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Why I Prefer Reading Books Over Videos For Help With Injury & Rehabilitation

Written by: Nick Jack
Category: 2014
on 20 January 2021
Hits: 469

The modern age of the internet and social media has made access to information extremely fast and easy enabling people to find answers to complex problems at the click of a few buttons. When it comes to injury and rehabilitation, the endless number of videos and articles on the internet has helped people find out how to treat their injury with exercises than ever before. While this sounds like a great progression, and at times it can be, it has also created a new set of problems and a new breed of people who over-analyse and self-diagnose problems based on information that they do not understand. You Tube has been good to me over the years and put me in touch with so many people around the world, but I find I am constantly having to reply to questions about how to use my information correctly and keep it in context of how it was intended to be used. Often I end up making additional videos to explain the things I left out of the original video. Personally I will always prefer a book or a long drawn out article with links to additional information over a video any day, as a book has a series of chapters you must read in order to understand how the author came to their conclusions. In this article, I will explain how videos can help you as long as you understand their place within the corrective exercise journey.

This year more than any other year in my 16 years as a trainer I have been really tested in terms of my communication skills, and the ability to clearly explain the thoughts and reasoning behind my programming concepts. In the past 6 months I have done more online Zoom training sessions than I have in the previous 15 years combined, and while many of these people have shown remarkable results this method of training has really frustrated me. I feel very restricted in not being able to use my skills and normal methods for finding answers to problems, and also teaching someone exactly what I want them to do. This is nothing to do with the client on the other end, it is just the limitation of working in a digital environment devoid of human interaction.

In my regular face to face training this is so much easier as I can be hands-on and guide the person into positions I want them to learn, as well as showing them visually the movement. Plus, I know I will get to see them again in a few days and go over it again and the learning process will be extremely fast. Any questions they may have I can answer on the spot and help them to see how the reasons behind their problems. It also allows me to investigate further for often the real problem is not easy to find and takes some time.

Often I spend one of the first sessions with the client showing them how to complete various exercises at home between the gym sessions to enable their body to improve stability, mobility, and general movement skills. This enables me to spend more time in our sessions in the gym drilling down on the reasons behind their trouble, and be able to work on the more complex movements the client would not be able to do on their own. I know they are likely to forget most of the important details of exercises I show them, so I usually give them a handout with pictures and instructions. But by far the best way for them to remember is getting them to watch a video.

This is where I found creating You Tube videos to be extremely valuable, as I could break things down into slow motion and show them where things will go wrong and the things they need to do to ensure they avoid mistakes. I found this to the best way to ensure they did not forget all the details of the techniques I just showed them, for we know that exercise technique is everything.

But.....

This is where the video can be found by somebody on the internet who will begin using the information to help them with a particular problem. While this sounds like a good thing it can create a multitude of problems for the video is not in context of how it is meant to be used. If you have ever watched my videos you will know that many of them are more than 15 minutes long and I regularly will say something like, "There are many other things you will need to do than this, but this gives you an idea of how this works."

I will always learn more from a book than a You Tube video for it has a series of chapters you must read for the ending to make any sense. Sure, you could skip to the ending but you are unlikely to understand it. The process is just as important as the end result. In fact I would say the process is more important than the end result for this teaches you how to find out what is going on with your body. We are all unique and vary in so many ways and following a method that worked for someone else does not guarantee it will work for you.

Many of the books and training courses I have completed over the years were not easy for the everyday person to understand, so it has been a challenge trying to take a lot of heavy information and putting it into simple easy to implement steps. Many of the articles you read are the first time I have tried to explain complicated topics in simple language using small chapters so that you can easily follow what I am trying to say.

One of the things I have come across multiple times this year is HIP IMPINGEMENTS also known as FAI (femoral acetabulum impingement). This is a very difficult injury to explain as the reason behind it, and the corrective exercise solution goes completely against your instincts and logic.

