Latest / Build for Health with Srdjan Injac / Training After Surgery: Slow Is Fast
Transcript
- Pete Wright Welcome back to Build for Health, where we pull back the curtain on what it takes to build a strong, healthy body and a fitness routine that sticks. I’m Pete Wright, here with Srdjan Injac from ELEV8 Fitness, and today we’re talking about what happens when the body hits pause—whether it’s by surgery or injury or just pure dumb bad luck—and you’re left staring at the long, awkward road back to strength. It’s the part that no one puts in the highlight reel: the fear of re-injury, the impatience that whispers, “Just try it,” and the very human urge to rush the process because resting feels like losing. We’re digging into how to train after something goes wrong, how to rebuild strength without sabotaging recovery, how to pace progress when motivation runs faster than healing, and how to come back not just moving again, but stronger, smarter, and harder to break next time. Let’s get to it. Srdjan, let me tell you why I wanted to do this episode with you today. I have a friend—my business partner as a podcaster—his name is Andy Nelson. Srdjan Injac Okay. Pete Wright Andy, hello. This episode is for you. What I know about Andy is that he has, for years, had crappy knees. Terrible bone-on-bone knees. You might know something about that. Srdjan Injac Oh yeah, I have one too. Pete Wright Well, Andy is getting both knees replaced beginning in February. One in February, the next in the middle of March—one right after the other. And I want to give Andy a plan, a lesson plan, for how to rebuild after this kind of rehab. So let’s keep Andy in mind. We are, of course, talking about all kinds of injuries and joints today, but handsome Andy is the guy we’re trying to rehab. Srdjan Injac Oof, that must be tough. I’m just imagining having both knees replaced. I mean, I have a bad knee. I have no cartilage in my left knee, so it’s pretty much bone to bone. Pete Wright Yeah. Srdjan Injac And all my workouts—leg workouts—are modified. They’re completely different from everyone else, and I know the pain. And the training is always different. Every day is a different day. You’ll wake up sometimes with those aches and it hurts and you did nothing. It’s just… every little thing can affect it. Even the temperature outside—when it drops too low all of a sudden—you’ll feel it in your joints and stuff like that. And then every day when I start training, I never know if I’m going to have knee pain or if it’s going to feel fine, or how much pain I can tolerate. Because you have to know with those injuries: some injuries will never go away and you’re always going to feel a little bit of discomfort. You just have to know how much you can push it, what you can tolerate, what you shouldn’t tolerate. But that doesn’t mean it gives you an excuse not to do it and not to work on it. Because you still have to strengthen the muscles around it, because if you stop, it’s just going to get worse. It’s not going to get better. Everyone thinks, “Oh, I’ll just rest and things will get better.” Pete Wright Let’s do some context setting for me. What is your role when somebody comes to you and says, “I’m recovering from whatever it is—injury, surgery, whatever”? How do you see your role change when you’re taking on someone like this? Srdjan Injac Well, everything changes. It’s different, of course. It depends what kind of injury it is. If somebody’s coming from surgery, I would like to see the doctor notes so I can see what they had surgery on, what they’ve done. Now also after that, most of them have done a little bit of physical therapy. Some of them will finish the whole physical therapy and they get approved to go back to the gym. Some of them don’t. Some of them will come to me and be like, “Well, I feel like I’m going to physical therapy, but it’s not doing anything,” or, “It’s just going really slow. I want to speed things up.” So I take all the notes, see what they’ve done so far, and then I take it from there. Pete Wright Do you have any recommendations for working with physical therapy? I’m trying to gauge best practice. Should you be working in parallel—like you as a trainer in the gym and the physical therapist—or would they rather you not mess with it until they’re done? Srdjan Injac Well, they would rather not mess with anything. They want you to come straight to them. Now, this is what I experienced with all the injuries I have and going to physical therapy. Everything takes way longer, right? Because you can see them maybe once or twice a week and that’s all you do. And they’ll sometimes give you some exercises to do on your own. And it takes forever. So sometimes when they come to me, I can speed things up safely. They’re of course scared—you know, they don’t want you to get hurt again. It’s liability. That’s how they have to think about it. So the things that they can do that they will do in six months, I can do in four. Because I’ll push a little bit, depending on how the client feels, how they feel when they do certain things, and see if I can go to the next step. I did some physical