“Aaaugh, I’m Injured!”

Injuries Happen

First off, nobody can “avoid injury.” It’s just not humanly possible. We can all mitigate our injury risk.

Second, whether you chose to rest it or rehab it, most injuries feel better in <16 weeks. If you choose to rest it, you’re choosing to remain highly susceptible to re-injury.

Thirdly: If you’re in Peri-Menopause+, it’s not your Imagination. When bodies stop producing estrogen, the threshold for injury and inflammation drops, and voila, it feels like — or is — one thing after another!

How Injuries Happen

• Injuries aren’t caused by “bad form.”

• Injuries aren’t fault of a single exercise performed in one moment (coughs: 😮‍💨Deadlift).

• Injuries occur when training demands exceed your current capacity.

  • In the example here, the cause of injury was not anything about doing the Kettlebell Swings

  • Rather, KB Swings were the point at which overall demand exceeded the individual’s capacity.

• Gradual onset injuries (“lately I’ve been having this XYZ pain”) happen via the same mechanism as acute injuries, just at a more insidious rate.

“How could I let this happen 😥…”

Shame spiraling or blaming is not the best use of your energy immediately post-injury.

Objectively looking at what was different about ‘right now’ can help you start to hypothesize what led to your injury, and what changes you could implement when you get back to post-injury training.

Here are some common pathways:

1. 1. Increased stimulus applied

   • No graded exposure after time off or a previous injury = you jumped right back in at the same workloads you did after a 2-week break off or being sick.

   • Excessive increases in volume (sets x reps x weight), tension, speed, or exercise complexity.

   • Large load jumps (e.g., +20 lb on your squat each week). We want a gradually progressive overload of 2-5% week-over-week.

   • A “I felt good so I went really hard” workout

   2. Suppressed recovery

   • Poor sleep

   • High life stress

   • Inadequate time between demanding sessions

   • Under-fueled training energy (Carbs) and/or muscle repair (protein)

   3. Reduced functional capacity

   • Loss of mobility or flexibility

   • Reduced strength in key ranges

   • Poor strength balance between tissues

   4. Impaired movement variability

   • Longer desk hours recently

   • More or longer drives or flights

   • Training patterns that are too repetitive or redundant

   5. Irritated physiological systems

   • Musculoskeletal changes associated with menopause

   • Medication changes

   • Autoimmune flares

   • Nervous system dysregulation (over- or under-arousal)

   • Gut inflammation

   • Hormonal shifts in pre-/peri-menopause

   6. Psychological or belief triggers

   • Fear or guarding from a past injury

   • Hypervigilance and catastrophizing

   • Movement myths (e.g., “deadlifts are dangerous”)

   7. Program–person mismatch

   • Current training program doesn’t match your current skill, tolerance, or life stress

   • Progressions are too aggressive

     • Example: performing a “heavy triple” the fourth time you ever back squatted

     • Example: going from zero to 50 box jumps in a week

What to do: Days 0 - 3 Post-Injury

Promote blood flow & organized movement:

• Daily cardio, like walking, stationary bike, etc. (while accommodating injury).

• Restrict your activity only enough to mitigate re-injury or prevent additional swelling of injured fibers.

• Movement: (CARs) or other movement through the injured joint’s active range of motion, up to 3×2 min. daily.

• Consider increasing protein intake from 0.7 grams/pound to 15-40% higher.

  • If strained tissue, aim for 0.8 - 0.9 grams/pound of body weight/day

  • If rehab is involved: 0.9 - 1.0 grams/pound of body weight per day

  • If surgery recovery: 1.0 - 1.1 grams/pound of body weight per day

• *Consider taking OTC Painkillers if pain is interrupting sleep, you find yourself severely restricting your movement to avoid pain/jolts.

  • Tylenol at the high end of the recommended dosage (but never more than 4000mg in 24 hours), for as long as you’re serving the needs listed above.

  • Ibuprofen at the low end of the recommended dosage, for the shortest duration necessary (to avoid GI bleeding, kidney damage, & cardiovascular issues).

What to do Days 4+ Post-Injury

1. Get back into your Training Routine

Your usual training routine should resume as soon as possible, as early as 1-3 days after an injury.

The injury will recover better — and feel better — when you stimulate your body to allocate food toward building and repairing (via training), versus ‘taking a break,’ which signals your body to send nutrients to storage in fat cells.

• Training as usual for unaffected areas

• Load Management / Exposure Reduction for injured tissue

  • Adjust exercise set-up to mitigate load on injured tissue

  • Adjust technique to decrease aggravating progress (i.e., shorten jogging stride length while adductor heals)

• Cardio: intentional walks, bike rides, cardio machines - even ridiculously slow - will stimulate anabolic & oxidative nutrient partitioning.

2. Start Training your Injury

Spoiler: If your entire post-injury approach is to rest the injured area and sign up for passive therapies such as massage, cupping, acupuncture, etc. you have a dang high likelihood of incurring the same injury again.

Early movement and loading accelerates recovery and improves long-term outcomes compared to rest.

Rebuilding the injured tissue should look just like any other part of your lifting routine except that you start at a different point on the continuum.

How to Train Injured Soft Tissue

Training injured soft tissue, like a pulled hamstring, aggravated adductor, or torn finger tendon starts

Soft Tissue (muscles, tendons, & ligaments) respond to this step-wise progression:

0. Load Management

• Remove or modify aggravators from current routine

1. Circulation + AROM

• Frequent, low-load movement (Breathing drills, CARs, moving unloaded joint through active range of motion

2. Isometric Loading

• Start at mid-range → progress to longer lengths/end-ranges

• Yielding (holding a position against gravity) → overcoming (applying force against an immovable object)

3. Controlled Isotonics

• Gradual ROM expansion

• Slow tempo

4. Lengthened Loading

• Eccentric bias

• End-range strength

5. Dynamic / Elastic Loading

• Speed, reactivity, perturbation

6. Return to Task

• Gradual exposure to sport or life-specific demands

Severity of injury and the injured tissue quality (muscle, tendon, ligament) will determine where you need to begin on this progression timeline.

Navigating Load: When to Push, When to Wait

Key Guidelines for Soft Tissue Rehab Progression:

• The 3/10 Pain Rule: Keep pain during or after exercise below 3/10; if it exceeds this or lingers 24-48 hours, reduce load.

• Pain Behavior: If pain is sharp, burning, or worsening, stop and rest. Consistent, manageable pain that dissipates quickly allows for continued progress.

• Gradual Overload: Increase weekly volume or load by less than 10% to mitigate re-injury risk

• The "80% Rule": End sessions feeling like you could have done slightly more to maintain consistency without over-overloading.

What to do if an exercise causes a 3+ out of 10 pain response

1. Reduce workload

2. Reduce range of motion, if applicable

3. Rest from activity

4. If recurrent, regress the exercise

Weeks 12+: Mitigate Re-Injury Risk

Whether or not you’re doing rehab work, most injuries feel better by the 12-16 week mark.

It can take up to a year for tissue to regain — and if you’re doing your rehab, surpass — the structural integrity and strength the tissue had before injury.

Your Best Bet Injury Risk Mitigation Payout Pathways

• Manage Menopause symptoms

• Protect sleep quality & quantity

• Take recovery days

• Manage work-home-life stress

• Eat and drink enough to repair and build metabolic tissue

*This is general knowledge information, not medical advice!

References

Musculoskeletal Syndrome of Menopause PMID: 39077777

How Injuries Happen

PEACE & LOVE: British Journal of Medicine https://bjsm.bmj.com/content/54/2/72

Post-injury Protein Intake PMID: 26553492