Just last week I filmed a video that tries to explain this concept more clearly as I was struggling to explain it to a client online. (Click the image below to watch this video)

Now this is where this brings me to the point where I hate making videos for people take things out of context and believe this is all they need to do. When in reality there is many things you needed to do before this point and many things you need to do after this to successfully reach the outcome you are looking for. For me to make the video about this from start to finish it would take about 2-3 hours. There are so many things I have left out of the video to just keep things to the important point I wanted to make. Even though I say this several times in the video most people ignore what I say and begin putting this into practice.

In terms of finishing the job this video does not even come close, and this is the reason I created an online shop with extended videos and PDF books complete with step by step instructions to put my method into context.

There are two types of people I regularly come across who rely on You Tube to fix injuries.

  1. The research junkie
  2. The person looking for a simple quick fix

The most difficult person for me to ever work with is the research junkie, this is someone who has developed some anatomy knowledge and spends a lot of time researching on the internet. While I applaud their effort to understand what is going on, and their desire to find an answer to their injury, they often end up becoming the problem! Put simply they lack the ability to know what information to use, and what information to ignore. This is not their realm of expertise and they do not have the benefit of working with hundreds of people where you can see this information put to the test in real time to see if it works.

The biggest advantage I have over the research junkie is that I get to test out methods and concepts every single day on real people in our rehabilitation program, and this helps me uncover the truth about what works and what does not. I also get to develop processes and checklists to help me reveal where the real problems lie that will guide me on future situations where things are confusing. These secrets will not be found in a 5 minute You Tube video for there is no absolute answers, instead multiple paths to take based on answers to tests. It takes an experienced practitioner or coach years of experience to develop skills like this.

The person who researches too much will always end up with information overload and is never likely to get anywhere with their problem. They eventually become the problem and end up with...

Paralysis by Analysis

It is important to get a correct medical diagnosis before you do anything and never rely on Google to diagnose your injury based on your symptoms. To get a correct diagnosis you will need to consult a therapist or Doctor skilled in looking for these problems. Diagnosis should involve a review of the patient’s medical history, a physical examination looking for movement dysfunction and instability and possibly even x-ray or MRI. A good therapist will often be able to correctly make the diagnosis by using a process of elimination.

The person who loves to research and has some anatomy understanding will regularly make a mess of things as they constantly question every decision and plan to correct things. What they will find is that there will be contradicting information on the internet for all things relating to health and fitness. One report might say it is best to stretch before exercise, and another will say it is the worst thing to do (read this article to see several examples of this).

Both will have scientific research supporting their claim. Which one do you believe? The answer is they are both right.

The trick is knowing which one relates to you and your body, and this is where a skilled practitioner will investigate further to find this out. Also you need to know who is a credible source to listen to and if you are not in this field you are highly unlikely to know this. I doubt any of you reading my newsletters have ever read some of the books I provide in my research that caught my eye recently segment.

What often happens with the research junkie is they bounce from one idea and method to the next, never giving any process long enough to work as they constantly find more information contradicting what they are doing. This person must stick to one single plan for an extended period of time and avoid reading website articles or watching You Tube videos. They often find this very hard to do as they are so addicted to looking up more things on the internet to support their ideas.

On the flip side of the research junkie is the person looking for the quick fix.

There Is No Quick-Fix

Deep down we all know this to be true, but the clever headline on You Tube sucks us into believing that maybe this time it will work.

This person is not necessarily a lazy person but they are someone who thinks in simple equations. For example, "if this is weak I just need to strengthen it and it will be good". This person is drawn to videos that claim to get rid of your pain in 3 exercises or something along this line. If only it was that easy, but as we all know it very rarely is.

Today’s modern world is moving so fast and technology has allowed us to get things at the click of button that we have come to expect instant gratification in just about everything we do. And when it doesn’t happen people become discouraged very quickly. This person is very likely to cause more harm to themselves by adopting exercise strategies they are not ready for.

