10 Proven Strategies
Athletes spend significant time working to improve performance, and there are times when you're aiming for that next level that you might feel some increased soreness or an occasional tweak.
Usually dialing back on the intensity, load, or range of motion for a few days can clear up the additional soreness and training can return to normal.
But what happens if it’s something more significant that doesn’t seem to be getting better with activity modification?
Here is a starting point for what to do when your pain doesn't seem to be getting better but you want to stay active and keep training.
1. Take the time to keep track of your symptoms. Look for patterns of positions, loading, or movements that make them more noticeable and what helps to improve them.
A physical therapist can test your movement and notice where you might be avoiding specific movements or losing range of motion.
2. After mapping out your symptoms – look at what movements you can still perform without aggravating your issue more. It’s important to stay active during an injury.
3. Unload the irritated tissues during training– Sometimes you need to unload an irritated tissue to avoid overstraining it.
There are still ways to load surrounding tissue and muscles to continue working toward your goals while respecting the healing process.
For example: Using a belt squat variation can help build leg strength in someone who is having a hard time tolerating compressive loads of barbell squats.
4. Avoiding all painful motions is oftentimes not the answer.
Many muscle and tendon injuries require loading to heal and return to previous levels of fitness. It’s about modification of load, range of motion as well as intensity/duration. Load the tissue to levels that challenge the tissue but allow it to recover.
For example: Modifying a bench press to a floor press in the setting of a strained pec muscle or modifying the deadlift by elevating the bar a few inches off the ground while recovering from low back pain can serve to still load the tissue and continue building strength and confidence.
Deadlift From an Elevated Surface to Reduce Range of Motion
5. Use different variations of exercises – Small changes in movements you typically perform can be another great strategy for moving the dial forward while you are recovering.
Changing your grip, trunk angle, knee position, etc. can change the stresses your body is under.
For example: The front squat typically demands a more upright torso compared to the back squat. If you are having hip or back pain, this change in the setup can allow for pain-free training.
Front Squat with a more upright torso
Back squat with a more forward-leaning torso
A good physical therapist can show you what to do to keep training without irritating your symptoms, allowing you to maintain strength & motion while also healing.
6. Change up the loading.
Many times you want to train hard and heavy, but sometimes don’t have the capacity to push a maximal effort.
To keep training, you can modify your loading by lifting lighter weights but increasing the volume to create hypertrophy. This allows progressive loading of injured tissue to continue to promote strength and tolerance to heavier loads.
One example of this might look like this:
Week 1: 3 x 20-25 @ 25%
Week 2: 3 x 15-20 @ 35%
Week 3: 3 x 10-15 @ 45%
Week 4: 5 x 8-10 @ 55%
Week 5: 5 x 5-8 @ 65%
Week 6: 5 x 5 @ 75% - with the aim to return to your previous programming based on symptoms. This process can take several additional weeks depending on an individual case.
A qualified physical therapist can walk you through a plan specific to your symptoms and guide your recovery training plan.
7. Your technique can be a part of the equation when looking at the cause of an injury.
Take some time to dial in your form and make sure it is as efficient as possible.
This is another area where it’s essential to find a good physical therapist who understands injury as well as movements and loading that are specific to your sport.
8. Account for other factors that play a role in your body’s ability to recover including sleep, nutrition, hydration, and stress.
9. Trust that rehabbing an injury is a process.
Oftentimes with chronic/long-term issues, you won’t feel symptoms like pain or swelling right away. Sometimes the problem has been going on for a while so it will take longer than we think to see some progress in return to sport.
Dialing up the intensity and volume coming back from an injury is often a non-linear process.
True tissue injuries take time to recover.
Stick to a plan and document your progress for reassurance that things are improving when you get frustrated.
10. Ultimately, a physical therapist versed in the movements and sport you are training for will help you understand exactly what's actually going on and how to best work through an appropriate progression toward recovery.
Instead of spinning your wheels trying to figure things out on your own, a performance physical therapist will come up with a customized plan to modify your training to continue working toward your goals without taking unnecessary time off.
In conclusion, when working towards improving performance, it's typical for athletes to experience increased soreness or occasional tweaks.
Your first step should be to dial back on intensity, load, or range of motion for a few days.
However, if the issue persists and does not improve with activity modification, it may be something more significant that requires further attention.
Use these ten recommendations to have a context for understanding movement and training while injured, and reach out to a qualified physical therapist to get back to your sport quickly and stay resilient for the future.
***Disclaimer: None of the above should be considered medical advice and should not be substituted for care from a licensed medical professional. Use the above as information for discussion and dialogue with your medical team.***