TL;DR: Training around an injury usually starts with the opposite of the usual advice: more movement, not less. If an old injury or chronic pain has you avoiding the things you used to do, the fix is rebuilding strength through the full range of the joint that hurts, at a pace your body can handle, with a coach adjusting it in real time. Recovery and staying pain free are the same ongoing process, not a six week program that ends.
You used to not think about it. You’d load up for a hike, drop into a squat to grab a kid off the floor, take the stairs two at a time.
Now there’s a pause before each one. The knee catches. The low back flares when you bend to load the car. So you start saying no, and you don’t even announce it. You just stop signing up for the Saturday at Horsetooth and the ski day when the snow’s good.
Maybe this is just my age now. That’s the story you start telling yourself once a joint has hurt long enough, and it’s an easy one to believe.
I believed it for about ten years. My teens and twenties were littered with injuries: broken bones that cost me most of my senior football and lacrosse seasons, meniscus tears, chronic low back pain, plantar fasciitis that wouldn’t quit, and shoulders that dislocated more than once.
It ran right through my twenties and into my late twenties, the years I should have been out with all my friends. Instead I was stuck inside, watching them go do the things I couldn’t.
The worst part wasn’t any single injury. It was that I started to become “the injured one.” The guy who couldn’t do the hikes, couldn’t ski with his friends, sat out pickup games because he was scared of getting hurt again.
But it didn’t have to stay that way, and it doesn’t for you either. What put skiing and hiking back in my life wasn’t rest. It was the opposite, and it’s the same thing I now use with people who walk into RE:GEN carrying an injury history like mine.
Key Insights
- Rest and ice have their place, but past the acute stage, avoiding movement usually makes a stiff, painful joint worse, not better.
- Blood flow is the lever. Training the area that hurts, through a range it can handle, is how it gets stronger and calmer.
- Injury recovery and injury prevention are two sides of one process. Stop the work and the pain tends to creep back.
- A six week protocol that treats everyone the same is not the same as a plan built around your specific joint and your specific history.
- Doing this alongside other people who are also training through something makes you far more likely to keep showing up.
Why Rest and Ice Never Fixed Your Old Injury
Rest and ice never fixed your old injury because that advice stops too early. It calms the joint down for a while, but it does not rebuild the strength the joint lost. So the pain returns the moment you ask anything of it. Over time you stop asking. You skip the hike, sit out the game, and reach for the easy chair. The injury is not really the whole problem anymore. The bigger problem is the identity that grows around it, the quiet belief that this is simply your body now.
That belief is the thing I most want to argue with, because I lived inside it.
Once I stopped playing the sports I loved, the injury stopped being a knee or a back. It became who I was. And an identity is much harder to rehab than a joint.
Here’s the mechanical piece underneath it. When a joint hurts, you unload it. You limp, you shift your weight, you skip the movements that light it up. That protects you in the short term, but muscle answers to demand, and demand just dropped to zero. So the tissue around the joint gets weaker and less able to absorb load. Weeks of that, and the joint is genuinely more fragile than the day you got hurt, which makes the next flare feel like proof that you were right to stop.
Then there’s the layer nobody warns you about. Every flare teaches your nervous system that the movement is dangerous, so your body starts guarding before you even load it. That guarding feels like the injury. It usually isn’t. It’s a habit your body built to keep you safe, and training around an injury the right way is partly about teaching it that the movement is safe again.
How Training With an Injury Looks Different, Depending on Yours
No two injuries hold people back the same way, so no two plans to train around them should look the same either. Some people have a repaired joint that went stiff and quiet. Some have a low back that behaves until a normal day sets it off. Some are managing more than one nagging joint and have stopped trying to predict which one will act up on a given day. What they share is a history that makes normal training feel unsafe, and a list of things they’ve quietly crossed off. Naming which one you are is the first step, because the entry point is different for each.
You had it repaired, and now it’s stiff. The surgery worked, the joint is sound, but it’s tight and weak and it hurts to load. You’re not injured anymore. You’re deconditioned in that one spot, and you need to rebuild it.
Your low back flares on ordinary days. Nothing dramatic. You bend to load the car or sit too long and it locks up. You’ve been managing around it for years instead of fixing what’s underneath it.
You’re carrying more than one. A knee, a hip, a low back. You’ve stopped keeping score of which one will hurt, and you assume any real training will light one of them up.
You were cleared, but you never came all the way back. PT ended, the acute problem resolved, and you were sent off at maybe 80%. You want that last 20% back, the one movement or activity you still will not try.