therapy and it was just taking really slow. It was taking forever. I remember my shoulders. I stopped going after three weeks. I didn’t feel like they were doing anything for me. I was just resting. And I called my doctor, a specialist. He told me everything that was wrong and gave me all the paperwork and stuff like that, and then I rehabilitated on my own. I was going every day. I remember going to 24 Hour Fitness and being in the corner doing my rehab workouts and all that stuff, and I was back in the gym after, I think, four months after tearing all my rotator cuffs in both shoulders at the same time. Pete Wright Jesus. Yeah. But you’re back at the gym in four months. Srdjan Injac That was a bad one. Yeah. I learned a lot of stuff the hard way when I was younger, doing things that—oh my god—I shouldn’t do. But after like four months, I was doing shoulder press with like 50–60 pounds overhead. And I definitely thought I was going to need surgery. I couldn’t lift my hands. I had people help me put on a shirt and stuff like that. It was that bad. So that’s the thing: physical therapy is still good. I recommend you should still do it. But this is where people make mistakes after physical therapy. They think they’re good and then they just stop. Now physical therapy, all they do is get you back on your feet. You’re functional again. You got your range of motion back and now you’re able to move, right? Their job is not really to strengthen all those muscles around that joint. Now that’s your job. You’re supposed to do physical therapy, they got you functional—you can move again, you have range of motion—now it’s your job to go out, find someone who knows what they’re doing, and strengthen the muscles around it. Because if you don’t do that, you’re never going to be 100%. Because after physical therapy, you’re not really 100%. You can move, you can walk, but that’s it. And the risk of getting hurt again is so much higher. Because just a small move, bad move, twists—where you didn’t strengthen your stabilizer muscles, your other muscles around it—you’re going to pull that same joint and injure it again, and it’s going to get even worse. Now you’re going to need probably a second surgery, or more physical therapy, stuff like that. So please: after physical therapy, do strength training and strengthen the muscles around. It’s so important. That’s the only way you’re going to get it 100% healed. Because it’s healed, they got you functional, but you’ve got to do the rest. Pete Wright I’m trying to brainstorm where your head is at after this sort of thing. We’ve talked about fear of re-injury versus overconfidence, right? Historically I don’t have a great relationship with my own ability, so I’ll screw something up. But there’s also this idea: you have somebody who’s already athletic or physically fit who has an injury that’s harder to recover from or a surgery that’s a bigger surgery—there’s a loss of athletic or personal identity. How do you retrain yourself to rebuild trust in both movement and load? You just said that in four months you were back doing overhead shoulder presses at 50–60 pounds. I can’t tell if that’s ego-driven overconfidence on your part, or a legitimate “you have no trouble rebuilding trust in your body.” Srdjan Injac Well, yeah, you have to try yourself. I know the right form and how to execute, and I can tell if something’s off. If it starts hurting or if I’m not in the right position, I’ll stop right away. So you have to know what you’re doing to be able to push it. And then I never go really more than that. Sometimes you feel like you can do more—like you said, your ego kicks in, it’s like, “Yeah, I feel great. Let’s do more.” But that’s when you actually have to stop yourself. Be like, “Okay, I had this injury. I don’t need to do more,” because now you’re risking injuring it again. Anything that’s over your head, when you push weight, the injury comes even if you haven’t been hurt before. There’s a risk. So you always have to treat those parts of the body like you just recovered. Even when you feel great, even after—like I have clients that say, “Oh yeah, this injury was like three, four years ago,” stuff like that—I’m like, “You know what? I’m still going to train it like it was last year. I’m going to make sure I warm up those muscles. I’m going to make sure not to load up those joints,” stuff like that. So that way, once they learn the form, they’ll know how much they can actually push themselves and where they should draw the line and be like, “Okay, now it’s just my ego pushing me to do more, and I should stop.” Like before that, yeah, I was lifting more. I could do 70, 80 pounds. But after that I’m like, “You know what? 50–60 feels good. I don’t need to go anymore.” I can build my shoulders in a different way, doing exercises that are more safe. Because with exercises there’s a certain level of risk of getting hurt. So you pick the exercises that are less risky and you build the strength through those exercises. That way, the other ones—like shoulder press—I didn’t have to go harder and harder. I don’t even go now, even though they’re