They are quite prepared to skip steps in order to find an instant remedy to their problem and they do not have the patience to take their time and do it right. This person often has applied this strategy successfully in other parts of their life and see this approach as the way to go.

Unfortunately, the human body is complex system of systems and very rarely does the sledgehammer approach work when it comes to restoring function to the body after injury or illness. I have met many people who think that they only need one program for me to get rid of their problem, when I know it is going to take several programs over several months to get to the point they want to be. This person wants me to give them one program that does all of this at once! It is never going to happen.

What both types of people need to understand is the PROCESS, and that there is a series of steps within steps they must complete to find the long term solution they are looking for. Along the way you are constantly testing and assessing to see if you are still on track.

This is how it works.

5 Step Process You Need To Adopt

Whenever you watch one of my You Tube videos or any video for that matter, try to think what stage of the journey does the particular method or exercise fall into. There are 5 stages of the process that you need to work your way through from the bottom up if you want to succeed. I used to have only four stages (see the article about the success formula) but have since expanded it to five to include the most important of all, identifying the pain trigger.

You cannot skip steps at any point and some stages you will move quicker through than others, and this will vary greatly from person to person. This explains how programs can differ so much for treating the same injury and why you cannot follow a template that assumes we are all the same.

What are these 5 stages?

As you can see in the picture above the 5 stages are:

  1. Identify your pain trigger
  2. Restore mobility to joints and muscles
  3. Improve stability
  4. Improve integrated movement skills
  5. Improve muscular strength

For people who play sports there is another step to complete and that is sports specific skills and power development, but for majority of people this is the process I am trying to implement. It is impossible to do all of these things at once, they must be completed in gradual steps in order for the body to correct imbalances and dysfunction.

Some parts will be really quick to correct, but others may take considerable time.

The stage that you get stuck in the longest, and is the most frustrating to work with, is the key to all of your problems. This is where you will see the most mistakes made and it is even likely to aggravate your problem. This is where the research junkie inexperience and lack of knowledge reacts too quickly to pain symptoms and thinks it is not working and starts looking for another alternative method, instead of sticking to the plan and giving it a chance to work.

The mistakes are exactly what you needed to learn and part of the treatment process. The person looking for the quick fix thinks it is all too hard and just gives up.

Here are two examples of how this 5 stage process can differ greatly.

Example 1: Guy with Chronic Back Pain

I met a guy who had a hip/back injury who requested my help to find some strength exercises to help him get rid of his pain. He had tried several therapists and different exercises to help him and all it did was cause him more pain. Some of the exercises he described were ones I would often use for this particular injury, I knew I needed to find out more and investigate further to see what I could find.

During my assessment I find out he was excessively tight in almost every mobility test, and I also found out he never devoted anytime to working on mobility or flexibility. He had considerable strength but was not able to use it well. I asked him why he did not stretch and he told me he read some article informing him that stretching is bad for you and makes things worse.

This is where a bit of good information goes bad, and where things are taken out of context that works against you. In my article on Back Pain Myths stretching for back pain was one of the first things I tackled and I explain how stretching of the lower back is not a good idea. But I also explain that stretching of the hips and the thoracic region is extremely beneficial and vital for ensuring stability of the lumbar spine.

Click here to watch a video about the myth with stretching and back pain.

It was very important to address mobility first, for his body had no choice but to sacrifice stability of his lumbar spine for he did not have adequate freedom to use his hips or thoracic spine to move. Also you must remember the tonic muscles will inhibit weak phasic muscles which I have spoken about numerous times (See article about posture and muscle inhibition for more on this.)

Any strength gains he achieved were useless to him when he moved. I explained that the mobility stage would be very frustrating and take considerable time, there would be things he will need to do forever, but if he stuck to the plan it will pay off later on. Sure enough he stuck with it and after a few months things started to fall into place and he moved forward really quickly.

His progress through the strength stage was extremely fast, as he already had a decent foundation of muscle to work with already. The problem was he could never use his strength correctly as his body could not move into the right position and alignment.

