When is it safe to get back to gym after injury?

By Ethan Farr, Sports Myotherapist & Exercise Scientist

This is a bit of a loaded question. There are a lot of factors that contribute to when you are able to get back to exercise post injury; the severity of injury, what kind of injury, your strength/conditioning pre injury and the kind of training you do just to name a few.

Strictly speaking you are able to get back into the gym while injured as long as you are training around said injury and finding no increase in pain or swelling the next day e.g. an injured leg you can still train upper body, however for training the injury there are 3 general phases of healing: the inflammatory phase, the proliferative phase and the remodelling phase.

1. Inflammatory Phase: This is the initial stage of healing and typically lasts between 3 to up to 7 days after the injury. Inflammation occurs as the body's natural response to injury, causing swelling, redness, heat, and pain. During this phase, the body sends blood flow and immune cells to the injured area to begin the healing process.
2. Proliferative Phase: Also known as the repair phase, this stage begins a few days after the injury and can last for several weeks (day 4-21). During this phase, new tissue is formed to replace the damaged tissue. Fibroblasts, specialised cells responsible for producing collagen (a protein that provides structure and strength to tissues), proliferate in the injured area. This phase is characterised by the formation of scar tissue, which bridges the gap in the damaged tissue.
3. Remodelling Phase: This final stage of healing can last for several months or even years, depending on the severity of the injury (generally >17 days post injury). During this phase, the newly formed tissue undergoes remodelling, where it gradually becomes stronger and more organised. Collagen fibres align along the lines of stress, improving the tissue's strength and function. The goal of this phase is to restore the injured tissue to its pre-injury state as much as possible.

What do these stages mean for you and getting back to the gym? Realistically these stages are not quite set in stone as you may be able to tell as there is quite a large range in timeframe that these stages can occur in but these stages aid in creating a general guide to what kinds of exercise should be programmed into your rehabilitation pathway. Generally within those first 3-7 days you should be focusing on reducing inflammation and pain so exercise isn’t your main concern at this point.

However if you must, the exercise you should be doing generally consists of non-weight bearing exercise going through the range of motion of the injured site without increase in pain.
Between days 4-21 you are looking at introducing more weight bearing exercises for things like ankle sprains this could be a little as walking for shoulders you could be looking at light band work trying to use the full range of motion of the joint with some resistance.
In this stage a VAS pain scale can be used to guide your movements and exercise programming a VAS pain scale in this case would be a pain rating from 0 being no pain at all to 10 being incredibly painful, if the exercise you’re doing increases pain to the 7-10 ranges then it is not suitable for rehabilitation and could be doing more damage than good (No pain no gain need not apply to the rehabilitation pathway in this sense).
The last stage of healing is a long lasting stage most people may not even realise they’re still in the process of healing when they’re in this stage, it can present as something as small as having a reduced ability to balance on one leg compared to the other or even just being a little apprehensive in doing certain movements.
At this stage you are looking to incorporate increased challenge to the exercises programmed you are looking at including your bigger compound movements or increasing instability during the exercises, in this stage exercises will generally be guided by your daily life activity needs e.g. working a trade vs office work will have very different needs and if you play sport your exercises can be tailored to your sports needs. 

Getting back to the gym feeling better then you felt pre-injury is what I love about myotherapy and fitness so if you find all of this too complicated to follow but still want to get back to top shape after an injury, I would love to have the chance to guide your rehabilitation pathway and get you back to peak performance. Book with me on a Tuesday, Thursday or Sunday.

Simple Wellness Myotherapy is located at Shop 12B/150 Kelletts Rd, Rowville VIC 3178. Additionally, you can contact us on (03) 8204 0970 to arrange an appointment today.