Training with injuries

One of the more frustrating things about being injured which often tends to get overlooked, is the restriction in daily activities for the injured person. For a lot of people, being told they need rest and they can’t train can be worse than any pain that they are experiencing and therefore it should be an important consideration for the rehabilitation process.

There are obviously injuries or conditions where training the injured body part is not appropriate due to it’s current stage of the healing process and this must be respected. However, in a lot of cases there are modifications that can be made so that the injured person can continue to train in some capacity. When talking about training with or around an injury, it is important to acknowledge that when we are completing rehabilitation, low level pain or discomfort is generally acceptable during the process. We know that pain isn’t a reliable indicator of tissue damage, but more so a warning signal meant to keep us safe. As this is the case, we are accepting of low level pain or discomfort of up to a 3 out of 10 on a 0-10 pain scale as long as it settles quickly and it isn’t worse the next day (see below). If by chance things feel good during the activity but are more sensitive the next day, then we know it may have been a little too much for the tissue and we make an adjustment for the next session.

As activity restriction can have such a big impact on the injured person both physically and mentally, it’s our job as physiotherapists to give you modifications in order for you to maintain your training and routine as much as possible. Here are some basic examples of how we can modify your training to keep you as active during your rehabilitation period:

Reducing the volume – this could mean reducing the distance or frequency of your running for anterior knee pain or Achilles tendinopathy, or reducing your sets/reps in the gym for those with back pain
Reducing the intensity – for the runner this would be slowing down your running pace to more of a jog, or for back pain reducing your weight in the gym
Modifying the movement – this may be as simple as reducing the range of movement such as box squats or raised deadlifts, or changing from bench press to floor press for that sore shoulder
Changing the stimulus – changing exercise type is an easy way for you to get your training in e.g. changing from a high impact exercise like running, to a low impact exercise like rower, bike or swimming is an ideal way to still get a good cardio session in while limiting aggravation
Focusing on the other areas – this is probably the easiest but most neglected modification to activity. For those who have upper body injuries, there are a number of options for you to train not only the lower half, but also the other side of the upper body (and vice versa) – there are usually lots of options for both weights and cardio

As you can see, there are numerous ways to keep you active and moving when you have had an injury and are going through rehabilitation. There are obviously injuries that require a more conservative approach, but for the most part there should be a number of options to keep you moving and motivated. The added bonus is that you can structure your session to incorporate your rehabilitation exercises so it all gets done in the one session and doesn’t feel like another boring rehab program!