My Take: More Movement, Not Less
My honest opinion is that more movement beats rest for most people, most of the time. Torn ligaments, torn muscles, and serious injuries need real rest, and I’m not talking about those. I’m talking about the stiff, achy, been-there-for-years stuff. As soon as we can move it, I want to move it, because blood flow is at the center of health. The more blood we get to an area that’s healing, the faster it recovers. The more we keep sending it to an area that has healed, the less likely it is to flare again.
Here’s what I see go wrong. People either train straight through an injury and hope it sorts itself out, or they rest, then go back to the exact thing that hurt them and expect a different result. Both lead back to the same place.
If I take even a week or two off from moving and loading my joints, they start to talk to me. My knees get that tendonitis ache. My shoulders get cranky. The fix, every time, is more blood flow to the spot that’s inflamed, not less movement.
That’s also why I don’t believe in the six weeks and you’re done model that PT usually gives you. Injury recovery and injury prevention are two sides of the same process. The work that gets you out of pain is the same work that keeps you out of it. It doesn’t have an end date.
The other half of my take is that the plan has to be built for the exact joint in front of me. A knee that was surgically repaired needs something different from a low back that flares under a desk job, which needs something different again from a shoulder that has popped out twice. A protocol that runs everyone through the same six exercises is going to overshoot some people and leave others stuck. Training around an injury well means matching the load and the range to your history, then adjusting it week to week as you get stronger.
And I hold myself to the same thing. If I stop doing my own knee and shoulder work, the inflammation and the tendonitis come right back. It is not glamorous, and it never fully ends, but it is the price of doing the things I love without my body getting in the way.
What Actually Works for Training Around an Injury
What works is rebuilding strength through the full range of the joint, at a load it can handle today, with someone adjusting it in real time. This is the heart of ATG-style training, which I found through Ben Patrick, the Knees Over Toes Guy, after physical therapy failed to even diagnose my meniscus correctly. The idea is simple: you build strength in the ranges you actually want to own, so the joint gets stronger the deeper it goes instead of avoiding that range forever. You start where you are, you earn the next inch, and you keep the tissue fed with blood the whole way.
For me, that meant controlled, deep-range work that sent blood into my knee and slowly gave me back movements I thought were gone. It took me over a year to feel like I could perform on my own again. After I finally had the meniscus repaired, using everything ATG had taught me, I was skiing again twelve weeks to the day after surgery.
The other half is that it’s built for you, not off a sheet. We use regressions and progressions so there’s always a version of a movement that fits your joint on a given day. A coach watches the rep and changes it on the spot, which is the part you can’t get from a program you downloaded. And because blood flow is the goal, our sauna and cold plunge earn their place as recovery, not decoration.
A member’s story. (consent pending: confirm Alex’s signed media release in Kilo before publishing)
Take Alex. When he came to me, he couldn’t squat. He couldn’t take a knee. He couldn’t sit crisscross on the floor the way any twenty-something should be able to. Fielding a ground ball hurt.
He’d dislocated the same kneecap three times. The last one needed major surgery, where the surgeon cut the bone, repositioned it, and screwed it back into place. He was bedridden for a while, couldn’t put weight on it, and gained thirty to forty pounds.
That was a couple of years before I met him. By the time he found us, he’d technically recovered. But recovered had come to mean he’d stopped doing anything with the leg. The surgery didn’t leave his knee stiff. The years of avoiding it afterward did.
Before us, he bounced from one physical therapist to the next with no continuity. Each new one just read the last one’s notes. Nobody owned the plan.
We didn’t rest his knee. We loaded it, carefully, a little at a time. At first we stayed in a tiny range, holding on for dear life. Within three to four months he was squatting full range again. By five or six months he was lifting heavier, getting stronger, and losing the weight.
I still remember him sitting on the floor one day, crisscross, telling me he couldn’t do that before.
The hardest part wasn’t his knee. It was trusting his body again. The injury had been traumatic enough that loading the knee felt impossible, long after it was ready. I didn’t think my brain would let me. He got past that too. Now he’s chasing a 225 pound bench and planning to get back on the softball field next summer, not just coaching it.
What the Research Says About Exercise and Chronic Pain
The research lines up with what I’ve watched happen in the gym. Exercise is one of the safest and most effective ways to manage long standing pain, and doing something almost always beats doing nothing. Here is the short version of what the evidence shows.
Exercise therapy is a safe and effective way to treat chronic low back pain, and reviews of the research find that most studies show real reductions in pain and better daily function. Notably, no single type of exercise has proven clearly better than the rest, which is a strong argument for building a plan around the person in front of you rather than forcing everyone onto one protocol.
