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Recovery · 9 min read · May 2026Training Around Injuries: How to Stay in the Gym Without Making It Worse
Training Around Injuries: How to Stay in the Gym Without Making It Worse
Recovery9 min read🗓 Last updated: May 2026
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📅 Published: May 2026🔄 Updated: May 2026⏱ 9 min read📂 Recovery
The advice to 'rest' a minor injury is rarely optimal and often counterproductive. Modern sports medicine and physiotherapy have shifted significantly toward active rehabilitation — continuing movement within pain-free ranges, building blood flow to the injured tissue, and maintaining fitness and strength in the unaffected parts of the body. Complete rest produces muscle atrophy, reduces blood flow to the healing tissue, and decreases the mechanical loading that stimulates connective tissue remodelling. For most common training injuries, the right answer is not to stop — it is to modify.
The fundamental principle: train around, not through
Training around an injury means modifying your programme to avoid the specific movements or loads that aggravate the injury, while continuing to train the movements and muscle groups that are unaffected. Training through an injury means continuing the aggravating activity in the belief that it will resolve on its own, or that discomfort must be accepted. The first approach accelerates healing. The second extends it.
Pain is a signal. During rehabilitation, the appropriate working principle is: train at the highest load and volume that does not produce pain during the session or worsening symptoms in the 24 hours following. This is called the pain-monitoring model and is supported by current physiotherapy guidelines for most musculoskeletal conditions.
Common injuries and training modifications
Shoulder impingement/rotator cuff irritation: Avoid overhead pressing, internal rotation under load, and barbell bench press with wide grip. Substitute cable rows, neutral-grip dumbbell pressing at 30° incline, face pulls, and landmine pressing. Continue lower body training unrestricted.
Lower back strain: Avoid loaded spinal flexion and heavy axial loading (deadlifts, squats). Substitute hip hinges with minimal spine load (single-leg RDLs with light dumbbells), machine-based lower body work (leg press, leg curl), upper body pulling movements, and walking. Core work emphasising anti-extension and anti-rotation (dead bugs, pallof press) is often therapeutic.
Knee tendinopathy (patellar or quad tendon): Avoid deep loaded squatting and running. Isometric quad work (leg extension holds at 60° for 45–60 seconds) is documented to reduce tendon pain. Substitute hip-dominant movements (RDLs, hip thrusts), upper body training, and swimming or cycling at low resistance.
Biceps/elbow tendinopathy: Avoid supinated curling under heavy load and heavy pulling. Substitute neutral-grip pulling (hammer curls, neutral-grip rows), reduce load and increase reps on all pulling work, and consider eccentric-focused rehabilitation exercises.
When to see a professional
Training modification alone is appropriate for mild-to-moderate overuse injuries, post-exercise soreness, and temporary joint irritation. It is not appropriate for: acute trauma (sudden onset pain during exercise, audible pop or crack), symptoms that progressively worsen despite load modification over 2–3 weeks, pain that radiates into a limb, pain at rest, swelling or heat in a joint, or loss of range of motion.
A physiotherapist or sports medicine physician provides a specific diagnosis and structured rehabilitation programme — something that self-diagnosis and internet research cannot reliably replace. Many training injuries that are managed ineffectively for months resolve within weeks under professional guidance.
Getting professional assessment does not mean stopping training — it means training with specific information about what to avoid and what to do. The best sports medicine professionals build rehabilitation around your training, not instead of it.
Using injury time to fix weak points
An injury that prevents lower body training is an opportunity to develop upper body in detail. An injury that prevents pressing is an opportunity to develop the posterior chain, legs, and pulling strength to a level you would not have prioritised without the constraint.
Every experienced lifter has periods where an injury forced them to prioritise a previously neglected area and emerged with a more complete physique or more balanced programme as a result. The frustration of an injury is real. The strategic opportunity it provides is equally real.
The consistency of showing up to train in a modified form — maintaining the habit, the environment, and the practice — is worth more in the long run than the specific sessions missed. Complete training breaks disrupt the habit architecture that makes long-term training sustainable.
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Key takeaways
Train around injuries, not through them — modify to avoid aggravation while continuing unaffected training.
The pain-monitoring model: train at the highest load that does not produce pain during or 24 hours after a session.
Common modifications: avoid aggravating movements, substitute non-aggravating alternatives, maintain full training of unaffected areas.
See a physiotherapist for: progressive worsening, radiating pain, joint swelling, acute trauma.
Injury time is an opportunity to build neglected areas — maintain the training habit even in modified form.
📚Sources & Further ReadingVBE uses peer-reviewed research as its primary evidence base.
Brad Schoenfeld, PhD — Lehman College
The most-cited hypertrophy researcher in sport science.
Andy Galpin, PhD — CSU Fullerton
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