Example 2: Lady with Chronic Hip Pain

This is a lady who drove 50kms once a week to see me for help with a chronic hip injury she had for over 12 years that was not getting better. She was contemplating surgery and had seen at least 10 other therapists with little to no improvement.

Once again I put my assessment to the test and this is where things worked completely different to the last example that was very similar in terms of the injury diagnosis and pain symptoms. At first I applied all of the mobility and simple stability exercises and methods that had worked so well on previous occasions. But like all the other therapists before me all it seemed to do was make things worse. I kept trying other versions of the exercises I was using but to no avail.

And this is when experience over-rides research and where there is no rule book that can explain how I knew to do what I did next.

One of the most confusing people to work with is the person who moves really well but is in pain. It makes sense when someone moves poorly and they are in pain, but it is completely illogical when a person who moves perfectly still says it hurts. This lady was one of these cases and the few instances I have come across this person I found the best way to correct them was to do the exact opposite of what you normally would do!

Instead of working with mobility work and simple body-weight stability exercises keeping loads light to avoid compression of joints, I would load them up with 80-85% of their max! I know it sounds crazy and dangerous and in many ways it is and many times I had my heart in my mouth. Anyway this is exactly what I started to do with her and from the moment we took this road everything started to fall into place and her hip improved remarkably quickly. After a few months she was better than she had been in 12 years as we progressed various versions of the deadlift as the key part of her program.

You can read Sonia's story on the testimonials page.

Unfortunately, the method we used to help her with her hip injury ended up stirring up a shoulder problem and we had to spend some time working through this. In the end we found that she needed to work on mobility with the upper body but more strengthening and stability for the lower body.

This is a classic example of how the mistakes led us to the long term solution she was looking for. So many times we felt like it was going backwards, but we stuck to the plan for each time things were good it stayed that way for a longer time. By working through the various stages Sonia was able to really pinpoint the exact things her body needed her to do. If she got lazy and stopped doing certain exercises her problems would return. If she stuck to her plan for long enough her body would be able to hold itself together for longer periods.

How Many Exercises & Programs Did We Use?

In both of these examples there was not one program of 5 or 6 exercises that did the job. It was a combination of multiple programs in order of progression that we used to gradually move towards restoring movement function.

This MUST be the end goal of EVERY program. To improve how you move. In Sonia's case it was very tricky for she already moved well. But on the inside she did not stabilize well so one could argue she did not move well at all. I can say that with Sonia's plan we used over 6 different programs before we found the right one. Each week I was slightly adjusting things based on the results of how she pulled up after the workout and also how she adapted to things with me in the gym.

Each program would have focus on 5-6 key exercises we used within the 60 minute session. I would then prescribe some homework exercises to complete that week and take things from there. All up there might have been over 30 exercises we used to get to the one that we really needed. There is no way we could have got to the point where she needed to be without those exercises and programs being implemented first.

Can you begin to see how a You Tube video that I might make showing the exercise that put it all together is not really in context? For it leaves out all the mistakes and the information we needed to make the decision to do what we did. Each case is unique and requires its own unique assessment to find what works.

Far too many videos on You Tube focus solely on muscle function and have no intention of improving how you move. Blaming a single muscle for a movement problem never works. You must look at all the pieces and see how they interact with each other to uncover the true problem.

Always remember the quote shown below.

The Most Important Step Is The First One!

One of the best things I did several years ago was create a checklist to follow when completing an assessment. At first this was to help the new trainers I had join our team follow the complex methods and processes that I had in my head. What I discovered was that this was a great way to remove my own bias of previous injuries and assess each person on their own merit. It is easy to fall into the trap of templates and assuming outcomes based on things you have seen before.

"When holding a hammer everything you see looks like a nail"

This is the mistake many therapists make who specialize in a certain field. They are excellent at their craft and they believe they can help everyone with their particular method. Sometimes it is the thing you least suspect that the person needs and not your particular specialty that will help them. By following these 5 stages you can get to the root cause of the problem.