okay. Because I know one bad move, and if I lose control in a split second, that’s it. That’s all it is. It takes such a small movement if you’re not fully in control. That’s why I always say slow down. Slow down. Be in control. Once the weight takes control over you, that’s it. You have no control. So that’s how you have to know how much you can actually push. And I’ve never lifted as much as I did before, and I don’t want to. I don’t need to. I probably could if I tried—maybe I’d be able to do it—but do I want to risk it? No. Pete Wright So what I’m hearing—and I’ll just say it to make sure I understand it—is there’s a partnership between the physical therapist in the rehab process and the trainer. And the idea of there being a gap between physical therapy and general strength training is that you kind of have to take it case by case. You have to see what your body’s ready for and think of it like a team, right? You have a team of people helping you get back there. Let’s talk about readiness indicators. Because I think the other side of overconfidence is: “I can’t go back into strength training until I’m pain-free.” I want to hear how you talk about what it means to be ready to start lifting light weight again, to start pushing your body again, even when you are still aching from the injury. Does that make sense? Srdjan Injac Yeah, it does. Pete Wright Yeah. Srdjan Injac It can actually be more dangerous. I have one client—she’s doing physical therapy while she’s training with me, and the physical therapist is completely okay with that. We even spoke on the phone. He called me, I called him. We talked about what he’s doing with her and the stuff that I can do on my end to strengthen the muscles around. So we kind of work like a team. And you can definitely have that. A lot of physical therapists don’t mind doing that at all. So with her, she feels a certain amount of pain, and the doctors told her that she’s always going to feel it a little bit. It’s kind of a discomfort. But they told her the kind of pain not to tolerate. So I constantly check with her: how much is it hurting? Do you feel a little bit? Or is it kind of sharp pain, or a dull pain? Or is it just aching? Or does it feel like muscle soreness? All that stuff, so she can describe to me what it feels like. Some surgeries are not that extreme, and they go back where they don’t really feel pain. They’re like, “It feels great. I don’t feel anything.” I’m like, “That’s great.” But that doesn’t mean I’m just going to load up right away because you don’t feel anything. I’m like, “Okay, I’m going to go slow.” And then we’ll get to a certain weight where it feels like it’s good enough. It doesn’t need to go anymore, and it’s still pain-free. So like I said, it depends on the case. It depends on the injury, the body part, and the joint. Because shoulders—they’re the most movable joint in the body—so they’re going to work all the time, over time. Where, you know, maybe an ankle doesn’t really work all the time—like when you’re sitting and all that stuff for a lot of time and it’s resting. Pete Wright I think that’s the trick I’m trying to wrap my head around. The kinds of pain you just described—because I’m accustomed to soreness from working out. I know when you’re going to make me fail and it’s going to hurt for a couple days and it’s fine. But I’m not accustomed to being injured all the time. I can see how I might get to the point where I’m underconfident because I don’t know how to talk about whether the pain is soreness, or healing, or at risk of re-injuring myself. Do you know what I mean? Srdjan Injac Yeah. Because a lot of times when we work out, I’ll ask you between sets: “How’s your lower back? How does this feel? How’s that?” Because I know certain exercises—when you execute them—your lower back will kick in, you know, your knees and stuff like that. So I just check to see. It’s like, “Oh, it’s all right,” or “I feel a little bit,” you know. And then I know from there how much I can push it and when I should stop. At that point, your trainer should be able to modify. Pete Wright I get the feeling you’re not even paying attention to what I’m saying. You’re just looking at how I’m saying it because I’m a horrible liar when it comes to those things. Srdjan Injac Because sometimes I’ll notice it. I’m like, “You sure you’re not feeling anything in the lower back?” Pete Wright Yeah, right, right. Srdjan Injac And I’m like— Pete Wright Yeah. Srdjan Injac “You just used your whole lower back on that one.” So a lot of times I can tell with how you move. And then if something doesn’t sit right with me, I’m like, “I don’t feel this is right. I’m not going to do it.” I can modify everything—every kind of exercise that we do—and every client should be able to do that: modify it to where it feels and looks more safe. And then once you build strength around it, then you can kind of try that one again and move again. So take it step by step. Don’t push it. Don’t jump into something right away. But keep moving. Don’t just sit around and do nothing. A lot of people are like, “Oh, I’m still going to therapy. I’m