Stay In The Game: How to Train Around Injuries

By the time you’re 30, you’ve collected a list:

A wrist that aches when the weather turns.
A knee that doesn’t really love deep squats anymore.
A shoulder that complains when you reach behind your back.

You got those from sports, or from work, or from the simple math of three decades of opening every door with the same hand.

The list is real, and it’s not going away.

Oh, and bonus! (?) At 40, 50, 60, etc., it just keeps getting longer…

The fitness industry has a lie it likes to tell about that list: that you’re broken. You don’t match a baseline image of a body without history, so the right move is to fix yourself with the right corrective sequence, the right mobility work, the right protocol.

You’ll know you’re done when you’re symmetrical, pain-free, and ready to train like everything started yesterday 🤣

My friend, that is never going to happen.

Every person you’ve ever seen lift weights, climb a mountain, or run a marathon was working with a body that came pre-loaded with stuff. Their bodies have history, and so does yours.

When something’s actively hurt or healing, that history brings higher stakes. You’re in a negotiation.

Your body says: I’d like to keep moving, here are some specific terms today. The successful version of training-with-an-injury respects the terms, gets your work in anyway, and doesn’t trade tomorrow for today. The unsuccessful versions look like you’d expect. You stop completely and lose your fitness.

Or you push through and extend the flare for another two weeks.

This article is about the negotiation.

Most of it works for both fresh injuries that are healing and chronic stuff you’ve been managing for years. The framework is the same. The application changes with the situation.

🎙️ A Physical Therapist’s Advice for Training Around Injuries

Here’s me grilling Jarlo on this in real time. Based on over two decades of clinical work and tens of thousands of clients we’ve worked with directly at GMB.

More podcast episodes here.

The Two Defaults That Don’t Work Anymore

When something starts hurting in training, most people do one of two things:

1. stop completely and wait until everything feels perfect again
2. push through and hope the body sorts itself out

I’ve done both!

And honestly, either one of them probably worked when you were 22. A teenager sprains an ankle, takes two days off, and comes back at full speed. That’s not your situation now.

After 30, both defaults start failing in the same direction. They cost you more than they give you.

“Rest until you’re 100%” turns into three weeks of nothing, then six, and somewhere around eight weeks you’ve lost meaningful conditioning and developed a quiet fear of the movement that hurt you.

Now the injury isn’t even the problem anymore. The deconditioning and the avoidance are.

“Push through and hope” gives you a flare that lasts longer than the original injury. You felt fine in the moment. The next day you’re worse than you started. Two weeks later you’re still managing it.

Even people who know better (hiiiiii 👋) still default to one of these (embarrassing, but true).

Jarlo and I got into this in the recent podcast. We’ve both had situations where we knew we should rest something, and we kept training anyway, just because we wanted to keep going. He had nine months of strength cycles in motion when his hip flared up in the last six weeks. He almost just gritted through it because finishing what he started felt important. He stopped himself by asking what the six weeks were actually for. He wasn’t headed for an Olympics. He was just headed for another flare.

So this is a good place to be honest with yourself.

If you tend to rest too much when something hurts, you need a structure that nudges you to keep moving. If you tend to push through, you need a structure that tells you when to back off. Most of us know which one we are.

The framework that follows works either direction. You just lean on it from different sides.

First, What Counts as an Injury

The framework here works in two situations. Acute injuries that are healing, where you’re past the worst of it, cleared by a doctor if you needed one, and trying to figure out how to keep training while the tissue settles. And chronic stuff you’ve been managing for years, where there’s no fresh damage but there are limits you have to work with.

It does not work for fresh trauma or severe pain. If you’re in either of those, see a professional first.

When You Should Stop Reading and Call Your Doctor

Some signals mean the article isn’t for you yet. Get medical attention if any of these apply:

• Numbness or tingling that hasn’t gone away in a few days
• Significant weakness, like consistently dropping coffee cups or a foot dragging when you walk
• Pain that consistently wakes you up at night
• Sharp, shooting pain down your arms or legs
• Any pain from a trauma (sprained ankle, fall on a shoulder) that hasn’t improved within a week, or that’s still above 5 out of 10
• Fever, weight loss, or other unexplained changes

These are signs of stuff that needs a clinician’s eye. Don’t try to muscle through them.

What Kind of Injury You’re Working With

For everyone else, it helps to know which of four buckets you’re in. From Jarlo’s twenty-plus years of clinical practice, most injuries land in one of four categories.

