Injury – it’s a six letter word you’d rather not deal with, but, unfortunately, when you train consistently for many years, you’ll probably spend some time on the sidelines or modifying your workout due to an overuse injury. Whether it be tendonitis or a stress fracture, injuries are inconvenient and often painful.
Concerns about Losing Your Fitness
When you’re injured and have to take a rest, you may worry about losing your strength or cardiovascular fitness when you take time off. Fortunately, you don’t lose strength quickly. One study found that men who weight trained using heavy resistance lost around 12% of their muscle strength after taking a 14-day break. Other studies show a far less decline in strength.
In terms of aerobic fitness, research shows aerobic capacity begins to slightly decline after only 10 days of inactivity, while a study in runners found aerobic capacity dropped around 6% after one month of sitting on the sidelines. After about a month, your body loses some of its ability to deliver a large volume of oxygen to tissues, leading to a decline in endurance.
On the plus side, you can recoup any strength gains lost due to “muscle memory.” Yes, your muscles really do “remember.” Each time you do a workout, you carve neurological pathways that don’t automatically disappear when you stop training. When you start back up, strength is quickly regained due to the pathways previously etched.
As far as aerobic capacity, that too can be regained rapidly, although you can retain the majority of your aerobic fitness by doing short by intense workouts, as long as your injury doesn’t preclude it. If your lower body is injured, you may be able to do an upper body circuit workout that gets your heart rate up enough to preserve your aerobic fitness.
A Short Break is Better Than a Long One
Now you know that you don’t have to stress out too much when taking time off from training. Chances are you won’t have to stop long enough to lose all of your gains, and even if you do, gains are easier the second time around. Don’t hesitate to take a break if you need to, rather than risk injuring yourself further. What could have taken two weeks to heal could take a month or more if you “push through the pain.” Don’t forget that when you have pain or limitation in motion, it affects your form and increases your risk for further injury.
The other thing not to do is take non-steroidal anti-inflammatory medications (NSAID) to mask the pain and then try to work through the injury. Not only are NSAID not good for you, they only temporarily ease the inflammation. To make matters worse, some studies show NSAID delay healing of bone and tendon injuries.
Should you work out when you’re injured? It depends. In some cases, you may only need to modify your workout so that you’re not experiencing pain. When you’re injured, pain is your guide, and if you have a more serious injury, take the advice of the health care professional taking care of you.
Making a Comeback
So, you’re finally feeling better and almost completely pain-free. If you haven’t exercised in a few weeks, what’s the best way to make a comeback? Take it slowly, at first. If you haven’t trained in a week or two, it shouldn’t be business as usual. Depending upon the length of time you’ve been out, your connective tissue, including your tendons and ligaments, may have weakened, placing you at greater risk for re-injury. You may feel ready to get back to work, but your connective tissue, tendons, and ligaments may not be.
The safest approach? Lighten the resistance you’re using to no more than 60% of your one-rep max when you first start back and keep your total volume lighter. It may feel like you’re starting over again, but what’s wrong with that? Better to take it slow and gradually rebuild strength than to lose more time due to injury. Resistance training isn’t a race – you’re only competing with yourself.
A lot of how you train after an injury depends upon the type of injury you had. If you had a lower-body injury like Achilles tendonitis or a hip strain, you can do advance training quickly for your upper body but take it slow on lower body exercises like squats and lunges. Start with light reps and do only a single set initially and gradually build up. Pay attention to how you feel the next day and modify your workout accordingly.
Be Smart: Prevent a Future Injury
Take it slow when you come back from an injury, and then take steps to prevent future injuries that’ll keep you from getting your workout. Here are some tips:
Make sure you’re cross-training and not working the same muscle groups the same way repetitively. Vary the type of workouts you do.
Use good form. The biggest cause of weight training injuries is using crappy form and trying to control a weight that’s too heavy for your level of training.
Always start with a dynamic warm-up, even if you’re pressed for time. Warming up raises your core body temperature and heats up your muscles so they’re more flexible. Cold, rigid muscles are more injury prone.
Don’t overtrain. Your muscles need some stress to grow and your cardiovascular system needs it to adapt – up to a point. Beyond that point, you place yourself at greater risk for injury. Don’t suddenly increase your training volume or intensity, gradually work up to it. Recovery time is important. Give your muscles at least 48 hours to recover before strength training them again and give yourself an exercise-free or light day once a week for a full recovery.
If you have a history of repeated injuries, especially involving the same tendons or muscles, get a professional evaluation. You may have issues like a significant leg length discrepancy that’s contributing to your injuries. Muscle imbalances may also be a factor that you can correct through targeted strength training and stretches.
