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Surgery or Exercise?

Exercise is infinitely better than surgery where possible. This is not to say surgery doesn’t work, but surgery always comes with the added risk of the surgeons hand slipping, infections when they cut you open and not to forget the obvious one. If they cut you open, then the muscles, skin and fascia have been cut, so they will also need to be included in the planning of a rehab plan which will make it much longer and more complicated. Allowing for more things to be overlooked during rehab.

The body is designed to adapt to what you ask it to do. If you sit in a certain position and don’t move for a few hours it is understandable that your body will become very good at doing just that. The more you do it the better you become, so if your job has you sat at a desk all day, your body will be the best in the world at sitting in that position, (likely) in front of a laptop, as I am doing right now. However, if you then ask it to go for a run, climb a wall or jump, it will struggle and tell you so. If you are active most days of the week this effect may be less but it will be there at the beginning of your exercise. Your body may feel tight, stiff and some movements will be uncomfortable. It all comes down to preparing your body to do the tasks you ask of it. With a structured plan, this can be as little as 1 hour a week, in the gym, at home or even at your work place.

Many people have conditions similar to subacromial impingement syndrome and iliopsoas impingement syndrome. These conditions are effectively chronic injuries, meaning that they likely arise from repetitive motions and ignoring other areas of training. These are pinching injuries, where you may feel a pinch when you move through certain ranges of motion. Theories for why these occur are longer than a piece of string. But we don’t need to know what causes them if we know that the exercises we do for them reduce pain and increase the range of motion we have do we? Some say yes others say no, if you say yes then stay tuned for the reasons why blog post! Moving on, these conditions can be reversed or prevented by training in the correct manner. They can potentially be prevented by training the joint and not muscle groups, so if you hit biceps then hit triceps as well. If we hit muscle groups on either side of a joint then we can pull it evenly and not have pinchy problems manifest.

This is because, at least one theory suggests that it is the muscle imbalances that pull the joint slightly off from an optimal position, which intrudes on other muscles paths and hence, when we close the joint by moving to end ranges of motion, we get this horrible pinching pain in our hips and shoulders.

Points to take away:

  1. Impingement injuries are preventable

  2. Surgery should be an afterthought if exercise does not help

  3. Train the joint not the muscles

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