Training Around an Injury: Staying Fit While Something Heals
You can usually keep training while an injury heals, as long as you get it properly assessed first, train the parts of your body that are not injured, and use pain as a guide rather than something to push through. For most common niggles, a sore shoulder, a tweaked back, an irritated knee, complete rest is rarely what a physiotherapist recommends once the first few days have passed. Staying active keeps your fitness, your strength and your routine, and gentle, controlled movement often helps recovery. The rule is simple: if an exercise makes the injured area sharply painful or worse the next day, change it or drop it. Diagnosis and rehab belong to a GP or physiotherapist; a coach’s job is to keep everything else moving.
This article is about the practical side: what to do in the gym while something is healing, and the mistakes that turn a two-week problem into a two-month one.
First, get it looked at
Before you train around anything, know what it is. A coach cannot diagnose injuries, and neither can the internet. The NHS page on sprains and strains covers what to do in the first days and when to get help.
See a GP or go to urgent care if there is:
- Severe pain, swelling or bruising, or you cannot put weight on a limb.
- A joint that looks deformed, locks or gives way.
- Numbness, tingling or weakness that spreads.
- Back pain with problems controlling your bladder or bowels, or numbness around the groin or bottom. That needs urgent attention.
- Pain that is not improving after a week or two, or is getting worse.
Once you have a diagnosis and a physiotherapist’s guidance, training around the injury becomes much safer and more productive.
Why total rest is rarely the answer
After the first acute phase, most soft tissue injuries benefit from gradual, appropriate loading. Muscles, tendons and ligaments adapt to the stress put on them; complete rest takes that stimulus away. Rest also costs you elsewhere. A fortnight on the sofa with a sore ankle means lost fitness, lost strength in the other leg and both arms, and very often a lost habit. The person who keeps training their upper body twice a week while an ankle heals usually comes back to full training far more easily than the person who stopped altogether.
Using pain as a guide
Physiotherapists often use a simple traffic-light approach to pain during exercise. Your own physio may give you a specific version; this is the general idea.
| During or after exercise | What it usually means | What to do |
|---|---|---|
| No pain or mild awareness | The load is tolerated | Continue; progress gradually |
| Mild discomfort that settles quickly and is no worse the next day | Often acceptable | Keep the load the same for now |
| Sharp pain, or worse the next morning | Too much, too soon | Reduce load, range or volume, or change the exercise |
The next-morning check is the most useful one. Many injuries feel fine during a session and complain later. Our piece on why pain is not the goal covers the difference between effort and pain.
How to train around common problems
Shoulder
Most lower-body work carries on: goblet squats, which avoid holding a bar across the shoulders, split squats, hip hinges. For the upper body, many people find pulling more comfortable than pressing, and pressing at a lower angle more comfortable than overhead. The cable station is useful because you can adjust the angle precisely. If overhead pressing hurts, a dumbbell floor press, where the floor limits the range, may be tolerable. Our guide to shoulder discomfort on the bench covers setup changes.
Lower back
Often the hardest, because so much loads the back. Machines and supported positions help: seated rows with chest support, lat pulldowns, split squats holding light dumbbells. Gentle walking is usually encouraged. Avoid heavy spinal loading until your physio clears it.
Knee
Upper body training continues as normal. For the legs, there is often a range or depth that is comfortable: a box squat to a higher box, hip-dominant work such as glute bridges, and cycling on the air bike if it is pain-free. Train the uninjured leg too.
Wrist or hand
Swap barbells for movements that do not load the wrist: cable work with straps, leg exercises without holding weight, and the air bike if gripping is comfortable.
Ankle
Seated and lying upper-body work, glute bridges, and leg work for the uninjured side. Once your physio says so, gentle range-of-motion work.
A simple plan for the weeks while it heals
- Get a diagnosis and your physio’s dos and don’ts in writing. Bring them to your sessions.
- List what you can do pain-free. You will be surprised how long the list is.
- Keep training frequency the same. Same days, same times. The habit matters as much as the work.
- Do the rehab exercises first. At the start of the session, while you are fresh, not as an afterthought.
- Build back gradually. When you return to the movement that was injured, start lighter than you think and increase week to week.
- Train the other side. If one arm or leg is out, training the other is worthwhile and helps maintain strength.
Mistakes that make it worse
- Testing it every session. “Let’s see if it is better” with a heavy set is how it stays injured.
- Using painkillers to train through pain. Pain is information. Masking it to lift is a poor idea.
- Stopping everything. Fitness, strength and routine drift away together.
- Going straight back to the old weights. Even once pain-free, tissues need time to rebuild capacity. See getting back after a break.
Where a coach fits in
A good coach works within your physiotherapist’s guidance, not around it. In practice that means adapting every session to what you can do that day, choosing the right variation of each exercise, and keeping the rest of your training moving so that when you are cleared, there is not much to rebuild. In a private studio there is no pressure to perform or keep up; you do what your body allows. If that is useful to you, see how 1-1 personal training in Highgate works, with prices on the personal training page.
Check with your GP or physiotherapist first before training with an injury, and also if you have a heart condition, are pregnant or are returning after a long break.
Questions we get asked
Should I rest completely when injured?
For the first few days of an acute injury, often yes. After that, most physiotherapists encourage appropriate movement. Follow your own physio’s advice.
Is it OK to train with a little pain?
Mild discomfort that settles quickly and is not worse the next day is often acceptable. Sharp or worsening pain is not.
Can a personal trainer help with rehab?
A trainer can support the plan your physiotherapist sets and train everything else. Diagnosis and the rehab plan itself are for a physio or doctor.
How do I know I am ready to return to full training?
When you have full, pain-free movement and your physio has cleared you. Then build back gradually over several weeks.
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