Trauma is the obvious kind. You twisted, fell, got hit, and you knew immediately. The damage is proportional to the force. You saw it happen, and the recovery curve is relatively predictable. Bending over to pick up a sock and tweaking your back is not trauma, even if it felt like a specific incident. If the pain is out of proportion to what just happened, you’re dealing with one of the other three.

Overuse happens when you introduce a stress your body wasn’t ready for. You helped a friend move and your back’s annoyed for a week. You added an extra training day and your shoulder isn’t happy. The cause is recent and identifiable, and the symptoms show up within hours or days.

Repetitive stress builds over months or years. The carpenter whose wrist starts aching after fifteen years of swinging hammers. The desk worker whose elbow shows up in their thirties. There’s no specific moment you can point to. The tissue accumulates damage faster than it repairs, and eventually it makes itself heard.

Exhausted adaptive potential is the trickiest one. An old injury healed, but your body compensated to protect the original site, and now the compensation is the thing that hurts. The pain shows up somewhere different from the original problem. Slipped on ice last winter, shoulder hurt for two weeks, and now your neck won’t turn right. The cause and the symptom aren’t in the same place.

The training framework below applies to all four. The reason to know which bucket you’re in is so you have a reasonable expectation for how long things might take and where to look for the actual root.

The 3-Out-Of-10 Protocol

The framework starts with a number. During training, your discomfort in the affected area should not exceed a 3 or 4 out of 10.

Zero is no discomfort at all. Ten is severe pain you can’t function around. Emergency room territory. The middle is a sliding scale you have to calibrate against your own experience, and most people can locate themselves on it within a session or two of paying attention.

Three out of ten is “I notice it. It’s not nothing. I can keep working.” Four is the upper edge before you start compensating around it. Five is too much.

You’re tracking discomfort during the work, not at rest.

If your shoulder aches a 2 just sitting there but doesn’t get worse during your session, that’s a green light. If your shoulder is fine at rest but climbs to a 5 by minute 12 of bear, that’s the signal to back off load or change the variation.

The discomfort can stay flat. It can drop as you warm up, which is normal and fine.

What you don’t want is creep. If you start at 1 and you’re at 4 ten minutes in, and 5 fifteen minutes in, you’re not training the thing you came to train anymore. You’re training the injury.

Why 3, Not 5

The number that shows up in clinical research, particularly the post-op knee literature, is 5 out of 10. There’s a defined protocol for it, with specific rules about backing off when soreness persists.

That protocol assumes a clinician is watching. They are. The patient does the work in a clinic with a physical therapist who can read what’s happening and adjust the load on the spot.

Most readers of this article are training alone, in a living room or garage, with no one to catch a miscalibration. Three gives you buffer.

It also accounts for the delayed-reaction problem, which is the next part of the framework.

Irritability Tells You More Than Intensity

A 4 out of 10 pain that disappears the moment you stop is a different problem from a 4 out of 10 pain that hangs around afterward.

In clinical language, this is called irritability. It measures whether the tissue calms down quickly when you remove the stressor, or whether it stays angry.

Stub your toe in the dark on a coffee table. The pain is severe, maybe 8 or 9 in the moment, but it fades within seconds and you forget about it by morning. That’s not high irritability. The system reacts and resolves.

Now picture the opposite. You’re doing a bear and your wrist hurts to a 5. You stop, shake it out, and ten minutes later it still hurts. You sit down, drink water, half an hour passes. It’s still there, dimmer but present. That’s high irritability, and it’s a more serious flag than the original pain level.

In your training, the irritability test sounds like this. You feel something during a movement. You stop the movement.

Does the discomfort go down quickly? If yes, you’re working with a calm system that just doesn’t like that specific load right now, which is solvable. If no, the tissue is sensitized and you need to think harder about what’s underneath.

High irritability that doesn’t ease up over a few sessions is one of the signals that warrants getting a professional involved.

This is also why we insist on our clients taking a moment to check in after getting started.

After your prep, before you start the main work, take ten seconds to check in. How does the body feel? What’s lit up, and what’s not? In our programs, we built this check-in directly into the structure.

Do no skip this.

The Real Test Happens Tomorrow Morning

You finished your session, you stayed at a 3, you feel fine. That’s not the verdict yet.

Pain has a delayed-reaction property that catches a lot of experienced trainers off guard.

