Doctor, doctor: when following medical advice isn't the best Rx

Q: BECAUSE OF AN INJURY, my doctor told me to stop going to the gym. But doesn't it make more sense to train around the pain?

A: Good question. The answer: It depends. When you have an injury--sports-related or otherwise--you can generally expect that exercise will either help you overcome the injury or make it worse. The trick is in knowing when to follow your doctor's advice and when to override it, seeking expert advice from someone in the field of your specific injury or simply following your own common sense.

"Keep in mind that a doctor's first job is to do no harm," says Tom Seabourne, PhD, author of Pocket Idiot's Guide to a Great Upper Body (Alpha, 2006). "That means that the advice you get may not always be the best advice for overcoming an injury. A doctor can always safely advise you to take time away from the gym without concern that his advice will worsen your condition." If you want to keep training and work to overcome your injury, Seabourne makes the following recommendations.

>> Seek an expert's advice. "Rather than relying on general medical advice, seek out a specialist," suggests Seabourne. "Sports-med physicians and physical therapists want what you want--to get you back into the gym, pain-free, as soon as possible. Most PTs will show you exercises that increase the strength and flexibility of the muscles surrounding your injury so you'll prevent future injuries."

>> Train opposing muscles. "Often, the problem comes not from the injured muscle but from a weakness in the opposing muscle group," notes Seabourne. "Your body is a kinetic chain of muscles that work together in harmony: quads-hams, biceps-triceps, chest-back. When you're injured, consider emphasizing the opposing muscle group to develop muscle balance."

>> Find substitutes. "If a particular exercise is bothering you, eliminate it. Replace bench presses with machine presses; rather than squats, try leg presses," Seabourne advises. "Use other techniques, too; for example, if heavy weights are a problem, switch to lighter weights and higher reps. Work with very light weights for stabilizing moves such as overhead dumbbell presses, then use slightly more weight for machine presses, which don't require stabilization."

>> Take time off if training exacerbates the injury. "Be sensible," says Seabourne. "If you're at a point where your training impedes your [injury-rehabilitation] progress, then give it a full rest until you're pain-free."

RELATED ARTICLE: INJURY SCHEDULE

While every injury needs its own timeline, here's an approximation of what you should do for the average non-debilitating injury.

DAY 1      Stop training
           Ice your injury (cycle the ice 20 minutes on, 20 minutes
           off, 2-3 times)
           See your doctor or specialist if the injury is severe
DAY 2      Don't train, or train around injury
           Ice your injury (cycle the ice 20 minutes on, 20 minutes off,
           2-3 times)
           See your doctor, chiropractor, etc. as appropriate
DAYS 3-7   Don't train, or train around injury
           Use moist heat on injury
WEEK 2     Begin rehab with a specialist, if necessary
           Or, begin new workout regimen that takes injury into account
WEEKS 3-6  Continue rehab training regimen

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