Anthony Donskov

Anthony Donskov is the founder of DSC where he serves as the Director of Sport Performance. Donskov holds a Masters Degree in Exercise Science & is the author of Physical Preparation for Ice Hockey.

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Life Long Patient Syndrome: A Case Study

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As a former competitive athlete, I enjoyed being pushed in the weight room and on the ice. Intense workouts, overnight bus rides, three games in three nights and a body the recovered faster than David Hasselhoff’s lifeguarding career.




These memories live in the hearts of current/former athletes forever, so does the painful reminder of the abuse our bodies took. My body has aged tremendously since those days (degeneration, bi-lateral shoulder surgery, overuse and musculo-skeletal imbalance). The good news is that my brain is just now just catching up. I was a long sufferer of what is now known as “Life Long Patient Syndrome.” It’s the equivalent of fitting square pegs in round holes or as Coach Boyle would say looking to slam your hand in the car door every week or so. Bottom line: you can’t train a 33-year-old athlete the same as you’d train a University freshman yet alone a desk jockey. I have learned this lesson the hard way. Due to my shoulder injuries, I can no longer: bench press, overhead press, and front squat with heavy load. The unfortunate part is that I LOVE these exercises, but when I perform them my body hurts. It has taken me years to figure this out. Pushing through discomfort because “I always lift this way.” It’s more of a mindset than it is anything else. The “disease” has four stages and has nothing to do with technical proficiency. It has to do with neglect and personal choice. You can pick ANY lift that causes pain and use the four stages below.


Stage 1: Mistake: Opps that hurt!


Stage 2: Pattern: It’s ok. I’ll just try that again!


Stage 3: Habit: I’ll add it too my protocol twice/week.


Stage 4: Life Long Patient Syndrome: It’s ok! I’ll call my PT or set up surgery.


The longer an athlete’s career, the more injuries add up and the body simply does not adapt or adjust. This can be due to decrease vascularity, scar tissue, degeneration, osseous adaptations, spurring, and other soft tissue adhesions. Gray Cook has said several times, the biggest potential for future injury is a previous injury. Below are five ways to avoid Lifelong Patient Syndrome.


Avoid Pain: Subtraction before addition! If it hurts, don’t do it: such simple advice but nearly impossible for athletes to comprehend. “But I love the bench, when can I get back to it?” “I’ve squatted all my life.” These are all forms of denial. Why do we slam our hands in car doors? Better question: why do we CONTNIUE slamming our hands in car doors?


Mobility Work/Corrective Exercise: The older the athlete, the more time needs to be spent on mobility/corrective exercise. Chances are there has been a history of chronic and/or traumatic injury. This leads to periods of immobilization and altered movement. Connective tissue elasticity is decreased in response to immobilization as is muscle shortening. This process appears to be correlated with AGE.


Multiple Tools: One tool wonders don’t work for Lifelong Patient Syndrome. When all you have is a hammer everything looks like a nail. This leads to pathology. Multiple tools (dumbbells, TRX, Kettlebells, bands, chains, barbells) need to be utilized to in order to promote function and comfort in the weight room. There is also a need for adequate regression in exercise selection (ex: floor press instead of bench press).


Stress: We all reach plateaus in the weight room. Our job as Strength Coaches is to fluctuate this stress in hopes of promoting adaptation and avoiding exhaustion. The more training years an athlete has spent in the weight room, the closer they are to reaching their genetic potential. We are still trying to build strength, but MORE importantly we are trying to extend careers. I would much rather have a healthy 33 year old player extend his career an additional two years than increasing his front squat twenty-five pounds in a summer.


Recovery: There is difference in mind set and physical attributes between a young, fiery college athlete worrying about his next meal at the cafeteria, and an older athlete with previous injury, a wife, family, career and bills to pay. Lifestyle, stressors, injuries, job demands all play a role! The older the athlete, the more time needed to recover from strenuous bouts of exercise. Soft tissue work is critical in decreasing density, promoting blood flow and avoiding a trip to the PT. A young thirteen-year-old athlete is not going to spend nearly as much time on a foam roller as compared with an athlete reaching the tail end of a career: one is hyper-mobile, the other may very well be hypo-mobile.


Lifelong patient syndrome has nothing to do with technical proficiency and everything to do with pride and choice. It’s difficult not to do something you’ve done your entire life. When my athletes bench press, overhead press and front squat there is a feeling sadness deep inside, but my body feels good since eliminating these exercises from my protocol. I still get after it with heavy weight and intense workouts, but I listen to my body. You don’t need to be a victim of Lifelong Patient syndrome nor do your athletes. The body can change over time due to injury. Square pegs DO NOT fit in round holes, nor do our hands in car doors. 


Anthony Donskov, MS, CSCS, PES, is a former collegiate and professional hockey player, founder of Donskov Strength and Conditioning Inc., ( and Head Instructor/Director of Off-Ice Strength and Conditioning for Donskov Hockey Development ( He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it. . 




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