You can do everything right during a session and wake up the next morning with the area noticeably worse. The session was within tolerance for the moment of training, and it pushed past what the tissue could absorb without pushback. The two readings don’t always match.

The real verdict is in the 6 to 24 hour window. Watch what happens that evening. Watch what’s there in the morning. Compare to where you started.

If you’re in a similar place to where you began, the session was well-calibrated and you can train similarly next time.

If you’re noticeably worse the next morning, you went too hard. Take two days off, or do something else entirely. When you come back, drop a level. Less load, narrower range, shorter duration, easier variation. Whichever lever you pulled to push the session, pull it back.

If you’re still sore at the next session two days later, that’s a stronger signal. Take more rest. Drop further. On your return, give it the conservative version of itself. The post-op protocols Jarlo’s referenced operate this way. Persistent soreness across sessions is the trigger for a structured de-load. The same principle applies here.

The harder version of this discipline is when the next-day check tells you something you didn’t want to hear. You felt great during the session. You’re certain you stayed at a 3. The morning is harsher anyway. The morning is the truth. Trust it.

Your First Session Back, Cut Everything in Half

Here’s a common pattern…

You’ve been off for a week or two with something. You’re feeling better, you go to train, and the warm-up feels easy. You think, this isn’t even hard. You add load, or duration, or both. The session feels great.

You wake up the next day feeling wrecked.

Your nervous system remembers what you used to be able to do. Your tissues, the connective stuff and the small stabilizers, do not. They’ve been quiet for two weeks. You can produce the force, but the tissues haven’t been asked to absorb it.

Jarlo’s example from the podcast up there is on point. He hadn’t done pull-ups for a few weeks. He did a couple of sets of twelve, which for him is a warm-up. He woke up the next morning unable to lift his arms over his head. The neurological capacity was intact. The tissue capacity was not.

That’s why our suggestion is to cut everything in half on the first session back.

Half the duration you’d usually do. Half the intensity. Half the volume of any one exercise. It will feel like you’re not training. That’s the point. You’re checking the tissue, not the nervous system.

If the next-day check is fine, work back toward your usual the session after. If the next-day check is rough, you now know your real starting point and can adjust from there.

Pick Your Variables, Then Vary the Load

When something’s tender, the practical move is to lock in everything you can and treat one variable as the dial.

Pick a movement you know well. This is not the time to learn something new. The familiar version gives you a reliable baseline against which to read what your body’s saying.

Set the time at 30 seconds, or whatever short, repeatable duration works for the movement. Time is fixed.

The 3-out-of-10 ceiling is fixed.

The dial is load. How much weight is going through the affected area during the work?

A concrete version. Your right elbow’s been irritable. You’re doing bear for 30 seconds. Start with less weight on that side than feels normal, about half. More weight on the legs, less on the arms, less still on the right arm. Move for 15 seconds and check in. If it’s at 2, fine. Around the 25-second mark you notice it climbing toward 4. Shift more weight to the other limbs, finish the 30 seconds, end at 3. That’s a successful set.

The same principle applies across most movements.

A pull-up doesn’t have to mean your full bodyweight on a bar. It can mean feet on the floor and assistance. An inverted press doesn’t have to mean a full pike with hips stacked. It can be more horizontal, with less load on the shoulders. A squat doesn’t have to mean full depth with full weight. It can be a shallow squat with hands lightly on a counter for support.

This is what most people are looking for when they ask for “modifications,” and the practical advice really comes down to “do what you can.”

Every Rep Is Already a Modification

Walking is not a fixed thing. Across an average day you’ll walk on flat ground, walk uphill, walk downstairs, walk while carrying something, walk while looking at your phone, walk on grass, walk on ice. None of those is your “true” walk. They’re all walking, with the parameters varied to suit the situation.

The movement exercises we teach work the same way.

Bear, monkey, frogger, push-ups, squats, pull-ups all have a clean reference version, and they all have a thousand expressions inside that definition that vary load, range, speed, and support.

When someone asks for “the modification” for an exercise, what they usually mean is: I’d like a version that fits my body’s current condition.

The honest answer in almost every case is: do a bit less.

Less load on the painful side, a shorter range of motion, or a shorter total work duration. Same exercise, done at a level your body can handle today.

This matters because most of the fitness industry has trained people to think about their bodies as broken specimens that need a custom exercise prescription. That’s a nice sales pitch, but it’s not making you stronger.

