Still weak on one side after an injury has recovered? read this!

I injured my right knee when I was 16 years old at football. I was on crutches for 2 weeks and I remember always being told to take it easy on this side for months after when I attended physio. The injury recovered and then through my 20's and 30's I continued to get pain in my knee every now and then, often up stairs and after long runs. I found a solution for this STRENGTH TRAINING.

Since taking part in 2 leg weight session per week my occasional knee pain faded. Two years ago I was less consistent with my regime and low and behold my mild knee ache returned. I then started my regime again and it faded. This made me interested in the reasons why. In our practice at the Performance Lab we are lucky to have state of the art isokinetic strength testing. this gives you a gold standard, reliable measurement of your muscle power.

Experiment - part 1

I had done now about 9 weeks of strength training. So I decided to look at my quads and hamstring strength. My output was above average for my age and activity level and there was less than 5% difference between left and right quads and hamstrings.

Experiment - part 2

I then purposefully stopped any leg training for 8 weeks. Amazingly when I retested my strength I was exactly the same for my left (previous non-injured) side but 20% weaker in my right quads!!

I have racked my brain for possible reasons. Do I just favour the opposite side more? Well a recent podcast from Professor Andrew Hubberman (head of neuroscience at Stanford University) may be able to shed some light.

Most people will recognise that when we are in a cast after a broken bone injury. Once the cast is removed we have lost muscle mass. Interestingly Hubberman tells us. This isn't due to not moving, it is due to a lack of nerve stimulation to that area of the body. Work done by Timothy Challor showed that if we have damage to a limb there's great benefit to restricting the use of the opposite uninjured side of the body and moving the injured side more. That doesn't mean to cast up the non damaged side but restrict movement to the maximum level the injured limb can tolerate. By doing this the experiments showed by encouraging pain tolerable movement on the non-injured side and keeping the other side at the same or less level lead to quicker recovery. These studies have been also followed up at molecular level and these theories have been supported.

By leaning heavy on your non-injured side creates a bias in the nervous system that can then become permanent. Hence is a possible reason why I still favour my previous non-injured limb and become weaker on the injured limb.

In simple terms what does this mean?

If you injure one limb - work this limb to its maximum tolerance taking into account pain and tissue healing.
Make sure this is slightly harder than the non-injured limb.
Once you can work fully on the injured side then increase the load through the non-injured limb so they are equal.

This may not now help me now with my old injury but something I will definitely take forward with future injuries and with the clients we see.

Thanks for reading everyone.

Matt

I have attached the podcast from Professor Andrew Hubberman here. He talks about this at 29mins but all the podcast is very interesting if you want to know more about pain.