The Bottom Line
Yes, injuries are a bummer, but the week or even month you spend allowing an injury to heal is time well spent in the bigger scheme of things.
References:
Exercise Physiology. Fifth edition. 2001.
Training Peaks. “How Much Down Time is Too Much: The Concept of Detraining”
Journal of Applied Physiology Published 15 September 2013 Vol. 115 no. 6, 892-899 DOI: 10.1152/japplphysiol.00053.2013.
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Strength Training and Rhabdomyolysis: Who’s at Risk?
5 Things You Might Be Getting Wrong about Rest Days
“Injury” has 6 letters. 🙂
The only thing I disagree with a bit here is the part over us losing strength quickly. The study mentioned is for men only- we do have to remember that women have only about half of the muscular strength of men naturally (meaning without training). It was also referring to men who did heavy resistance training. Depending upon our fitness level and recent training regime, we may not have been engaged in such heavy resistance work as those in the study did. As unfortunate as it is, some of us lose muscle and muscular strength much more quickly than others. I am one who loses strength and muscle tone quite quickly, and I lose cardiovascular endurance even faster. I regain neither one quickly, either. (I’m an endomorph, if that makes any difference.) Friends of mine who are mesomorphs seem to have no such issues. I’m not saying this to be discouraging to anyone with an injury, but to point out that this one study isn’t necessarily going to be representative of everyone, even those who train regularly.
Also, many of us with permanent osteoarthritis, post-polio syndrome, or conditions like fibromyalgia simply must take NSAIDs regularly if we want to train at all. I realize this article is not about those with pain conditions that won’t end, but I thought it was worth bringing up. I acknowledge fully that having to go the way of frequent NSAID treatment is not fair, it’s not ideal, and it’s not without side effects. Too much of it (which often happens when people won’t or can’t receive other medications and other treatments like therapy) is certainly very dangerous and should be avoided. However, going without training is probably even worse if some ways for the body, so it’s a fair trade off in my own very humble opinion. It is like aspirin therapy for those with a high risk of heart attack; taking an aspirin a day is not without risk, but one may feel it is worth the trade-off. Sadly, not all injuries or conditions are temporary, and I think that masking pain is perhaps misunderstood by people who do not face it on a chronic and unending basis. There are many people living under the tyranny of the anti-pain relief ideal of our society. They’re reduced to living in constant agony and limited physical mobility due either their own ambivalence about taking medication, or they live under this cloud due to that of the medical community regarding what level of pain these patients should just have to endure. Wonderful though it would be to say that every injury will heal and every patient can be cured through the right amount of therapy, training, and so on, it just isn’t a fact.
Regardless of my points stated above, I agree that having a positive mindset about it is very important. I do think we can be proactive about the muscle and fitness lost to an injury, at least to some degree. This is assuming that we can at least train some body parts even if we must rest others. We can train around the injury. If we injure something in the lower body, we can still do a fair amount of upper body exercises. Or vice versa. If it is an upper body injury, we could focus on walking, step aerobics (just taking out the arm movements when needed), and so on for cardiovascular endurance. We can go to physical therapy, get massages, use PT tools at home for proper stretching and pain relief, and possibly begin to train weak or imbalanced muscles so that we avoid re-injuring the same area down the road.
From my own experience with serious knee injuries that have affected virtually every facet of the knees (meniscus tears, falling directly on my right patella and crashing it into a concrete floor, LCL issues, ACL issues, water on the knee, and osteoarthritis) often we must work THROUGH the pain in order to relieve it. Strengthening muscles that are out of balance is imperative. Many women have quadriceps that are about three times as strong as the hamstring muscles. Due to nature’s building of us, we can often have weak adductor muscles, especially if we did not engage in serious athletic activity in childhood that helped train them at all. Sitting at a desk constantly can be murder on the spine, hips, glutes, and all the muscles surrounding the knees. Many of us have weak or underdeveloped calves and shins. Our feet – and the shoes we wear both while training and in our daily life – can also be the source of many problems that we think are based in some other area.
No matter what our weight and activity level, I believe we also have to see our doctors early and rule out any congenital issues that could harm us down the road (including knock knees, hip dysplasia, flat feet, etc.) through regular physicals and getting x-rays to view the bone structure properly. Women are at a risk for hip dysplasia at 8 times the risk of men, we usually have a higher osteoporosis risk, and that our knees are generally also more vulnerable. Addressing our imbalances or congenital issues sooner rather than later will help lower our injury risk to start with, and may help us recover more quickly from any injury that has occurred.