The first step is the most important and that is - Finding the pain trigger!

Recognizing and avoiding the pain mechanism is essential to a pain free life. By understanding your pain trigger you can begin to avoid placing your body in positions that create more damage and pain. But how do you find your trigger? Try to observe what movements or positions you repetitively use during the day.

During my initial consultation with people one of the first questions I ask is what makes your body feel good? And what makes your body feel worse? I try to get them to be aware of what position their body was sitting, lying, or standing in prior to the onset of severe pain. There may be no actual pain in the position or movement you were using at the time, but if there is an escalation in pain straight afterwards this is a clue as to where the pain trigger lies.

Great articles to read about this are shown below.

Working through the other stages bit by bit will help to formulate the specific plan to you that you need. It takes time and it requires a lot of patience as you will make many mistakes. Just remember the mistakes are exactly what you need, you just need to ensure you learn from them.

Mobility Must Be Completed Before Strengthening

Every time you improve mobility you provide new opportunities for the brain to improve movement skills and stability of joints. When mobility is a known problem it is wise to correct this first before you attempt to strengthen muscles. This is for several reasons but most notably for the effect of muscle inhibition.

In Vladimir Janda’s book “Assessment & Treatment of Muscle Imbalance” he explains great detail muscle inhibition and the difference between tonic and phasic muscles.

  • In simple terms tonic system muscles are prone to tightness or shortness and are more concerned with stability, posture, and working for long periods. They are made up mostly of slow twitch fibres and are easily facilitated with constant repetitive movements.
  • On the other side is the phasic system muscles who are prone to weakness or inhibition and more concerned with fast and powerful movements. They are predominately fast twitch muscle fibres and require specific movement to keep them functional.

The tonic muscles by way of their design begin to develop a method of overworking and dominating all movements and in essence “shut down” or "steal" the phasic muscles workload completely. This creates an imbalance within the body as muscles not capable to perform various movements continue to work developing trigger points and tightness, while at the same time other muscles are becoming weaker due to lack of work.

This is where you could have the exact exercise you need to correct a dysfunction but the body will make a mess of it due to the mobility restriction and muscle inhibition. The very muscles you were targeting to strengthen will not do the job as the over-active tonic muscles steal their work. This is clearly seen during exercises for the shoulder when the levator scapula and upper trapezius inhibit the work of serratus anterior and the lower trapezius creating problems with scapula stability.

Watch the video below for an example of this.

Now a video that claims to solve an injury by ONLY using mobility work is claiming false results. For while you have taken a big step forward, you are only just getting started for you still need to improve the stability of the joint/s, and increase the strength of the weakened muscles that are inhibited.

Are you starting to see how easily videos are taken out of context? For any mobility work to truly be successful it MUST be immediately followed up with the stability and strength work.

You can read more about mobility in this article – Mobility and flexibility explained

Stability & Movement Skills

Once you have begun working on mobility restrictions, you can start working on correcting the stability and movement skills. In fact it is essential to use basic stability exercises in combination with your mobility work to show the body how to move without stiffness.

Stability training is very misunderstood and it is more than doing some planks and abdominal work. True stability is all about TIMING! Being able to react with perfect reflexes to be able to maintain joint alignment ready for efficient and smooth movement. And it not just limited to the legs or the trunk. All joints require stability!

Basic stability exercises can be easily modified to target a particular joint, they are usually very simple to execute and performed in a lying, kneeling or sitting position.

The value of kneeling exercises cannot be overstated as these can be a great way to regress a movement and avoid the need for strength but at the same time increase the need for stability. The reason these work so well is due to the demand placed upon the central nervous system.

Input from the mechanoreceptors supports reflexes, controlled by a central nervous system that tracks up and down your spinal cord. You need a very healthy input from the periphery into the central nervous system so the CNS can detect it and then process the movement.  The CNS has to detect movement extremely quickly and needs to stabilise against that or allow it to occur in a controlled fashion. This happens so quickly that you can’t generate a thought in response. That reflex is not trained by doing conscious exercise; it’s trained by being exposed to the stimulus that affects movement and developing strategies to become more efficient and stable. To become more efficient at correcting joints for movement you need to use exercises that demand this skill. 

