Everyone who trains hard will go through some kind of injury at some point in his or her lifting career. The question this article seeks to answer is what steps can be taken after a layoff to make sure you’re training in on point.
This article isn’t a guide to healing a specific injury. More of a troubleshooting guide to help you get back into training and making sure you don’t reinjure yourself immediately, and how to determine a proper training load, among other things.
Let’s first discuss what the main issues are:
- What joint(s) did the injury effect?
- How do you know if you’re ready to get back at it?
- Where should you start in terms of exercise selection?
- What decrease in training loads are appropriate?
This is a pretty simple question to answer, but a very important one as well. What joint or joints were injured (or are aching, arthritic etc.)?
The most popular ones are low back, shoulders and knees in my experience. Others include: wrists, elbows, and hips.
Sometimes you will have different injuries at different joints with different severities. So that’s another point to keep in mind. Remember: just because a joint is bothering you does not mean you need to stop training altogether. I’ve noticed many people feel they need to take extended breaks just because they have a joint injury; this is usually from people who aren’t keeners about the gym in the first place.
For those who cannot wait to get into the gym, this doesn’t tend to be an issue.
So now that you have an idea of what joints are painful from your injury, the next question becomes are you ready to get back to hard training?
The simple question I like to ask my clients is “does it hurt?” If the answer is “yes” then they aren’t ready to train exercises that will have movement at the painful joint. If the answer is “no” and they are mentally and physically ready to begin training again, we can start training.
If the injury is severe, you probably sought medical attention, whether that is a doctor, a physiotherapist, chiropractor, kinesthiologist etc. Follow what they say. If they have cleared you for exercise and they’re competent you should be good to go. If they say something is contraindicated, then make sure you understand what that contraindication is and avoid it until further notice.
For those who are a little crazy and like to live on the edge, a trial and error approach will be your best bet. I still think you should always follow medical advice, but I know people who want to get back into training as fast as possible (like me) and will cut corners to do so.
For instance, I’m dealing with a back injury right now that I sustained from deadlifting about 10 days ago. My physio says I should avoid high impact exercise like running (I have no problem with that, lol). I’m still training though. Through my own experience with back pain and from learning from very good physiotherapists, the main question to ask yourself is always “does it hurt.”
For me this means until my back feels normal, I won’t do any axial loaded exercises with heavy loads. Axial loads is a force with its resultant passing through the centroid of a particular section and being perpendicular to the plane of the section, or in layman’s terms, no squats or deadlifts or their variants.
If your doctor says you’re good to go, you head to gym excited as a pig in shit, and start doing an exercise and it hurts. Stop. Always let pain be your guide. The main thing to think about is how you can work around that pain, which is the next topic.
Exercise selection is huge when it comes to dealing with injuries. I’ve had clients have small aches and pains yet be able to have a very successful training cycle on all their major lifts.
Believe me, I’m not a magician. The “magic” comes from not being a dumbass, and understanding what alternatives can be used to still produce muscular tension and strength, without hurting the athlete.
I’ve had some clients e-mail me with and injury and say they have to stop training because “squats are bothering my knees” or “I hurt my back deadlifting.” I’m going to tell you right now that unless you are now suffering from paralysis, you can always find a way to train (might not be the body part or movement pattern you want) around it.
Does your back hurt? Last time I checked you have a front area of your body…
You get the picture.
I said I wasn’t going to go over specific injuries and how to work around them at the beginning of this article. You know why? People can have pain or an injury in the exact same area and have completely different pain patterns. I’ve had clients with ACL surgeries who go through pain from merely mentioning the word “squat.” I’ve had clients with the same surgery able to work up to Squat PR’s.
The point is when it comes to dealing with injuries it’s a lot of trial and error. I’ve had clients with painful shoulders. Most coaches will tell you to train the back. Guess what, I’ve had clients who can do certain horizontal/vertical rows, and still have other horizontal/vertical rows that are painful.
How do you find what can work and what can’t?
Start light. The importance of this point cannot be stressed enough. When you are coming back from an injury start light! You might find you can do the exercise with a low load and no pain, but when you being ramping up the intensity you experience pain. We’ll go over this more shortly.
Examine alternatives. The biggest one here is usually when the bench is giving people problems. A few things to tweak:
- Reduce ROM (use blocks, or bench to pins)
- Change hand angles (usually narrower is the way to go, this is counterintuitive because narrowing the hands actually increases the ROM, but your elbows track differently)
- Use specialty bars
- Ditch barbells for dumbbells, or even… Kettlebells.
For squats and deads almost the entire above still holds true. For back injuries using a weighted belt can still be a good way to stress the quads. Single leg exercises where the load is held in each hand works very well.
I touched on this in the previous section of this article. A lot of people will ask: “how light?”
Honestly it depends on the severity of the injury. Small aches and pains are less severe than blowing your back out. A simple way to keep things light when coming back from issues:
- Start with just the barbell
- Use gym math to increase weight, aka go up by 25’s, 45’s.
- You should get a good feel by ramping up the weight how heavy you can go
- Prepare to feel like a weak piece of shit
- Be patient
I’ve seen people come back from injuries and push the weight way too hard too soon. This can result in a few things: you reinjure yourself, or lengthen or the healing process. Both of these are something you should try and avoid, if you can’t understand this, you’re a fucking idiot. Straight and simple.
So let’s say you did something to your back. It’s starting to get back to normal after 4 weeks. You go into the gym and start with the bar, do a some nice easy reps. It’s easy and you keep ramping up until you hit something that represents ~80% of your 1RM. There is no pain present but the weight feels lighter. Unfortunately after not training the deathlift for a month you will go through a certain degree of detraining.
There isn’t any specific load you should work up to or a specific decrease in strength that you can expect. Detraining will be different for different people. If you’re a serious lifter and want to jump back into a program you can try retesting your 3RM and use a calculation to get your estimated 1 RM. If you autoregulate your training, just be prepared for lighter loads and higher RPE’s than you’re used to.
That’s it! Good luck, take it at your own pace, and talk to your doctor.
Featured image courtesy of rockerBOO and used under a Creative Commons license.