How to Work Around Injuries

Sep 15, 2025

a soccer player is laying on the ground — Photo by Omar Ramadan on Unsplash

Things are going well, even great.

You’ve been steady and consistent with training. You’ve been hitting your calories and macro targets.

And then BAM. Now there’s a muscle strain or a joint sprain. Or worse.

If you’re alive, an injury is bound to happen at some point, whether it’s an overuse injury at the gym, a tweak during an athletic event or competition, or you trip over your own two feet at home.

Injuries aren’t just the result of living hard and fast but can even occur in the most habitual and sterile of activities, including eating, drinking, and even sleeping.

In one paper1, researchers combined the stats from two US national surveys to put some hard numbers on injury rates in the US. Among their findings was that there were about 8 injuries for every 200,000 hours of exposure to sleeping, resting, eating and drinking (which comes to less than 1%, but there’s always a chance, right?).

In a meta-analysis of running injuries2, the authors found that novice runners tend to have more injuries per 1,000 hours of activity compared to recreational (more experienced) runners, about 18 injuries compared to about 8, respectively.

In yet another study3, researchers looked at injury rates of different sports for adolescents and young adult athletes (ages 14-21). It was a prospective study (forward and ongoing) for all of 2019. They had close to 500 participants in the study, and the researchers tracked how many of them sustained some kind of injury in their sport. First, about 40% of all of these athletes had some sort of injury during the year. Second, “On analyzing the injury rate by sport, it was observed that soccer presented the highest rate (7.21), followed by judo (4.82) and basketball (4.31).” They emphasized that contact sports have the highest propensity for injury, and American football and contact-fighting sports were not measured, which definitely have higher injury rates.

And with all sports surveyed, “The average injury rate (per 1000 playing and training hours) found in the present study was 2.64 per 1000 h.” This translates into about .0264% injuries per hour of athletic activity. Obviously, it’s not a lot.

Nothing can derail training routines like an injury. So, what do you do? Is it time to stop everything and heal up?

In one study4, researchers interviewed participants who were one to three years post-injury at a Level One university trauma center. The participants came from a range of ages and backgrounds, though mostly men, and the investigators set forth with the intent of identifying what makes a successful recovery.

At the forefront of their findings, the authors’ “analysis adds to the idea that injury can threaten one’s sense of self,” and therefore “highlight the importance of maintaining a coherent sense of self after injury.”

Many athletes, recreational ones but especially professionals, as well as everyday gym-goers root parts of their identity in their physical activities, which is great because it removes a lot of the decision-making and sets up systems of successful and sustainable long-term adherence, which usually--but not always--promotes healthier living.

Still, even for those that are just casually active, even if it’s yard work, having an injury that prevents that activity can be its own heavy load to bear.

So first and foremost, as the authors of this paper explain, an injury can threaten the very idea of who we identify as and who we feel we are, so we must be proactive to maintain that identity or at least work towards transitioning into the new variant.

Lately, at my gym, I’ve seen a young man who has one arm, and he’s been hitting the weights with solid effort. He has something that’s called an adaptive lifting harness secured on his shoulder, which allows him to fasten a bungee cord to it on one end and to a weight so that he can move his shoulder joint through a range of motion under load.

It’s impressive and inspiring for so many reasons.

And it’s a great example of maintaining identity and sense of self after a traumatic injury.

So, if it’s a severe or even a traumatic injury, to the level that it impairs activities of daily living, then yeah, lay off for a bit until you’re recovered enough that you can resume those activities without pain or discomfort.

As I often recount, in October of 2020, I tore the labrum of my left hip, basically because it briefly popped out of the socket while grinding a deadlift. I had to lay off most lower body movements for several months. I couldn’t even sit for a few minutes without being in a lot of pain. Running was off the list. In the gym, I was limited to leg extensions, leg curls, and calf raises. As injured as I was with the chronic pain, I was happy to be able to do that much. Once the acute injury was healed enough, I basically had to rebuild my squat and deadlift, using just an empty bar. It took months to work up to a load that was anywhere near my body weight.

The injury also impacted some upper body movements I can do, even to this day. For example, I can’t really do upper body movements with unsupported static hip hinges, like bent over barbell rows or even seated cable rows. For lower body movements, I can do light RDLs, but that’s pushing it. Ironically, I can still do conventional deadlifts, but I’ve had to modify my form a bit. I can squat, but I just make sure my form is locked in (and I always use safety bars). The one movement that hurts the most, unfortunately, is overhead squats, which I really started loving for a while.

The lesson here is to have the self-awareness, or even an honest conversation with yourself, to know when you have to literally give it a rest so that you can heal up.

And rest means rest, and part of rest is adequate sleep because healing takes place through the immune system, and “Immune responsiveness is degraded by short-term sleep restriction.”5

Moreover, adequate nutrition is key. Nutrition for injury recovery warrants its own discussion, but “Adequate energy intake should be the first nutritional consideration as negative energy balance accelerates muscle loss especially in disuse/immobility period.”6 More than anything, this means that you should not be trying to lose weight while injured, and depending on the severity of the injury, you may want to be in an energy surplus to give your body every resource it needs to heal, repair, and recover.

Let’s say that your sleep is in check, your energy intake is adequate. After that, then what?

If you’re good to go but only are impaired when it comes to exercise training and activity, you want to do as much as you can within reason, which often involves deloading or even unloading an exercise or movement and building it back up again, slowly increasing the load in small increments

Authors of one narrative review looked at studies that got injured athletes returning to their sport.7 The two major conclusions they had were that the sooner the athletes initiated rehabilitation, the better, as well as working a muscle eccentrically and through long muscle lengths.

The idea is to get a jump on being proactive about recovery. Lack of movement and especially unloading a muscle or limb can result in rapid muscle atrophy. Rehabilitation can take many forms, but physical therapy often includes doing as much work around the injury as much as possible, sometimes doing the same movements that caused the injury but doing so without load.

Working a muscle eccentrically is typically the negative portion of a movement, the part where you’re not pushing or pulling but resisting. Working through long muscle lengths effectively means working through its fully stretched position.

For example, I’m currently nursing a biceps strain on one arm, so I’ve limited the amount of biceps work (as well as some back movements that also involve biceps) that I’m doing. Once I feel like the strain is on the mend, I will start doing very light dumbbell biceps curls, focusing on the lowering of the weight--the eccentric portion--and making sure that I’m stretching the biceps as much as possible under load. I’ve actually done this a few times already as a litmus test, using only 10-lbs. dumbbells, but even that was a bit too much, so I’ll check back with that test in a couple more weeks.

Though the authors of this paper don’t get into the specifics, the idea with focusing on slow eccentrics and at long muscle lengths is that there is better architectural recovery compared to regular training or with shortened or shorter muscle lengths. (This is something of a hot topic in exercise science at the moment).

Another idea is that as a muscle stretches, it allows more blood to perfuse it and to do so better, allowing the delivery of more nutrients for recovery.

Being injured is definitely deflating, but it’s important to keep our momentum going, even if that means slowing things down. When it comes to injury recovery, we have to be flexible and work around or with the injury as much as possible. Adequate sleep and calories are the easiest first responders to recruit, but then we still need to keep the injured area moving as much as possible, even if it’s only a little. In this sense, movement is medicine, and motion is lotion.

The Flexitorium by Joseph Anthony

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