Over time, we learn. Achievements are made daily, but sometimes the original concept is better. Trauma rehabilitation is a great example of both progression and regression. In this article I will show you when “with the old, with the new” is well suited for the rehabilitation of the lower body, and when it is better to “get rid of the new and return to the old! " Like this ...
Treat ankle injuries with METH
Let me start talking about my experience with METH.
Date: Tuesday, July 19, 2011
Location: my backyard
It was a hot summer day, and I decided to finally trim the branches that were shaking against my barn. I jumped onto the fence behind the barn, did what I had to do, then I jumped down. The distance was a little further than I expected, and in the end I turned my ankle over a river stone.
First there is no pain. A few hours later, a lot of pain! However, there was no time for discomfort. I had a lot of workouts ahead of me. But as the night progressed, so did the swelling and the pain! By the time the last person left, I could barely move, let alone walk. When I started to act.
The standard procedure for such an injury includes anti-inflammatory drugs and pain killers, as well as RICE: rest, ice, compression and boost.
What I've done?
Almost the exact opposite!
Without rest and without compression - instead, I used traffic with human trafficking. According to Dr. Tim McKite (2010), rest will lead to atrophy and weakness and may upset the balance and proper positioning of the body. In addition, compression can stop blood flow to the area; whereas craving will release pressure, and movement will stimulate blood, which is rich in healing factors, such as oxygen, white and red blood cells, to flow into this area. In addition, movement with a pain relieves pain, improves lymphatic removal of inflammation, improves flexibility, and restores normal alignment of joints.
Absolutely no ice - instead I used some damp heat. Again, the key is blood flow. If you want to heal something, it requires blood! Do not slow down this process with ice. However, I used a variable degree of elevation in the process. I learned this procedure from Dick Harcell, co-author of the book Do not ice that ankle (Keep in mind that this procedure is intended only for extensions of 1 or 2 degrees.)
I call this approach METH: movement, elevation, thrust and warmth.
Did I take anti-inflammatory drugs and pain killers? Well, yes and no. I took proteolytic enzymes (natural anti-inflammatory drugs), and I took them on a boat on an empty stomach.
The end result: no pain and full function the next day, full leg training after 2 days and a chain of balls in the local football field after 4 days. This injury was rehabilitated within a few hours, not days or weeks. I bet if I used the RICE approach, it would take much longer!
The bottom line: Forget RICE, do METH, instead of quickly healing your wounds!
The amount of training for the rehabilitation of the knee
Now we will cover knee injuries, in particular, post-operative rehabilitation of knee injuries ... but first let me touch on a topic that is very popular in strength training, bulk training.
There are many great procedures. One of the most popular systems includes 10 sets of 10 repetitive methods, such as the German Volume Protocol (GVT), which was introduced in the July 1996 issue. Muscle Media 2000 This type of routine is focused on fast and maximum hypertrophy - large size in a short amount of time!
Is this a new concept?
Not really. You will see this system scattered throughout the literature for decades from various sources. For example, in a document originally published in a Russian journal Theory and practice of physical culture , the authors of Vaitsehofsky & Kiselev (1989) discuss a protocol that includes 10 sets of 10 pull-ups, where the weight decreases every second set (i.e. the additional load is used to start, for example, 9 kg, then 6 kg, then 3 kg, then body weight to the end), or the grip changes in the later series to draw new, dissatisfied fibers into work. A lot of time iron Man contributor George Turner outlined a similar approach in his Real bodybuilding a series of audio cassettes in the nineties.
What does this have to do with the rehabilitation of injuries?
Well, think about it for a second. What are three things you need to recover from injury, especially after surgery? If you said the range of motion (ROM), muscle mass and strength, then you are right. The faster you can achieve these goals, the faster you can return to your daily activities and / or athletic ventures. Intensity will initially be low, because strength levels are low (pain and inflammation can impede strength), but to achieve your goals in a short time you must often repeat a sufficient stimulant. The process of learning volumes can be well suited to the account, if it is properly connected.
Are you still with me?
Well, let's take a criminal moment and go tangentially.
Known DeLorme scheme
If I asked what is the most popular set / rep scheme in strength training, most people will answer with 3 sets of 10 repetitions. It seems to be a universal recipe for learning, but where did it come from?
The concept stems from a document by John Thomas DeLorm (John Thomas) and Dr. Arthur Watkins (1948), in which they recommend 3 sets of 10 repetitions using heavier weights as follows:
Set # 1 - 50% of 10 reps maximum
Set # 2 - 75% of 10 reps maximum
Set # 3 - 100% of 10 reps maximum
In this scheme, only the limit limit is executed only last. The first two sets can be considered as warm-ups. Several years later, in his book Progressive Resistance in 1951, DeLorm and Watkins declare: “Asserting three sets of exercises from 10 repetitions in each set, the likelihood that other combinations can be just as effective is not overlooked.” However, most trainees today automatically accept a 3x10 scheme, as if it were written in stone.
DeLorme scheme is not very well known.
Now, let's take a little walk in time until 1945, when the same Dr. Thomas DeLorm released a notebook with the words “Restoring Muscle Strength with Heavy Resistance Exercises”, published in Journal of Bone and Joint Surgery At that time, more than 3 sets were recommended for each exercise with excellent results. Clinical observations conducted in 300 cases showed “an excellent response to muscle hypertrophy and power, along with symptomatic relief,” as DeLorm put it. Why change the system? We will look at this a little later, but first, first ...
