The reason for every injury you’ll ever have, and how to prevent it

It’s January. A New Year’s resolution led to you lacing up your running shoes and hitting the road, and it’s going well. You’re moving smoothly, the endorphins are starting to stir, then – a pain erupts somewhere in your body.

This is a familiar scene for many. It’s also a major reason why people stop exercising, or they are reluctant to start in the first place. But what if there was a way to identify the root of the problem and prevent it before injury strikes? According to movement specialist Ash Grossmann, founder of The Training Stimulus, there is.

“All injuries arise from the same thing,” he says, “and that is exceeding tissue tolerance. If you’ve damaged part of your body, then, on some level, a tissue has been exposed to more stress or load than it could manage. This could be acute or chronic, experienced through the sudden impact of a car crash or a repetitive strain disorder from using a mouse too much at work.”

When muscles, bones, ligaments and tendons are underused, they will gradually become weaker. Then, when you suddenly ask a lot of them – for example, going for a run or playing five-a-side football after years away from the sport – they are particularly susceptible to injury.

However, Grossmann says, if you know which tissues you are going to be using and make them more robust ahead of time, these issues can be prevented.

“Tissue tolerance is the amount of stress, force or load that a particular tissue or body part can handle,” Grossmann explains. “When that is exceeded, injury happens. If those tissues were more robust, the injury wouldn't have come about.”

Tissue tolerance is also relative. Someone with a lifetime of strength training and sport behind them might emerge from a fall unscathed, while a similar fall might lead to serious injury in a more sedentary or frail person of the same age.

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“Your body can get used to almost anything if you go slowly enough,” Grossmann says. To illustrate this, he recommends thinking of your muscle and other tissues as the skin on your hand.

“If you were to rub your hands with really coarse sandpaper, your skin would open up and bleed because you’ve exceeded the rate at which it can recover,” Grossmann says. “But if you were to do it very gently with a fine sandpaper, and build it up gradually over time, you would build nice, thick calluses and your hand would be more resistant to abrasion than before.”

In other words, when ramping up your exercise routine, slow and steady wins the race. But the trap people often fall into is doing too much too soon, sending their injury risk skywards.

“Because people are impatient for results, they want to run as fast or lift as heavy as possible straight away,” Grossmann explains. “It’s at this end of the spectrum that the highest performances are reached, but this is also where the greatest risk exists.”

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Grossmann’s prescription for preventing injury is simple: “We want our tissue tolerance to exceed the demands we place on our body.”

“Obviously, accidents happen and we can't prepare for those,” he continues. “But there are predictable activities we can account for. This is why boxers do a lot of neck training – unless they’re incredibly gifted, they’re going to be punched in the head.”

This sport-specific lens can also be applied to everyday life – preparing for fundamental behaviours like walking and picking things up from the ground.

If you can identify the stresses you are likely to face, you can expose yourself to small doses of these stresses to strengthen the relevant tissues – usually through strength training in some form. Over time, you can progressively overload (or gradually increase) these stresses at a rate your body can adapt to.

An everyday example of this is climbing the stairs – responsible for hundreds of thousands of hospitalisations each year in the UK. This requires strength in the tissues surrounding your knees, hips and ankles. To make these areas more resilient, you can start with simple exercises such as a sit-to-stand (moving between standing and sitting in a chair) before graduating to low step-ups and later weighted step-ups to a higher surface (demonstrated in the video above).

By doing this, you are building strength in a controlled environment and then applying it in the dynamic environment of your daily life. Think of it this way: climbing the stairs is likely to pose no problems to someone who can perform weighted step-ups with relative ease.

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As well as strengthening specific tissues, Grossmann recommends regularly exposing your body to a variety of movements in all three planes of motion: the sagittal plane (moving up, down, forward and backward), frontal plane (side-to-side movements) and transverse plane (rotational movements).

“If we move in three-dimensional full-body movements, we can learn to move our body more effectively as one integrated system,” he says. “The carryover of this into sport and life is profound.”

Doing this also provides an insurance policy in case a usually predictable movement doesn’t go to plan.

“A lot of injuries related to deadlifts, or people picking stuff up off the floor, come from people getting slightly out of position,” says Grossmann. “They might get a back spasm because they’ve never lifted ‘badly’ before.

“The exercise below offers a deliberate and controlled exposure to these ‘bad positions’, making us stronger in them, increasing our tissue tolerance and preparing our body.

“Whether you’re picking a baby up off the floor or picking up a heavy box, you’re very rarely in a perfect [lifting] position. Building tissue tolerance in this way will allow you to pick things up at awkward angles without injury.”

As explained above, you should start easy and build from there. Begin by doing these exercises with just your body weight, only reaching part of the way towards the ground. Then, as your tissues become stronger and more capable, you can gradually add weight and increase your range of motion, reaching further towards the ground. Over time, if progressed at a rate your body can positively adapt to, this will increase robustness.

Now you have the framework needed to build a body that is more resilient against any injury. The next step is to put this into action.

With running being the in-vogue exercise of the moment, I asked Grossmann how to build a set of legs capable of racking up the miles without developing any pain or niggles. He recommended the exercises below.

Goal: Ankle stability Sets: 2 Reps: 3 reaches in each direction, on each leg

Goal: Hip mobility and coordination Sets: 2 Reps: 3-5 per leg in each direction

Goal: Leg strength, stability and coordination Sets: 2 Reps: 10-20 each side

Goal: Leg strength, stability and coordination Sets: 2 Reps: 5-10 of each variation on each leg

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