Training Around Injury: How to Modify and Stay Strong

In a strength and conditioning setting, injury is not a question of if but when. For general population clients, injuries may stem from previous sport participation, occupational stress, sedentary lifestyles, degenerative conditions, or acute incidents outside the gym. Unlike collegiate or professional athletes, general population clients often lack access to full-time medical teams and may present with incomplete rehabilitation histories. The role of the strength and conditioning professional is not to diagnose or treat injury, but to appropriately modify training to maintain progress, reduce deconditioning, and support long-term resilience. Training around injury requires clinical awareness, programming creativity, and disciplined decision-making rooted in movement quality and load management.

In order to train around injury, it is important to define the scope of practice for strength and conditioning professionals. While not physical therapists, personal trainers are tasked with keeping global strength throughout the body without sacrificing previously made progress, or progress yet to come.

Additionally, personal trainers are also tasked with preserving aerobic/anaerobic conditioning and reducing detraining onset by the nature of the injury. It is often considered that rest is the most optimal form of recovery from injuries. While this may be valid in acute settings, long periods of rest post-injury can actually prove more detrimental to our physiological systems. The importance of maintaining some form of exercise during injury is paramount. This doesn’t mean the location of injury should be directly targeted at all times, however the surrounding muscular tissue is just as important as the injury site itself. 

How We Modify To Keep You Training Around Injury

Modifying Range of Motion

Altering joint range of motion (ROM) is one of the most effective tools for training around injury. By adjusting ROM, strength and conditioning professionals can maintain muscular stimulus while reducing mechanical stress on sensitive tissues. For example, if a client has experienced a knee injury (e.g., ACL, PCL, or patellar tendinopathy), using a box squat can limit excessive knee flexion while still strengthening the quadriceps, hamstrings, and hip extensors.

This modification reduces joint excursion and potentially provocative angles without eliminating the squat pattern entirely. Load selection will vary based on training age and injury severity; however, range of motion is often the first variable that should be modified when pain or irritation arises. Preserving the movement pattern while controlling depth allows continued adaptation without unnecessary aggravation.

Modifying Load and Tempo

Load is typically the final variable to significantly increase following injury. High mechanical loads can place excessive stress on healing tissues before they are sufficiently prepared to tolerate it. For this reason, manipulating tempo in conjunction with reduced load provides a strategic pathway toward restoring full capacity.

Controlled eccentrics and isometric contractions are particularly useful during this phase. These methods enhance motor control, increase time under tension, and promote tissue remodeling without requiring maximal loading. For instance, if a client is returning from a lumbar-related injury and is cleared for hinge-based work, the prescription may emphasize:

• Mid-thigh barbell isometric holds (10–20 seconds)

  
  

• Rack pulls above the knee with a 3–4 second eccentric focus

  
  

Both variations allow activation of the posterior chain and spinal extensors while minimizing excessive spinal flexion or compressive stress. Over time, load can be reintroduced progressively as tolerance improves.

Modifying Exercise Selection

Exercise selection must remain fluid when training around injury. No two clients present identically, and pain is often position-specific rather than pattern-specific. Strength and conditioning professionals must recognize that similar physiological stimuli can be achieved through multiple movement variations. Consider a client with shoulder irritation who experiences pain during deep shoulder extension while bench pressing. A practical modification would be performing the bench press from pins positioned at or just above the sticking point. This maintains pressing strength and neuromuscular stimulus without forcing the shoulder into a provocative range.

Additionally, it is important to consider multiplanar functions. The shoulder joint is multiaxial, and discomfort may present in one plane of motion but not others. If a client experiences pain during a front raise (sagittal plane, anterior deltoid emphasis), modifying the exercise to a lateral raise (frontal plane, medial deltoid emphasis) may allow continued training of the shoulder complex without exacerbating symptoms. This principle reinforces a critical concept: when one variation becomes intolerable, the entire movement category does not need to be eliminated. Instead, intelligent substitutions can preserve training continuity.

Summary

Training around injury within a strength and conditioning setting requires adaptability, restraint, and a clear understanding of professional scope. For general population clients, the objective is not to eliminate movement, but to intelligently modify it in a way that preserves strength, conditioning, and confidence while respecting tissue tolerance.

By adjusting range of motion, load, tempo, and exercise selection, practitioners can maintain meaningful training stimulus without exacerbating symptoms. Ultimately, injury should not signify regression, but rather a temporary shift in strategy. When approached with disciplined programming and sound clinical judgment, periods of injury can become opportunities to reinforce movement quality, improve positional strength, and build long-term resilience.