Real bodies have history.

The modifications you need are usually the same three knobs. Less load. Shorter range. Shorter duration.

There’s a deeper reframe inside this. The exercise bends to fit your body, on this particular day, with this particular history. That mindset alone solves a lot.

When You Have to Lay Off Something, Redirect Smart

Sometimes you genuinely can’t load the affected area today.

Tweaked your knee badly enough that squatting’s off the table. Shoulder won’t tolerate any pressing. The framework lets you lay something off without giving up training.

The wrong move is to take all the energy you would have spent on the irritated thing and pour it into another high-intensity activity. One client told us, “I actually tend to go all out on the healthy parts to compensate for drawback.” He was joking, but he’s also describing the exact pattern that does more damage than good.

The body doesn’t recover well from that, especially when it’s also in repair mode.

The smarter version is to redirect the energy into different attributes. We organize movement quality into three of them: strength, flexibility, and motor control. When you can’t push strength, that’s a chance to put real work into flexibility, or into the precision and control of movements you usually rush through.

You probably know what you’ve been wanting to work on but never make time for. Most of us have been telling ourselves for months that we need more flexibility, or more handstand work, or more time on a specific skill. An injury that takes one option off the table is a reasonable nudge to put time into the other ones.

When the irritated area is ready to come back, you keep the new attribute work and re-introduce the strength work gradually. You end up coming back better-rounded than you were before.

The Other Sixteen Hours

Your training is probably 30 to 60 minutes a day. There are 23 other hours you’re spending in the same body, and they affect the negotiation as much as the session does.

A heavy day at work, where you’re carrying stuff or holding awkward positions, increases the cumulative load on the body. A long flight or a five-hour drive does the opposite, parking joints in compressed positions for hours. A night of bad sleep changes the body’s recovery state. Stress changes inflammation. Sitting at a desk for ten hours is its own kind of repetitive stress.

When you’re working around an injury, none of that is background noise.

Take the situation into account when you set the day’s load. Hauling boxes for six hours? Bring the training intensity down. Slept badly? Drop a level. Just got off a plane? Spend more time on prep. None of these is profound. They acknowledge that the body doesn’t reset between work and training. It carries the day forward.

When to Stop, and When to Get Help

Most readers of this article can self-manage most minor stuff with the framework above. The honest thing to add is a list of conditions where the framework is not enough, and you need a professional.

Stop training the affected area and see a clinician if:

• Your pain is persistently above 5 out of 10 and isn’t getting better
• The discomfort is keeping you up at night
• You have shooting pain that travels (down the arm, down the leg)
• You have numbness, tingling, or weakness that lasts
• The thing isn’t improving over a couple of weeks of conservative work
• You don’t trust your read on it and it’s bothering you

A good physical therapist or sports medicine clinician does two things for you. They stop you from doing things that will make it worse, and they teach you what to do instead. The teaching part is what most people miss. A clinician who only works on you while you’re in the office and gives you no education isn’t doing the better part of the job.

The trade-off is straightforward.

A few sessions with a good professional, even at $150 a visit, is dramatically cheaper than years of an ignored issue that turns into a compensation that turns into a new issue.

That math works out the right way. Don’t try to muscle through something that genuinely needs expert help.

For the Specific Body Part

We’ve built body-part guides covering shoulder, back, hip, and other common areas, with restorative exercise sequences and specific protocols for each.

Use them as your reference for the area you’re negotiating with.

The framework above tells you how to approach the work. The body-part guides tell you what work to do.

The Practice Is the Negotiation

There’s no certificate that says you’re done. No moment where the body becomes a clean slate and you go back to training the way you did at 22.

The list keeps existing. Things keep adding to it.

Your hip in five years will have new history that your hip today doesn’t have.

That’s fine.

It’s exactly what should happen to a person who keeps living and exploring and doing things with their body.

The framework we’re sharing isn’t a one-time fix for a specific injury.

It’s the ongoing process of training a body that has history. The 3-out-of-10 read, the next-day check, the load calibration, the redirect when you can’t load something, the awareness of the rest of your day. None of those go away when this particular injury is no longer the issue.

They scale up and down as your situation changes, and they stay in the practice for the long haul.

You will always be negotiating. That is the practice.

The people who train well into their 60s and 70s and beyond are not the ones with no history. They’re the ones who got good at the negotiation.

Train the Body You Actually Have

The framework in this article is the same one we built into Elements.