Exercise Modifications to stay in the game

Written by Dr. Kyle Rogus PT, DPT, CSCS, CF-L1, USAW-L1

Do you have an injury but don’t want to skip a workout? Maybe you have a competition or race coming up and you need to train for it? We’ve all been there, injuries happen. But I’m here to tell you that you don’t need to skip the gym if you’re dealing with pain or an injury!

Now, you’re probably thinking, “so and so told me that I can’t do XY and Z because Ihave this going on” or “I’m injured, isn’t rest the only thing that will help?”

Yes, there may be certain movements, positions or loading restrictions you may need to TEMPORARILY avoid based on YOUR individual injury and presentation, but this article is intended to give general strategies for how you can modify your training session AROUND that injury. So let’s shift our mindset from, “I can’t do _____, so I mine as well not workout” to “I can do this ______ instead, and get a similar workout.”

The beauty of exercise is that it is infinitely scalable and modifiable to meet you where you are at.

So, here are our go-to exercise modification strategies that you can use on your own to help you stay in the gym.

Strategy #1) Reduce the Range of Motion

If there is a certain point in the motion of an exercise that increases your pain, cut the range of motion down to stop just before the pain point. Keep a pain-free range of motion during the exercises.

Examples

- Rack pulls instead of deadlifting from the floor

- Squat to a box

- Perform a pushup to foam roller or yoga block

Strategy # 2) Decrease the Load and Add a Tempo

Generally movements performed at high speeds require greater force production and control, something painful areas don’t tend to like. So if you have an injury, try slowing the movement down. Adding a tempo and increasing the time spent under tension of a motion, can be better tolerated and will also lead to great strength adaptations. You can also give isometrics a go. Holding your movement position just above the pain point will help build strength in that range of motion while keeping pain levels low.

Examples

- Add a 3sec negative/lower to the motion

- Add a pause in the middle of the motion

- Hold a Isometric, such as a wall sit or pushup hold

Strategy #3) Change the Exercise Variation

If a certain exercise is painful, or you want to keep a full range of motion, changing the exercise variation that you do can be a great way to keep training that movement pattern. At the end of the day, most gym movements can be broken into 4 categories, upper body press, upper body pull, lower body squat, and lower body hinge. There are a plethora of ways to hit these patters by variating the exercise.

Examples:

- Back Squat to Goblet Squat

- Conventional DL to Sumo DL

- Barbell Press to Dumbbell Press

- Pullups to Chin-ups

Strategy #4) Reduce the Volume

This one is likely a bit self-explanatory, if you cannot tie your discomfort to a certain task, it just hurts, there is a chance you could simply be overworking the area and dong to much. In this case, consider dropping a set or decreasing the reps of an exercise or cutting back on the overall volume you do over a week to allow your body time to recover.

Strategy #5) Focus on Unilateral Work

A lot of the big lifts that we do in the gym are what we call “bilateral” movements, meaning we are asking both limbs (both legs or both arms), to be working together at the same time. If these motions are irritating, try swapping them out for some unilateral work, or movements that require effort from only one limb. This will allow you to keep strengthen the limb with a different task with less overall load on the area, but can be equally beneficial for strengthening.

Examples:

- DL Squatting to Split Squats

- Barbell Pressing to Dumbbell Pressing

- Pullups to Single Arm Lat Pulldowns

Strategy #6) Change the Exercise Selection

If you’ve tried these strategies and the movement still isn’t working for you, or you don’t think you are getting the right stimulus, you can simply substitute the exercise for something else that is more tolerable. This works great if you are training for something, say a marathon but running is bugging you but you need to keep your cardiovascular training, you can substitute running for biking or even swimming.

Examples:

- Biking for Running

- Hip thrusts for Deadlifts

- Dumbbell Bench Press for Overhead Strict Presses

Strategy #7) Use a combination of these strategies

We just talked through a bunch of different strategies to modify your gym routing, but which one you use will be open to you and what your body is able to tolerate. However, it is possible just 1 of these may not be enough and that’s ok. In these cases, feel free to combine 2 or more of these strategies to get the most you can out of your training session.

Examples:

- Dumbbell Floor Press for Barbell Benching (change the variation, the range of motion

and creating a unilateral bias)

- Goblet Split Squats a 3sec lower for Barbell Back Squats (change the exercise selection, add a tempo, screate a unilateral bias)

There is no reason you can’t get a killer training session in while dealing with an injury. If exercise is good for us when we are healthy, it becomes that more important for us when we are dealing with an injury. If you are dealing with an injury and are wondering how to stay in the gym, take these strategies listed above and apply 1 or more of them to your next workout!

As a reminder, these strategies are designed with intent of helping you stay in the gym while training AROUND an injury, they are not intended to address or correct your specific injury. To truly address your pain or injury, we highly recommend that you connect with a skilled physical therapist to evaluate your injury so that they can help you improve your pain, address the main cause, and get you back to your goals, because addressing pain is a highly individualized process that is based on YOU.

Hope you find these tips and strategies helpful!