The 1945 DeLorme method corresponded to 7-10 sets of 10 repetitions for each set for a total of 70-100 repetitions of each workout. The weight will begin to light for the first set, and then it will become increasingly heavy until the 10RM load is reached. The trainings were short (about half an hour on average), but often repeated during the week. In the GVT, for example, each body part is trained once in a 5-day period. When using the 1945 DeLorme system, the injured part of the body trains once a day for 5 consecutive days! Of course, the difference is due to the direct relationship between intensity and recovery - the greater the intensity, the more recovery is required, and vice versa.
If you accept this approach, will you be ill initially?
Yeah!
Will soreness subside after a week or so?
Yeah!
Will you be delighted with improved hypertrophy, strength, mobility and function after a few weeks, while others complain that they can barely move and are in extreme pain?
Yeah!
Now here it is important to read the entire article, not just an abstraction. DeLorme insists that a pulley system (common to most selector machines today) should not be used. Instead, use the iron load, plate-laden machine, or just the weight of the ankle to overload the end of the knee extension. This method will increase the overload of the muscles of the vastus medialis oblique (VMO), the main stabilizer of the knee (weakness of this muscle can impair function and cause pain in the knee).
Of course, there are many ways to skin a cat. Terminal expansion of the knee joint can be performed as a more “functional” movement of a closed kinetic chain (CKC) (t. E. Standing with a tie to a tape or cable tied behind the knee or by amplification with a low amplitude) (OKC) mentioned earlier. However, DeLorme indicates that tolerance exercises give symptoms of pain, thickening and fluid in the knee joints, which are controlled by weak, atrophied muscles. It is best to realize the CKC movements only after strength is matched in both limbs with the help of OCC's weightless movements.
In addition, many patients are advised to stop all activities until the pain disappears. I disagree! I have talked about this many times in the past, so I will not dwell on it much further; however, if you feel that you should rest in the area, try the treatment here and there, and everything will return to normal, think again! You can do all the work of soft tissue in the world to try to break down the fibrous tissue - the muscle will still be weak, atrophied and heavy! If you really want to make progress, stop pampering your muscles and start training with progressive resistance. DeLorme makes it perfectly clear.
Let's return to the question: why change up to 10 sets for only 3 sets?
This is what DeLorme & Watkins (1948) said: “In the initial publications on the exercises on progressive resistance, 70 to 100 repetitions were expressed, repetitions were performed in 7-10 sets with 10 repetitions in the set. and that in most cases, a total of 20 to 30 repetitions is much more satisfactory. Fewer repetitions allow you to exercise with heavier muscle loads, which leads to greater and faster muscle hypertrophy. ”
This sounds reasonable, but before we continue, let's establish two relationships:
- There is an inverse relationship between intensity and volume (t. E. The higher the intensity, the lower the volume and vice versa).
- There is an inverse relationship between intensity and frequency (t. E. The higher the intensity, the lower the frequency and vice versa).
If the intensity starts to increase, but the frequency lasts the same way, something should give! At higher intensity, one universal set of 10RM can be performed 5 days a week. These are just 5 sets distributed throughout the week. (Yes, I know that for each workout there are 3 sets, but, as mentioned earlier, the first two sets are just warm-ups.) The contrast of 5 sets to 50 sets (although not all of these 50 sets are accepted to the limit), and you You will quickly understand why the 1948 "3x10" method was considered superior to the 1945 "10x10" method, but was held for a second. DeLorme still had considerable success with this original method, and I believe that it still has its merits and can provide a “more satisfactory” result if it is implemented in a certain way.
Here it goes: if the intensity increases and the volume is maintained, the variable that is to decrease is the frequency to ensure sufficient recovery. Using the 10x10 method can actually be higher if the frequency changes as follows:
Stage 1: 5 days a week (Mon, Tues, Wed, Thu, Fri)
Stage 2: 4 days a week (Mon, Tues, Thurs, Fri)
Stage 3: 3 days a week (Mon, Wed, Fri)
Stage 4: 2 days a week (Monday, Thursday)
Stage 5: 1 day in a 5-7 day period
Now, how long each stage will last will depend on the person and his injury, but the key must progress every week, and as soon as it starts to stagnate, to the next stage. Think about it, because progressive resistance meets a regressive frequency! In stages No. 5, muscle strength, mass, and ROM should return to normal — this is the frequency used in most volume training procedures.
Try this new twist to the original concept introduced by Dr. DeLorm over 60 years ago.
Here are some points to take:
- Read the whole study is not only abstract, and as far as possible, check the links.
- 10 sets of 10 repetitive methods are by no means a new method, and this does not mean strictly for bodybuilders. This form of bulk education can be a great way to rehabilitate trauma.
- The main task during the rehabilitation of injuries is to restore muscle strength, hypertrophy and range of motion. Endurance training can be counterproductive for these purposes and should be performed only when the strength of the involved limbs is about the same.
- During rehabilitation after injury, continue active (non-passive) treatment using exercises with progressive resistance, conducted at regular intervals with maximum effort.
Captain Thomas L. DeLorm, MD, orthopedic surgeon, retired at the Massachusetts Grand Hospital, has developed several new methods to speed up the rehabilitation of the wounded during World War II. Dr. DeLorme, a true pioneer in the power game, passed away on June 14, 2003 at the age of 85, but his concept of progressive resistance is evident today.
Recommendations are available on request.
