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By Dr. Liam Johnston

Embarking on a fitness journey often requires a delicate balance between pushing one’s limits and respecting the body’s signals. There is often a baseline level of delayed onset muscle soreness (DOMS) associated with training, which is a normal physiological response to stressing your muscles. However, it is crucial to distinguish between normal muscle soreness and pain associated with an injury. If the pain/soreness is experienced during training or exercise, or the pain levels are greatly increased after training, that is your body’s way of saying there is an injury that needs to be addressed! While regular exercise is essential for overall well-being, injuries can throw a wrench into the works. The question then arises: when is it appropriate to continue training with an injury, and when should one prioritize rest and recovery? Simply put, it depends! If the discomfort is manageable and doesn’t aggravate the injury, modified training may be possible.

a woman is running on a trail in the sun

Modifying your workouts is a great way to accommodate the injury. This might involve avoiding specific movements or exercises that aggravate the affected area or adopting alternative movements that reduce strain. For example, if you have a knee injury, focusing on upper body workouts or low-impact activities may be a suitable alternative. Another way to modify your workouts is to find what movement patterns aggravate the injury. If you have a nagging shoulder injury that elicits pain when the arm is above shoulder level, accommodate for this short-term limitation by only performing shoulder/arm exercises with the arm under 90 degrees of flexion. This allows you to continue to build strength/stability in the shoulder and stay on track with your fitness goals, without aggravating the injury. In the case of an acute hip injury, high intensity running may be exacerbating the issue and not feasible for 2-3 weeks until an appropriate amount of healing occurs. However, this does not mean that inactivity is the right response either. A short term shift in focus towards strengthening your lumbopelvic musculature, combined with a less intense cardiovascular workout (swimming, biking, elliptical, etc.) would be a great alternative that will provide benefits in the long run while not aggravating the hip! For many individuals, exercise is not just about physical health but also a vital component of mental well-being. If the injury allows, continuing with a modified workout routine can help maintain a positive mindset during the healing process. However, it’s essential to strike a balance between mental well-being and the risk of aggravating the injury.

a woman is running on a trail in the sun

Ignoring pain signals and pushing through workouts that exacerbate the injury can lead to long-term damage. It’s essential to prioritize healing over short-term fitness gains. Continuing to train with an injury that requires rest may prolong recovery time and lead to more issues down the road. Some injuries, especially those involving joints, ligaments, or fractures, may pose a higher risk of complications if subjected to stress through exercise. In such cases, it is wiser to err on the side of caution and allow the body ample time to heal without additional strain. If modified training is manageable, it is important to note that training with an injury may alter your natural movement patterns, leading to compensations that can result in further injuries. This is especially true if you’re adjusting your form to accommodate pain. Compensation patterns can be very subtle at first, and mostly consists of transferring load or tension to a different area of the body to avoid excessive strain through the injured area. However, extended periods of training with compensation patterns can lead to a domino effect that is detrimental to an individual’s movement quality and biomechanical integrity. For example, for an acute Gluteus Medius injury, the body accommodates by increasing activity of the ipsilateral TFL and Quadratus Lumborum to avoid the pelvis from dropping, which then leads to these muscles being tight and overactive, making them more prone to injury. Therefore, it is extremely important to prioritize maintaining proper form/biomechanics to prevent additional strain or risk of injury in other areas of the body.

Woman rolling spiked ball under her feet in physical therapy

Deciding whether to train with an injury is a nuanced process that requires careful consideration of the type and severity of the injury. While some situations may allow for modified workouts, others demand a period of rest and recovery. Listening to your body, seeking professional guidance, and prioritizing long-term health over short-term gains are essential principles to guide this decision-making process. Pain is the body’s way of signaling distress, and pushing through significant pain can have severe consequences. If an exercise consistently causes pain or discomfort, it’s essential to reassess and modify your approach based on how your body is reacting to the training that you are doing. The same goes for when an injury is seemingly on the mend, a gradual return to high-intensity or pre-injury level is advisable. Rushing back into high-intensity workouts can increase the risk of re-injury and bring you back to square one. Start with low-impact exercises and progressively increase the intensity as the body responds positively. Ultimately, striking the right balance between pushing boundaries and respecting the body’s need for healing will contribute to a more sustainable and fulfilling fitness journey.

man stretching on a bridge railing. sport concept

Deciding whether to train with an injury is a complex and individualized process, with each injury being unique to the individual. While minor injuries may not require a complete halt to exercise, serious or persistent issues necessitate professional evaluation. The decision hinges on the nature and severity of the injury, and a deep understanding of the body. At Active Approach, we pride ourselves in our ability to evaluate, diagnose and help treat musculoskeletal injuries. With the complexity of injuries, is it crucial to get a professional assessment of the complaint. The right diagnosis, combined with specific manual treatment of the injury can make a huge difference in healing time, and ultimately getting back to your regular training.
Furthermore, a necessary part of our treatment process is designing a targeted and progressive rehabilitation plan, while ensuring a safe return to regular training and activity!