resting now,” all that stuff. It still hurts when you do it, but there are a lot of other things you can do. If you have access to a pool, when you have those injuries you go to the pool and you try to move around inside the pool. You can move weights a little bit. They have weights for the pool. Because the water will help, and there’s less pressure on the joint itself when you’re in the pool. So try working and building your muscles and working on muscle strength in a pool or something like that. But keep moving. Now if I get hurt—if I pull a ligament or muscle or tear a muscle—I’ll go to my chiropractor right away. He’ll treat it, and my chiropractor would say, “Now go work out.” Just because it hurt—like tearing my shoulder—doesn’t mean I get to rest now. I do the workout, but he’s like, “Light weights, everything 15 or more reps.” Because you want that muscle to keep working. You need the blood flow so it can actually work on healing itself. And then after that, there’s usually a little bit of internal inflammation. Even if you don’t see it, it doesn’t mean the joint is just going to swell up right away. Something could be more internal, so you put some ice, make sure the inflammation goes down. There are all these other treatments that you do. And then you can use either red light therapy or you can put some warm pad on it just to create blood flow a little bit, and rest. When we say rest, we mean different types of recovery, not just sit and do nothing. Sometimes, yeah, you’ll relax and sit and do nothing, but people do too much of that and they don’t move a lot. And then when they try to move—oh my god—that hurts. “I’m okay,” because you haven’t used it. Pete Wright Right, right. Well, that gets to the next thing I’m most interested in. Because we’re talking about my business partner here, handsome Andy, and his knee replacements. Now we’re talking about rebuilding with asymmetry, right? Training around injuries that are not necessarily right down the middle. So how do you think about training and imbalance when it comes to building through rehab? Srdjan Injac Well, you’ve got to train your stabilizer muscles. I’m sure they’re going to be doing a lot of squatting, a lot of slow lunges, and leg extensions that are very light. They might start a lot of stuff with bands and things like that, just to get the knee to move. Because now the body has got to get used to this joint. It’s not its own natural joint. So the body has to accept this foreign thing, and the muscles around it now have to get stronger. So he’ll start slow. And it would be great for him to be in the pool after surgery—if he has access to a pool—to go walk and do some leg raises and stuff like that in a pool. It will help with the knee. He’s going to feel less pain but activate the muscles around it. And then you do usually one-legged stuff. You do one leg first, then the other one. That kind of challenges your balance a little bit and all your stabilizer muscles now kick in. Train it that way, and then you get out of the pool and you do the same things out of the pool. Then slowly after that—it takes step by step—and you put a little bit more weight so you get an exercise that’s a little bit more challenging. But just because it feels fine and doesn’t hurt when you walk doesn’t mean, “Okay, now you feel completely fine,” and you stop. Pete Wright Yeah. There’s still risk of being under-strong from where you started. Srdjan Injac Exactly. People get too confident. They’re like, “Well, it doesn’t hurt, I’m good, I’m 100%.” Well, not really. Because your muscles are weak. Especially if you don’t work out and don’t do anything, they’re not strong enough and you’re going to re-injure yourself really quick. Pete Wright You’ve been nursing one of those arms of yours for a long, long time. And this gets to the asymmetry part, right? Specifically your arms—because your arm and shoulder, it’s not like you’ve been wearing a cast. You didn’t break anything. But it’s been aggravated for a very long time. Srdjan Injac Yeah. I tore my bicep along where it’s connecting in the shoulder. So my problem here is I need to rest more. I use it too much—overuse it. Because when I’m here at the gym, I pick up the weights, put them on the rack, take them off the rack, helping my clients all day. So when I work all day, I’m actually using it, not even sometimes realizing that I’m doing it. And sometimes I’ll catch myself in a bad spot and I can feel it and I’m like, “Oh man, I should have used my other arm.” Because my right arm is the most dominant, the one you do everything with. So it’s not like—unless I put my arm in a cast or a sling—so I wouldn’t use it. That’s the only way I get to rest. And then if you sleep on the side, you sleep on that shoulder, you wake up and now you’re more sore from that. So mine is a little bit longer recovery because I’m using it nonstop. I’m not letting it rest and recover a little bit. So there is that thing too: you don’t want to overuse it. Pete Wright Well, and that gets into my question though, because you still train, right? You’re still actively training. How do you deal