Don’t Let Injury Stop Your Training Momentum
What do you do when you get injured? Some of you may continue training, hoping that you can ignore the pain until it goes away. (Hint: hope is not a strategy in injury recovery). A lot of you may have even had medical providers tell you to “just rest” until your body recovers. In my opinion, neither of those options are a great strategy.
Today we are going to talk about how to continue training through an injury. First off, why do you want to continue exercising during an injury?
Exercise helps to reduce pain through the release of endorphins and by pumping blood to the injured area to manage local inflammation.
You do not want to lose your hard-earned fitness. Continuing to train will help you at least maintain (if not increase) those gains during rehabilitation.
Now, let’s look at some specific training modifications you can make when “just rest” is not an option for you.
Adjust Range of Motion
Often tissues are irritable at a specific portion of the movement. If that’s the case, it is a great way to modify training to continue performing an irritable movement and progressing load as you are able through a smaller range of motion.
For example, if you have pain in the front of your knee at the bottom of the squat, reduce the range of motion to stop just before the onset of pain.
Perform Different Variations
Making slight changes in movement choice can help to reduce the stress on irritable tissues. This might look like changing bar placement or type, grip, torso angle, or knee positioning.
For example, front squats utilize a more upright torso compared to back squats, which helps reduce the stress on the low back and make it more tolerable for those with back pain.
Unload Irritable Tissues
In some cases, we have to completely unload a muscle or joint during recovery. This is where we get creative in loading methods to continue loading and to progress gains in other regions during rehab.
For example, a post-op shoulder often can’t tolerate barbell squat variations. A belt squat is a great alternative to load the lower body without stress on the shoulder.
Adjust Load, Intensity, Volume
Another way to modify during injury is to reduce the load, intensity, and/or total volume of training. We utilize submaximal training in order to progress performance without continuing to flare up the irritable tissues.
For example, symptoms of knee pain may present with a back squat at 185# or after 6 reps, but not at lower weight or fewer reps. So we modify the load or reps in order to prevent the onset of knee pain.
Train Adjacent Muscles
This modification works to train neighboring muscles during the phase of high irritability symptoms. This builds strength in the supporting muscles to allow the injured tissues to settle down enough to load them directly.
For example, pain in the shoulder with overhead positioning can cause limits in both barbell and gymnastic movements. Training the surrounding muscles of the shoulder blade, upper back, and lats help to relieve the load on the shoulder and allow time to recover.
Alter Tempo
The key element of any tempo movement is time under tension. Despite often working at a lower load, changing the tempo of a movement forces your muscles to be active for a longer period of time. It also helps to build stability through the whole range of motion.
For example, if you have back pain with squats, performing tempo squats can help to build strength and control through the movement and reduce pain. Try a slow descent for 4 seconds, hold at the bottom for 3 seconds, then stand up and repeat 3-5 times.
Train Contralateral Side
Training the non-injured side can actually lead to small strength gains on the injured side. This phenomenon is called the “crossover effect.” It demonstrates the value of continuing to train the non-injured side while recovering.
For example, after knee or shoulder surgery, training the non-surgical limb can help to improve strength of the surgical side. This is especially valuable during the time when you may have to wear a brace.
Blood Flow Restriction
Blood Flow Restriction (BFR) training is a valuable tool used to achieve strength gains and muscle growth while working at lower intensities for shorter periods of time. It utilizes inflated cuffs to create an environment with less oxygen available, making your muscles work harder at lower intensities.
It is great to utilize early post-op or with acute injuries when your body will not tolerate higher intensity exercise.
Final Thoughts
As a physical therapist, my goal is not to prevent you from training and repeatedly remind you what you cannot do during an injury. Instead, my goal is to identify what you can do to maintain fitness and improve your injury recovery.
If you want guidance for how to modify and optimize your training while recovering from an injury, schedule with Ascent Physical Therapy & Performance!