Olympic Weightlifting for Rehabilitation
8 Easy Steps to adding Olympic Weightlifting for Rehabilitation of Injuries
I know the concept is unheard of to most people but Olympic Weightlifting for rehabilitation of injuries is actually very safe depending upon the injury.
For the purposes of this article the term “Olympic Weightlifting” is going to include all lifts needed to attain a safe Olympic Lift (i.e. Deadlift and Squats are needed for Cleans and Snatches)
Note: In my office I don’t stress Jerks or Snatches in a rehabilitation setting.
Physical Therapy and Rehabilitation providers often times give basic exercises to restore a basic of function with an injured person but we should not stop there.
Most people, whether they lifted before or not, should add in resistance training to their rehab… Olympic Weightlifting is a safe way to accomplish this.
The purpose of this article is to bridge the gap between therapy exercises and weight training, in this case it will be with barbell work.
This concept is one I battle everyday in my clinic. Many people have never lifted before and are very afraid, which is perfectly normal.
Allow me to explain:
The best-case treatment plan for an injured person would be the following:
1. Education about the injury
2. Attain a level of comfort and control pain
3. Begin to normalize movement patterns
4. Re-enforce normal movement patterns
5. Progress from basic therapy exercise to more advance therapy exercise
6. Learn technique for Olympic Weightlifting with no weight
7. Add weight to Olympic Weightlifting
8. Increase weights and trouble shoot
In a therapy setting, our first goal is to “do no harm” but in an effort to challenge the injury for a tolerance of load we often need to perform provocative tests. The body response to challenges places upon it.
Before adding in olympic weightlifting for rehabilitation we need to establish normal movement patterns and what is the person/ injuries load tolerance.
An example is walking.
If a person can only walk 10 minutes without pain then we take them up to 10 minutes and improve form for that 10 minutes before form degrades… we can load them over time.
Another example:
Say the patient has cleaned before but now can no longer clean without pain the day after… perhaps we change to pin pulls or pull & drops before allowing a catch. We may even work on front squat technique on after with very light weight and focus on form and drive from the hole.
There are endless ways to build a tolerance to load.
#1 Education about the injury
Education is the foundation for a successful recovery. Realistically this part of the process is 90% in the patient’s control.
Healthcare providers do have a major part in it but the patient MUST ask questions and speak up when they do not understand.
They choose how much they pay attention, learn on their own, ask questions, and stay accountable for their work.
A good healthcare provider will have resources for teaching you what you need to know, but you need to tell use what you don’t understand.
#2 Attain a level of comfort and control pain
Examples:
• Medication
• Injections
• Deep tissue work
• Active Release
• Graston
• Taping
• Joint mobilization
• More
Logically it’s unrealistic to ask a patient to perform a rehab exercise if they are in pain. Often times if they are still in a significant amount of pain they movement differently creating “compensatory motion.”
As a healthcare provider it is our job to apply the correct treatment to decrease pain to a manageable level. Treatment can be drugs, manual techniques or even movement corrections…whatever gets the job done is correct.
Honestly, it sometimes comes down to a psychological approach. Regardless, the goal of this level of care is to help the patient along the way to “Active Therapies,” such as therapy exercises, weightlifting and more.
#3 Begin to normalize movement patterns
Examples:
• Breathing Patterns
• Sit to stand
• Kneeling to stand
• Rolling
• Core Bracing
• Shoulder Blade Motion Awareness
• More
It doesn’t take a lot to alter normal motion. Even stubbing a toe changes walking gait. Asthma can change breathing patterns, trunk stabilization, walking gait and create hip pain. Habits form over time and before you know it your walking this way all the time.
In this level of care you should be able to self-recognize what is going on and correct it.
#4 Re-enforce normal movement patterns
Now you are doing the previous re-education exercises everyday, or sometimes multiple times a day. As your pain decreases you can do this less and we start to get into more advanced rehab.
Repetition is key in relearning how to move.
This is the level in care many people get stuck in from my experience.
They often times lose focus of why they are doing it and get bored. Just remember there is more to come.
During this level of care you are not really stronger. I call it “turning the light switch on,” next we will “increase the bulbs wattage.”
If you have been in this phase of care for more than a few weeks perhaps ask your therapist questions about what is to come. Their answer may get you motivated again.
#5 Progress from basic therapy exercise to more advance therapy exercise
Examples:
• Goodmorning to Deadlifting technique
• Rolling to ½ Kneeling Pallof Press
• Plank Progressions
• Bridge Progressions
• Isolated Gluteus Medius Exercises Side Planks
• Deep Neck Flexor Exercises
This is another sticking point for many people. They get handed a list of floor exercises and never progress beyond them. I’m not going to lie… this is better than nothing but if you stop here you are only a fraction of where you should be if you want to improve your injury.
We live in a world where we need to learn to control our body while standing.
We live in a world where you will be sitting and standing multiple times a day, so you’d better learn to squat well.
