Preventing injury when returning to physical activity


The coronavirus pandemic has disrupted many parts of our lives, including keeping us from going to the gym for our normal workouts.

Maybe you’ve longed for the squat racks or swimming pool. Or perhaps you’ve been sidelined by an injury or illness or are otherwise picking yourself up after a period of inactivity.

Whatever the reason, when we return to physical activity we might be rushing into our old routines too quickly. Starting where we left off, whenever that was, is not always the best idea.

Research has found that a rapid loss of muscle mass occurs within the first one to two weeks of disuse. Then the rate of loss slows and each muscle group atrophies at a different rate (1).

The bottom line is that our muscles are not as strong as they were the last time we left the gym. Therefore, our workouts need to be modified to reduce injury risk.

Return to Cardiovascular Training

Whether you are a runner, swimmer or cyclist, returning to cardiovascular exercise can be a challenge after time off. The key is the begin at a lower level than when training ceased. Exercise physiologists offer the guidelines in this chart for returning to running; they can be applied to all cardiovascular exercises (2).

From this beginning, you may progress either your pace or your mileage by 10 percent each week but not both to reduce injury risk (3).

When choosing a running course, look for one that is mostly flat to avoid the additional challenges of hills. Hills can be added as your cardiovascular endurance improves. It is important to ensure proper warm-ups and cool downs before and after cardiovascular endurance.

Return to Weightlifting

Similar to returning to cardio, this requires a decrease in initial weights and a slow progression to return (4). Initially with returning to strength training, you will see improvements with less weight. To determine your initial weight for return, focus on a challenging weight when you reach repetition seven or eight of a 10-repetition exercise. This indicates an appropriate challenge while being able to maintain good form throughout the exercise.

As you progress, you will require more weight to continue to achieve strength gains. Most studies recommend 80-85 percent of your one-rep maximum for the most effective strength training.

As you return to working out, whether after the lifting of a stay-at-home order or other extended period on the sidelines, the most important thing is to you listen to your body. If you are having aches or pains as you return, please reach out to a physical therapist for an evaluation to ensure a safe, individual return.

1. Bodine, S. C. (2013). Disuse-induced muscle wasting. International Journal of Cell Biology, 45(10), doi: 10.1016/j.biocel.2013.06.11.
2. Johnson, C.A.M., Taunton J.E., Lloyd-Smith, D.R., & McKenzie, D.C. (2003) Preventing running injuries Practical approach for family doctors. Can Family Phyisicans, (49).
3. Nielsen, R.O., Parner, E.T., Nohr, E.A., Sorensen, H. Lind, M. Ramussen, S. (2014). Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries. JOSPT, 44(10), 724-840.
4. Kraemer, W.J., Ratamess, N.A. (2004). Fundamental of Resistance training. Medicine & Science in Sports & Exercise, 36(4), 674-688.

Written by Kelly Gerrity, PT, DPT, OCS, Charlotte – Ballantyne, NC center

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