with—because so many of the exercises and the lifting you do involve both arms—how do you accommodate? Srdjan Injac Yeah, sometimes some of the exercises I don’t do because it still hurts and I don’t want to push it. I don’t want to make it worse. There are some exercises where I feel a little pain. I can feel a little bit—that’s because it’s torn, it’s not 100%—but it’s fine. It’s not putting any pressure on that, you know, because I’m doing different body parts. Like I’m doing chest, but I can feel a little shoulder. So it’s not a shoulder workout, but you can feel it when you do certain chest exercises. And I’m like, “Well, it just feels that way.” But if it starts hurting more, then I’ll stop. I’m not going to put too much weight. I’m just going to go lighter until I start feeling better and less and less pain. Then I’m going to start putting a little bit more and more weight. But that’s how I do it. And sometimes it hurts really bad and I’m just not going to do it at all. I’m going to find something else to do that I can tolerate. That’s how I work around it. I’ll try something. That doesn’t feel right. I can kind of do it, I’d be pushing it, but maybe it doesn’t feel right, and I’ll stop. So that’s why it’s been a while, but I still train. It’s not an excuse not to train. Some movements I can do completely and go heavy and I don’t feel anything, and it’s fine because I’m not really using that particular muscle in that instance. But yeah, I’ve been through so many injuries and I never stop. I keep going, it gets better, and then you get back to it. You’ve got to keep moving. Pete Wright Yeah, for sure. We’re mostly a strength show. It’s not like we hate heavy cardio. Cardio’s good. But I do want to bring up the whole, “Hey, during my rehab I’m going to assume cardio is safer than resistance training,” because it just seems like it should be. Can you bust that myth? Srdjan Injac Yeah. In those instances, people will go do the things that they can do. Like, “Okay, my shoulder hurts now. I’m not going to lift weights, but I’m going to go do this.” And okay, that’s fine. That’s great—go do the cardio. But then focus on the other things that you’re maybe struggling with when it comes to nutrition, for example. Since I can’t really work out, I want to keep my body composition, I want to keep my muscle mass there, I don’t want to lose that. So even if I do the cardio, I’m going to make sure my diet’s on point: my nutrition, that I’m getting my protein intake, so that way while I’m recovering I’m not losing the muscle mass that I gained, that I had before. So that’s another crucial part through recovery. I always focus. I’m strict on my protein intake and my calories and everything. And then I’ll do the things that I can actually do with cardio. You can run, ride a bike, and all that stuff, which is great. But I don’t want, by doing that, to start losing my muscle mass because I can’t do other things when it comes to weight lifting and stuff like that. So there are always things you can work on, improve on, focus on those things, get better, and then once you get back and you feel better, now you’re going back to lifting and now your eating is even better because you worked on it. So I use those times to perfect other things. Pete Wright That’s a really good way for me to reframe it. Because for me, the Christmas/New Year holiday was practically an injury. I came back to work out on Tuesday this week and it was a disaster. I can hardly breathe, right? But you just forget. And I think that’s the really important lesson: you forget how long an injury takes you out if you really fall into under-training. That can really mess you up. Srdjan Injac It can really set you back. And you know it’s going to happen, it’s going to set you back, but how much it’s going to set you back depends on you. So if I know it’s going to set me back, I don’t want it to set me back too far where I’m going to have to do so much work just to get back to where I was. I want that damage to be minimal. Pete Wright It’s good stuff, man. It’s good stuff. Thank you. And thank Andy. Good luck, man. Good luck with those knees. I’m very excited about it. Srdjan Injac Yes. But you can do it. Keep working on it. Pete Wright He told me he wanted to have our annual business meeting in his hometown because maybe while we’re working I could help him walk about during his surgery, or after his surgery. So I might be on site rehabbing for knee recovery. I’m very much looking forward to that. Thank you, everybody, for downloading and listening to the show. We appreciate your time and your attention. If you’ve got questions about training or recovery or rehab or how to stop chasing quick fixes and start building something that lasts, we want to hear them. Head to the show notes—swipe up in your podcast app—or look for it in the show notes on the socials. Click that link that says “Send a question into the coach,” and we will answer it in an upcoming episode. Don’t forget to subscribe and share. This is how we grow stronger together. Thanks for listening to Build for Health. We’ll see you next week in the gym.