We live in a world where you will want to pick up your 8 year old kid, so you better get really good at deadlifting as well.
I don’t know about you but I plan on dying on my feet… so I am going to rehab that way too.
#6 Learn technique for Olympic Weightlifting with no weight
Examples:
• Squats with a wood dowel
• Hip Hinging with a wood dowel
• Breathing Patterns with Olympic Lifts
• Posture with Olympic Lifts
• Proper knee stacking
• Proper Rotational and Lateral Patterns
#7 Add weight to Olympic Weightlift
Examples:
• Front Squat 45 – 65lbs
• Deadlift 45 – 65lbs
• Strict Pressing (depends on injury)
• Maybe even Power Cleans (depends on injury)
These are only examples. The reality of adding this type of loaded motion is that it comes with a risk.
You will diminish this risk if you are working with a good sports medicine therapist, chiropractor or strength coach.
Strength, stabilization and proper movements will only prove the long-term health of your joints.
Muscles follow roughly the same principles as bones… put them under some load and they will adapt to handle the load. Doctors have preached weight training to offset osteoporosis and osteopenia for years. Just like bones, muscles will become stronger with weight training… and no that doesn’t always lead to becoming bulky.
I wrote an article on “Sarcopenia,” which maybe helpful in understanding why Olympic Weightlifting for rehabilitation of injuries can be extremely helpful.
Want more information on how muscles response to weights? I wrote an article and made some chart to assist your understanding. LINK TO RESISTANCE TRAINING RUNNER
#8 Increase weights and trouble shoot
Examples:
• Front Squat 65 – 100lbs (modifying foot position and depth of motion)
• Deadlift 65 – 150lbs (modifying foot position and depth of motion via blocks)
• Strict Pressing
• Cleans (Maybe Clean Pulls)
How much you choose to lift is up to your healthcare provider.
When I assess how much I want to load an injury I use many factors, flexibility and strength are just two of them. How a person moves is another major factor but we will have to cover this in another article.
If I’m testing flexibility and strength I figure out if this person has a “normal” amount of flexibility or strength to do the activity they love.
As for flexibility, if we were to only look at hamstring flexibility I would want the person to come within 2 inches of touching their toes (while keeping the spine straight). That would be fairly “normal” in my book, regardless if the patient “feels” tight or not.
As for strength, I am looking for the following benchmarks. If they cannot or have not tried to hit those marks the first correction I would recommend working up to strengthen after we correct movement pattern/ form issues.
For Women:
• Deadlift 101% of your Ideal Body Weight
• Squat 75% of your Ideal Body Weight
• 15 Modified Push-ups (full depth) within a minute
• 1 Pull-up would be impressive within a minute!
• 2 Minute Plank Hold (no wobbling)
• 30 seconds holding a Single Leg Bridge (no wobbling)
For Men:
• Deadlift 133% of your Ideal Body Weight
• Squat 101% of your Ideal Body Weight
• 15 Push-ups (full depth) within a minute
• 5 Pull-up would be impressive within a minute
• 2 Minute Plank Hold (no wobbling)
• 30 seconds holding a Single Leg Bridge (no wobbling)
Generally I recommend “Strength” Olympic Weightlifting, like deadlifts and squats, for an injured person since the eccentric loads on the damaged tissue is slower and can be controlled.
“Power” Olympic Weightlifting can come later but often times are too complex for a beginner. These include: Cleans, Snatch and Jerks.
What is Olympic Weightlifting?
Olympic Weightlifting a sport where athletes attempt to lift heavy weights on barbells. It actually only includes two lifts: the Snatch and the Clean and Jerk.
However, basic fundamentals of Olympic Weightlifting require strength and competency from other lifts, such as the Deadlift and the Front Squat.
Why is Olympic Weightlifting for Rehabilitation of many injuries safe?
Olympic Weightlifting for rehabilitation is not common practice in most rehabilitation settings, I theorize for a few reasons.
- Not all healthcare professionals know how to coach proper form. If I had to estimate I would guess only 5% of healthcare providers know how.
- Lack of space can limit if you have weightlifting as rehab.
The purpose of therapy exercise is to strengthen weak parts of the body in isolation.
The purpose of Olympic Weightlifting is to bring it all together in one complex movement.
With correct form and weight, injuries from Olympic Weightlifting are very low.
Typically we don’t go above the parameters noted above in a rehabilitation setting. Beyond that point, they are often seeing a Strength and Conditioning Coach.
What types of injuries can we use Olympic Weightlifting for Rehabilitation?
Just know any Olympic lift can be modified. For example, if you cannot deadlift due to a back injury, perhaps we will start you with a Barbell Hip Thruster or work on the end of the motion with blocks.
Here’s a short list of conditions we use barbell work to rehab:
- Achilles Tendonitis
- Hip Impingement
- Low Back Pain
- Runner’s Knee
- Meniscus Tears
- Rotator Cuff Tendonitis
- IT Band Syndrome
- Calf Strains
- Plantar Fasciitis
- Upper Back Pain