction, and keeping the reps controlled. MOVE WITH INTENTION! In addition to preventing further injury, this will also result in a better stimulus for the muscles, which leads to more gainz. As always, play it safe and get your provider involved early. Be smart, and you'll continue to maximize your health through strength, and strength through health.

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