Below are two great videos that expand upon this stability concept.

  

Whereas the complex movement skills are usually performed standing up and require multiple joint integration, as seen in squats, lunges, or bending. As there is so many moving parts there is more chances of things going wrong with these exercises, but at the same time they have a greater chance of making rapid improvements.

For best results it is wise to use a combination of the two versions in the beginning and as the person improves you spend more time with the complex movement patterns to prepare for the next stage, which is strengthening.

Below is a great free report you can download with many examples of how to improve movement skills you require before progressing to strengthening phase.

You Must Strengthen To Finish The Job

This last stage is where you begin to build strength to the weakened muscles to restore muscle balance and joint centration to ensure fluid and efficient movement. And once again this is where many You Tube videos make many big mistakes in their claims.

For starters how many will have mentioned all the things I have just outlined in this article that you needed to do prior to strengthening? Secondly, most videos focus on isolating a muscle in order to build strength.

Traditional resistance training model focuses on isolating the muscle within a safe and simple movement pattern in order to fatigue the working muscle as much as possible. In this situation, neuromuscular activation (brain), is actually minimised. Simple isolation movements do not challenge and overload the nervous system, rather it is “dumbed down”. The consequence is low skill integration.

Movements are predictable and the objective is to perform the same movement at the same speed with the same technique every time. While this sounds like a good idea to keep the exercises safe it is creating more problems than it solves. The danger of performing isolation exercises all the time is, they ruin the timing and sequence of muscles needed to create stability of our joints when we move.

For example, during the landing phase of running the quads are contracting eccentrically to prevent the knee from flexing, while the hamstrings are contracting to prevent both the knee and the hip from flexing. The muscles in the foot and ankle are also contracting at various stages to decelerate, lock, and unlock the multiple joints in the foot to provide motion. All of this happens in the space of a millisecond. Using a slow isolated strength exercise has little chance of changing this complex timing.

You can read more about this in the article – Do you need an isolated exercise for every muscle?

Getting the strengthening phase right is essential to long term health and success, but it can very easily backfire on you if you are not careful or gradually implemented all of the mobility and stability steps first. It is impossible for me to list all the possible scenarios and methods of various injuries but if you do need help you can download the advanced online programs shown below.

Do You Need More Help?

These are the 3 most popular programs I have in my online shop and each provides you with step by step instructions for completing each of the stages outlined in this article.

Click on the image below of the program you need to get your instant copy.

   

Summary

I hope this article helps you to see that there is a lot more to finding solutions to problems than a simple You Tube video. While I do enjoy sharing great information and exercises I hate the fact that I know some people will abuse this information and not use it in the way it is intended. I hope I have been able to share with you how to make a complicated and messy situation very simple by following this 5 step process.

The exercises and methods you use will be based on the results of the tests you complete. If you treat every workout like a test you will eventually find the answer you are looking for. And when you reach that point you need to be patient and consistent for the program to work. You must avoid steering off course looking for a faster way and work your way through the minefield.

If you stay the course it will pay off and you will never look back.

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 200 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily.

If you live in Melbourne and would like to book in for a Free Postural and Movement assessment click the image below to schedule a time.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

  • Movement - By Gray Cook
  • Corrective Exercise Solutions for the Hip & Shoulder - by Evan Osar
  • The Psoas Solution - by Evan Osar
  • Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
  • Low Back Disorders - by Stuart McGill
  • Knee Injuries In Athletes - by Sports Injury Bulletin
  • Anatomy Trains - by Thomas Meyers
  • Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
  • Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
  • How To Eat, Move & Be Healthy by Paul Chek
  • Scientific Core Conditioning Correspondence Course - By Paul Chek
  • Advanced Program Design - By Paul Chek