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Training After an Injury?

What is your immediate reaction to an injury? 

 

Is it to try to power through it and walk it off?

Is it to cease all activity until it’s resolved?

Is it to proceed with caution and see what happens?

 

Very few people can go through a lifetime of activity completely unscathed, and it is likely that you will experience at least one or two minor injuries at some point in your training career. 

 

Obviously we can protect ourselves against injury by using proper form, eating well, and building a durable body, but there are too many variables in life to be fully protected all the time.

 

Let’s discuss some of your options as to how to proceed when it happens to you. 

 

SHOULD YOU COMPLETELY STOP TRAINING FOR AN INJURY

 

Many people will immediately jump to the conclusion that they should halt their training entirely, that the injury is debilitating, and that any movement, especially with external resistance, will only exacerbate the problem. 

 

While this seems like a safe option, there are two primary reasons it may not be the best.

 

REASON 1 - DETRAINING:

Fitness, both muscular and cardiovascular, is a “use it or lose it” type deal. When you take a break from training, your fitness decreases.

 

For cardiovascular fitness, you can lose up to 10% in just over a week of inactivity. 

 

Strength gains are slower to diminish but can still decrease by about a third after a few months of inactivity. 

 

The good news though, is the more active you remain, the less gains you will lose. If you do nothing but lay in bed 24 hours a day, your progress will be lost much quicker than if you were to continue moving and doing any pain-free activity. 

 

And while cardiovascular gains may take longer to regain, strength will come back quickly due to the largely neuromuscular aspect of the movement. 

 

So continuing to be as active as possible while injured will slow the rate at which hard-earned progress is lost. 

 

REASON 2 - MORE INJURIES:

If you get injured and then switch over to a sedentary lifestyle, you are probably setting yourself up for more injury later on. 

 

A significant benefit of exercise and activity (when done with proper form and guidance), is that it physically builds the human body. It makes you stronger, and causes your body to work as a whole, each individual component working together in the most efficient way possible like a well oiled machine. 

 

Individuals who have inactive lifestyles, do not have this type of durability and efficiency built into their machine and they are more likely to break down and get injured when activity is required. The kinetic chain is an intricate system and suboptimal performance is related to higher injury risk and worse recovery (U.S. Department of Health and Human Services, 2008).

 

On that note, some injuries, especially muscular injuries, are actually caused by imbalances in the kinetic chain, either above or below the site of the injury. Going through a movement pattern such as a squat, deadlift, or even running gait with improper mechanics WILL, over time, lead to injury. This is referred to as an overuse injury

 

This is relevant because even static posture is a movement pattern. When you sit still at a computer, or in a chair, you are using muscles in your body to hold whatever position you are in. Those muscles are being used and therefore can potentially lead to overuse injuries. 

 

Let’s use knee pain as an example: 

 

Let’s say you’ve been squatting and the last 2 weeks you’ve been feeling some pain in the front of your knee and now it’s so bad that it hurts to put pressure on it. So now you spend as much time seated as possible to “stay off your bad knee”. 

 

In your extra time spent sitting, your hips are chronically flexed. Hip flexion lengthens the glutes (like when you go down on a deadlift) and shortens the quadriceps.

 

Chronically lengthened muscles tend to be underactive and chronically shortened muscles are overactive

 

Now, you will have less control over your hip joint, leading to dysfunctional movement at the knee, in addition to tight quadriceps which will chronically “pull” at the patella and tibia. 

 

In trying to limit movement of the lower extremity due to knee injury, what you’ve actually done is set yourself up to make it much worse. 

 

SO, WHAT SHOULD YOU DO WHEN YOU GET HURT?

 

So we have established that you probably shouldn’t do nothing at all, so what should you do?

 

Well the question really should be “what can you do?”.

 

In my opinion, I believe that you should do as much as you can without pain.

 

If you can keep a joint or muscle moving, pain-free, through an injury, you can prevent it becoming stiff, promoting blood flow and recovery in the area.

 

Moving the injured area should always be done cautiously, and you may be better off working on areas around the injury.

 

Never forget that no single point on the body is independent of any other point. The kinetic chain includes every part of the body. A movement in the toe could shift ankle alignment, which causes the knee and hip to compensate, leading to the torso and shoulders to reposition out of a preferred position. 

 

Using the previous example, you may spend more time doing glute-specific training. 

 

Glute training can be done while holding the knee in a fixed position, and without load. This removes the mobility and stability demands from the knee, but will have the upstream effect of creating better control and better postural alignment of the knee joint. 

 

In addition to training upstream, you may also adjust your current training to accommodate specific injuries. 

 

MODIFICATIONS

There are many variables in a movement pattern which can be manipulated. These include:

 

 

Strategically manipulating these five elements, you may be able to  maintain, or possibly continue progressing through your injury. 

 

Let's go back to the squat example:

 

Let’s say that in the squat, your knee hurts only when you go past parallel and you are squatting with heavy weight. 

 

Well, you don’t have any pain above parallel, so throw in some heavy squats to a high box on one day during your week. This gets you a heavy stimulus (high load) but a low range of motion. 

 

On a second day, you may do light, or even bodyweight, squats but go past parallel. This will let you train in a large range of motion with low load. 



FINAL THOUGHTS

 

All of this being said, everything will depend on the severity of the injury.  

 

Obviously, some injuries will completely take you out of the gym, and that is ok. Physiological adaptations are regained more quickly than they are built the first time. 

 

That being said, don’t let a small setback turn into a big one. Don’t be the person who overreacts, and thinks that total cessation is the only solution. 

 

In most cases, keep doing what you can. Focus on your weak points, upstream muscle groups and movement patterns that may help prevent further injury. Take advantage of the many variables in your training to explore new methods and find what works for you. 

 

Always exercise caution with any injury, but do not throw in the towel when you don’t have to. 

 

And finally, try to stay positive, no matter the severity of the injury. Injuries can be an opportunity to learn more about yourself and your training, dial in form, strengthen discipline, and promote creative problem solving. 

 

Very few people can go through a lifetime of activity completely unscathed, so it is better to be prepared for when that time comes. 

 

A WORD OF CAUTION:

I am not a medical professional. If you have a serious injury contact a licensed medical professional. 

 

Sam Turk

BS, CPT, CES



 

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