Strength training in particular has been shown to reduce chronic musculoskeletal pain across a range of conditions, from neck and back pain to arthritic joints, while improving strength, function, and how healthy people rate their own bodies.
There is also good evidence that guided, progressive exercise does more than build muscle. It lowers the fear and avoidance that keep people from moving in the first place, which lines up with what I see every week: once someone loads a movement a few times and nothing bad happens, the guarding starts to fade and the joint feels like theirs again. That is why supervision matters. The same review work that supports exercise for pain also points to better outcomes when the loading is appropriate and someone is guiding it, rather than left to guesswork.
References
- Impact of Exercise Therapy on Outcomes in Patients with Low Back Pain: An Umbrella Review of Systematic Reviews. Journal of Clinical Medicine, 2025. Read the umbrella review on low back pain and exercise
- Strength Training Improves Fatigue Resistance and Self-Rated Health in Workers with Chronic Pain: A Randomized Controlled Trial. BioMed Research International, 2016. Read the strength training and chronic pain trial
- Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments. American Family Physician, 2020. Read the AAFP review of nondrug pain treatments
How to Start Training Around an Injury This Week
Training around an injury does not require a perfect plan or a pain free joint. It requires one movement you can do today without a sharp warning sign, and a way to add a little to it each week. You do not earn the right to start by resting longer. You start where the joint is now and build from there.
Pick the movement you miss most. Squatting down to the floor, stepping onto a trail, reaching overhead. That is your target, and every session points back at it.
Find the range you actually own. Go only as deep or as loaded as you can without a sharp signal. A box to squat to, a shorter step, a lighter carry. That range is your starting line, not your ceiling.
Load it lightly and often. Blood flow is what rebuilds the tissue, so frequent, manageable work beats occasional heroics. A little, most days, moves the needle more than one punishing session a week.
Add a small amount each week. A little more depth, a little more weight, one more rep. Slow enough that the joint keeps saying yes.
Get eyes on it if you can. The fastest progress I see comes when someone else is watching the rep, catching the compensation you can’t feel, and telling you when it’s safe to push. That is the part that’s hardest to do alone.
Frequently Asked Questions
Is it safe to keep training around an injury? For most stiff, long standing aches, yes, and it’s usually safer than continuing to avoid it, as long as the loading is appropriate and someone is watching your form. Serious or acute injuries are the exception and need rest and a professional first. The safest setup for training around an injury is starting light, in a range that doesn’t provoke sharp pain, with a coach adjusting each movement.
Do I need to be pain free before I start? No. Waiting to be pain free before you start is what keeps a lot of people stuck for years. The goal is to find the version of a movement you can do today without a sharp warning sign, then build from there. A dull, tolerable ache that settles quickly is usually fine to work through. A sharp, catching, or lingering pain is a signal to change the movement, not to stop training altogether.
How is this different from physical therapy? PT is often excellent for the acute phase, but it usually ends on a schedule, three times a week for six weeks, and then you’re on your own around 80%. We pick up where that leaves off and keep going for the long haul, in a room full of other people doing the same, so the work that got you better becomes the routine that keeps you that way.
How long until I notice a difference? It depends on the joint and how long it’s been stuck, but most people feel the area calm down within a few weeks of consistent, appropriately loaded work, and start trusting it again within a couple of months. Alex was squatting full range within three to four months. The bigger changes, the strength and the confidence, keep building for as long as you keep training.
What if I’ve already tried everything? Almost everyone who walks in has already rested it, iced it, stretched it, and done a round or two of PT. The piece that was usually missing is progressive loading that keeps going past the point where the pain first settled, built around your specific joint. That’s the gap we fill.
Training Around an Injury in Fort Collins
Fort Collins is an outdoor town. The mountains, the trails, and the snow are a big part of why people live here, and an old injury quietly taking those away is a real loss, not a small one. One of the things we say around here is simple: never let your body get in the way of your life. Skiing and hiking were slowly getting taken from me, and the work I’ve described is what brought them back.
If a knee, a back, or a shoulder has been shrinking your list, come see what training around it actually looks like. You can book a free No-Sweat Intro at RE:GEN and we’ll talk through your history, no obligation to sign up for anything.
Josh Maranian is the Founder and Owner of RE:GEN Fitness Club, a semi-private personal training gym in North Fort Collins, Colorado. The gym specializes in helping adults who want to get strong, move well, and stay consistent without fitness taking over their lives.
