You’ve had an injury.

Maybe you tore your hamstrings.  Or pulled a low back muscle, strained your forearm with the repetitive stress of keyboarding, or threw out your shoulder getting jerked by your dog on a leash.

Exercise is an essential part of rehab.

In the earliest phase after an injury, you may have to avoid movement of the injured area altogether.  Soon though, you’ll be ready for step two: easy limbering exercises to maintain range of motion.

It’s the third phase of healing that presents a challenge – how do you retrain your injured muscles to rebuild strength?

Start with the wrong exercise, at the wrong time, or performed too enthusiastically, and you could easily set back your recovery.  On the other hand, if you do too little, you’ve needlessly prolonged your rehab and left yourself (and your weakened muscles) vulnerable to re-injury.

Fortunately, rehabilitation specialists have now reached general agreement on the way to avoid these pitfalls and begin to rebuild your muscle power after sprains, sprains, tendinitis, and the like.

Accentuate the Negative

The most benign form of muscle exercise – with the least chance of re-injuring the area and the best chance of enhancing the healing process – is slow movement activating the muscle during the negative work phase.

Here’s what I mean.

Picture to yourself the well-known exercise of a biceps curl.  Your arm hangs at your side.  You hold a dumbbell in your hand and bend your elbow, lifting the weight.  You’ve activated your biceps muscle to perform the positive work of raising the dumbbell against the downward pull of gravity.

If your biceps muscle went completely limp, the dumbbell you’ve just lifted would plummet.

If instead you lower the weight slowly, your biceps muscle is now doing the negative work of controlling and counteracting the downward action of gravity.  The biceps is firing while it’s being lengthened by an outside force (gravity, in this case).

Same Rose, Different Name

They also call muscle activation as the muscle lengthens during the negative work phase eccentric muscle contraction.  When the muscle activates and shortens, doing positive work, that can be called concentric contraction.

The secret to healthy rehabilitation of an injured muscle is to postpone challenging the muscle with heavy concentric contraction and instead perform eccentric contraction: activating the muscle to do the negative work of counteracting gravity.

In other words – don’t lift, but lower slowly.

Eccentric Workouts Applied to Your Recovery

It can take a little creativity to apply the negative work principle to your rehab.  But once you understand the mechanics of the situation, it shouldn’t be too hard to create an exercise that works for your injury.

For example, if you have a biceps strain on the right side, here’s how you’d exercise:

• Hold the dumbbell with both hands.
• Bend both elbows to lift the weight.  This is the positive work phase, but you’re not overworking the right biceps because the load is shared by both arms.
• Let go with your left hand.
• Slowly lower the weight using the right arm only.  This is the payoff – the negative work phase.

(By the way, did I mention that you should activate your core abdominal supporting muscles while performing this exercise?)

Here’s another example for someone with a left-sided calf strain or Achilles tendinitis:

• Stand on the edge of a stair, with your weight on the balls of your feet and your heels hanging over the edge.
• With your weight on both feet, perform a toe rise.  This is the positive work phase, but you’re using both legs.
• Lift your right foot, so your weight is entirely supported by your left.
• Slowly lower your body weight to a position slightly below horizontal.  You’ll feel a mild stretch of the left calf.  This is the negative work phase.

Warning Warning

It’s not supposed to hurt.  If it does, don’t do these exercises.  Your injury is still too delicate.   Back up one step in your rehab.

Designing Your Rehab

Regardless of what area you’ve injured, you should be able to design a simple rehabilitation exercise using the negative work principle.

You could also consult your physical therapist, doctor of chiropractic, or sports trainer.

Or contact Dr. Lavine at 212-400-9663.  Or by e-mail drlavine@askdrlavine.com

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