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Tips & Techniques to Get You Back to Full Strength

How to Continue to Train when Injured

Abby Schenk 
 • 
February 22, 2021
How to Continue to Train when Injured

If you are a runner or any kind of performance athletes you know that minor injuries, tendinitis, and strains may occur.  Often you can rest and modify for a day or 2 and these little setbacks will resolve themselves and it is business as usual.  Sometimes though this is not the case and the little tweak that initially presented itself has now been going on for several weeks.  After months of marathon training, strength training, or putting a lot of hard work in at the gym improving your fitness performance you now are faced with the decision to push through or hold off.  We agree with you that continuing your fitness journey is in most case the right option, however this may need to look differently.  We do not recommend our athletes to stop strength training, endurance training, or to stop pushing gains over a period of injury or recovery.  Fortunately, modifications and redirecting your focus can help you stay on track with training without altering tissue healing.

 

For the fitness strength training athlete, we recommend:

  1. Limiting you range of motion.
  2. Train the opposite side.
  3. Lighten the load or change of variation of the load.
  4. Use exercise variations.
  5. Unload the injured tissue.

 

Limiting your Range of Motion during Injury:

Continued injury occurs when tissue is under a load or tension for extended period.  This is often more exacerbating when the tissue is under load in the end of its stretched position.  For instance, if you injured your knee and you are working on a squat where you typically squat to the depth of parallel or below with load you can continue the load but place a bench behind you and limit your range to above 90 degrees.  Or let’s say you injured your back and you are doing kettlebell swings, instead of swinging above shoulder height keep the swing to below shoulder height to limit the range of the hinge pattern.  Another modification when lifting from the ground for a clean or a deadlift for the low back would be to elevate the bar off the ground so you are lifting from a higher surface.

 

Train the Opposite Side:

Some of you may be saying what if I had knee surgery and I can not load that tissue at all.  This is a great way to continue to get your cardiovascular conditioning up and train the muscles on the opposite side.  Our brain needs to continue to make connections to the motor pathway and by training the opposite side the body continues to make the brain body connection.  Research shows that training the opposite side will continue to make gains on the injured side when ready to begin training.  For example, if you had a shoulder  surgery repair on the left side then work on performing a kettle bell push press overhead on the right side.  You can also train upper body versus lower body.  If you are a runner and you injured your knee you could sit and do upper body strengthening or perform your lower body in “opened chain position.”  This mean you perform on a table or on floor without putting weight through the lower body side that is injured.  For example, instead of performing standing clam shells in single leg you could perform them laying on your side.  Open chain also means you could do a hip extension kick on the injured side without loading that side in standing.

 

Lighten the load or resistance: 

Often when injured we cannot withstand heavy loads or pressure that comes from significant resistance.  It is better until recovered to pick lighter weights, focus on form, and increase repetitions.  As you can handle improved range of motion, and heavier weights you can slowly decrease the number of reps and focus on lifting heavier.  If you are a runner and you find you are injured consider backing down on miles and focusing on conditioning, mobility, or drill/agility training to keep the legs in tuned while not over burdening them with excessive miles on injured tissue. I often recommend to my runners to focus on longer drills/agility training and throw in short bouts of running with good mechanics if pain free. You therefore can increase the time spent in running over time.

Here is an example of starting light and increasing run time. The walk could also be a drill such as skipping.

Day 1. 4x: 1min jog, 4min walk

Day 2. rest

Day 3. 4x: 1min jog, 4min walk

Day 4. Rest

Day 5. 4x: 2min jog, 3 min walk

Day 6. Rest

Day 7. 4x: 2min jog, 3 min walk

Day 8. Rest

Day 9. 4x: 3min jog, 2 min walk

Etc

 

Here is an example of a rep increase with lighter loads:

 

First Week: 3 sets of 25 reps light load

Second week:  3 sets of 20 reps continued light load

Third Week: 3 sets of 15 reps increased load

Fourth week:  5 sets of 10-12 reps medium- heavy load

5th week: 5 sets of 8 reps heavier load

 

 

Use exercise variation:

 

Sometimes just changing a variation of an exercise can help.  For example, if you are having pain with front squatting because of a shoulder injury that limits your ability to get into the front rack position change it to a goblet squat where you load with heavy kettlebell or dumbbell by holding at chest.  If pullups are bothersome try changing the angle and perform a TRX or suspension row, or even a banded assisted pull up.   If running all together is bothersome you could try cross-training on the bike.

 

Unload the irritated tissue:

 

Sometimes loading the tissue altogether is not an option.  For example, if you have a shoulder injury and you still want to load you lower body, but you cannot hold or load the upper body try a banded hip hinge, or bench hip dips with weight/barbell stacked on hips.  If you are having pain with running, try aqua jogging in the pool to get the same intensity of the heart rate but to limit load and strain to the knees, ankles, hips that would come from loading on land.

Meet the Author
Abby graduated with her doctorate in Physical Therapy from the St. Francis University in 2013. Since graduation she has been spending her time advancing her manual and professional skills through additional certifications. Her vision is to be able to offer elite services to her patients through spending quality one on one time in order to education, specify individualized therapy sessions, and make a greater long-term impact by creating adaptable changes. Her mission is to refine the physical therapy experience by creating a path of recovery unique to each and above the standard of care. Abby ran cross-country, track, and was on the high school swim team. She went on to run cross-country and track in college and was All- American, and captain. She loves working with the fitness athlete, the collegiate athlete, and the active adult population because she understands personally what it feels like to be both on the injury and recovery side. Abby understands life happens and the body gets tired of our daily poor movement habits, however her intention is to prevent injuries from interfering with your health and fitness goals. Her mission is to empower her patients to be their very best self and move freely without pain or restraints. The outcome is accelerated healing by providing the highest level of skilled services for each patient’s needs. Combining a patient’s dedication, higher level sport-specific conditioning, and movement re-training, the result will be the best you. Some of Abby’s advanced training includes: Rock tape and Certified Rock Blades Technique Specialist, Blood Flow Restriction Certified, CrossFit Level 1 Trainer, Myofascial Decompression, Myofascial Release, Pose Certified Running Technique Specialist, amongst other advanced education.
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