Working Out While Injured
One of the most common questions my clients often ask is whether or not they should try to work out when they are injured or experiencing a pain flare-up.
My answer is almost always an astounding YES, for a few reasons described below.
Of course there are some exceptions, but more often than not, moving in some way, shape, or form is helpful while going through rehab.
This blog will cover the main reasons I often recommend staying active through the rehab process and some tips on how to modify workouts accordingly.
Benefits of Working Out While Injured
First, exercise is good for us. Of course you know this, but one of the benefits of exercise is that the increased blood circulation can help with recovery. Another is that exercise also helps us think more logically, which can prevent us from getting sucked into negative thought spirals that can lead us to ruminating or catastrophizing, which can make our pain experience worse. Not to mention, exercise can help reduce the pain we experience, both acutely (during/after) and over prolonged periods of regular exercise.
Second, the recovery process for rehab can take a long time. Whether you are recovering from an ankle sprain or are dealing with some persistent lower back pain, it may take weeks or months for the pain to resolve depending on how severe it is. While you may not be able to train or load the injured area, there are often many other options for working out other areas of your body. This means less fitness lost along the rehab process.
Third, while it may feel like “all is lost” when you can’t train the way you’re used to, there is actually some evidence that shows training one side of your body has some carry over to the other side. So if you’re unable to move your left shoulder as you’re rehabbing it, you will lose less strength and muscle mass if you are still training your right shoulder as best as you can.
Finally, rehab is exercise, just more specific with the choice of exercises, the loads, and the types of adaptations being stimulated. Your rehab exercises are often mini-workouts that should eventually be progressed to more challenging loads to prepare your body (particularly the injured area) for the type of workouts you like to do. So the idea that you can’t workout while injured doesn’t make sense because rehab for your injury is exercise!
How To Modify Your Workouts
There is no perfect way to modify your workouts, and how you modify them depends on the type of injury you’re navigating and the type of training you are doing.
Ultimately, the best option is to work closely with your physical therapist or rehab provider to come up with a temporary alternative program with appropriate exercise modifications or guidelines that allow you to make adjustments based on how your body responds.
How much modifying you need to do depends on the type of injury you are rehabbing. Some injuries require relatively strict rest or very minimal movement or loading allowed (fractured or broken bone, rotator cuff repair, etc.).
So I like to break up these recommendations into 2 categories: complete rest of an area vs within pain tolerance.
1. Complete Rest: This is going to be for someone who has recommendations to avoid loading or moving an area as much as possible (usually after an intense surgery, while wearing a cast, etc)
These recommendations are typically a prolonged amount of time (weeks- months), which means it’s best to restructure the entire training program.
Strength training: Train the non-loaded side as much as possible. This can be done through unilateral exercises if you have one extremity injured (dumbbells are a great option), seated exercises if you’re unable to load one or more of your legs, or by using machines or straps.
Cardio: Choose a form of cardio that can mimic closely the activity you were training prior, but reduces the loads as needed.
Example: If you were running and training for a race, but have a stress fracture or lower leg injury and are not able to continue running, choosing a bike or row machine may be a great alternative option until you’re able to work back up to running again.
The main goal during this type of injury is to maintain your fitness as much as possible, or keep your training as close to what it was prior WITHOUT loading your injured area more than the restrictions your provider has provided for you.
2. Loading Within Pain Tolerance: This is for people who have a nagging injury or some persistent pain that comes and goes and are currently in a pain flare up. Common examples are “tweaking” your neck or “throwing out” your back.
This approach is very dependent on the person and the situation. Most of the clients I work with are dealing with this, and it is a process to learn which tools work best for them when these flare ups happen. Remember that what works one time may not work the next.
General guidelines I give these clients:
- Approach your workout with curiosity
- Start with your warm-up and gather data on how things feel; consider spending a little extra time here
- Try to maintain your normal workout as much as possible by doing the things that don’t increase the pain, especially if the pain is <5/10.
- If something hurts, try modifying the exercise by: decreasing your range of motion, dropping the weight, subbing a different variation of the exercise that feels better (ie RDLs vs deadlifts from the ground) or as a last case resort opting for an entirely different exercise that loads the same muscle group (ie hamstring curls instead of deadlifts)
- For cardio, we can also modify the workout by decreasing the intensity by going slower, performing intervals for rest just before pain begins, or doing less overall time/distance as dictated by when the pain or symptoms begin.
Overall, you want to keep moving throughout an injury or pain flare up if possible, even if the intensity is as low as a simple walk and some CARs (low intensity doesn’t mean it’s not beneficial!). More often than not, those I work with are surprised at what they’re still able to accomplish, and how much better they feel after (even if it’s a portion of their usual workout).
While injuries always suck, they can also be a great opportunity for practicing being more flexible and adaptable in your training, learning new exercises or types of training, and being more fluid in how you view fitness overall (ie saying good-bye to all-or-nothing thinking).
Hi, I'm Dr. Jen Hosler.
I’m a bookworm, science nerd, and coach of all things movement (physical therapist and strength & mobility coach). You can catch me sleeping in & having a slow morning, doing CARs & lifting heavy things, or sipping a glass of wine on my time off.
Through a blend of strength & mobility training, I’ll help you master your movement & build a more resilient body that won’t hold you back from all the activities you love doing.
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