Updated: Apr 20
Why do we shy away from strength training when there's an injury?
1. It’s what we’ve been taught
In physical therapy school, a lot of the treatments I learned focused on decreasing pain
and other symptoms. We also focused a lot on improving range of motion by stretching
the tight tissues. We learned that if a movement was painful, stop doing it. I think this is
a common thought coaches and athletes have as well. It goes against what we’ve
learned or been told, to now think about using that painful area, strengthening it and
loading it with weight.
I tore my ACL while playing tennis in high school and had to have knee surgery. I didn’t
know this at the time, but if I would have been lifting weights and been stronger, my risk
of injury would have decreased. Even through my rehab process, I don’t remember ever
doing any exercises with weights. Today, I’m sure many people would tell me that I
shouldn’t be squatting with heavy weight because that’s what they were taught.
A few years ago, I had a disc injury in my low back and was told by another physical
therapist that I needed to stop lifting weights. Luckily, at that time I had enough
experience lifting, studying the current research, and working as a physical therapist
and a CrossFit coach, that I knew the answer was not to stop lifting. In fact, progressive
strength training and loading of my spine is what I did to fix my back and what I continue
to do to keep my knees strong and pain-free while also preventing other injuries.
2. We got injured because we were “too tight” or “not flexible enough”
Many of the clients I see believe this is why they got injured and have either been told
by a professional or the Internet that they need to be more flexible and stretch more.
I too have been told that I need to stretch more and that I have “tight” hip flexors and
lats. However, I have a lot of flexibility and feel worse when I stretch or do yoga. I don’t
have enough strength to control all the motion I have in my joints. I have a hard time
finding tension and staying stable when lifting weights. However, all of these things
have improved over time by LOADING my body with heavy weights, not by avoiding
My back injury was life changing for me because shortly after that, I left my job in a
“traditional” physical therapy clinic and joined Arrow Physical Therapy Seattle, where we
focus specifically on strength training with our clients. We specialize in working with
functional fitness athletes and weightlifters, as well as dancers and those with hip
impingement. Most of the clients we see have pain or injuries related to a lack of strength and stability. More often than not, they have been receiving passive treatments
or have only been focused on stretching and avoiding the things that cause pain when
they actually need to be strengthening those things.
My philosophy is to get my clients deadlifting, squatting, pressing weight overhead,
carrying heavy objects or lifting weights in some capacity as soon as possible. Many of
them (myself included) were initially injured because they don’t know how to create
stability and tension within their bodies. It is a common thought that we all need to be
more flexible. This may be true in some cases, but most of the time we need more
strength and stability.
3. We don’t understand that loading tissues is preventative
Current research has shown that stressing tissues (muscles, tendons, ligaments) is
what makes them stronger and more resilient. So, if a tissue is injured, we actually want
to stress it and load it but this needs to be done in a progressive way that will usually
require guidance from a professional. If we avoid doing the painful movement, that
tissue will get only get weaker over time and be even more prone to pain or further
4. We’ve had a bad experience with a personal trainer or a physical therapist
I’ve seen many clients who were injured while lifting weights and naturally they are
scared to try lifting again. But if our clients are scared to workout, scared of injury and
scared of pain, we as healthcare providers and fitness professionals cannot also be
nervous. We cannot be scared to give exercises to clients or give them weights to lift.
We cannot tell them to avoid squats or deadlifts.
Physical therapists and other healthcare providers need to work in tandem with
personal trainers and coaches. Often, we think about the fitness and healthcare
industries as separate.
It is imperative for us, in the healthcare and fitness world, to work together to get
information out there on the importance of strength training and to quit creating this fear
for people around movement and lifting weights.
We are all after the same goal - to help people live their best lives, have less pain, avoid
injuries, gain more strength and be active through the lifespan.
Have you been nervous about lifting weights or going back to the gym? Have you been
told that you shouldn’t squat anymore? Have you had a bad experience with a personal
trainer or physical therapist? I am here to tell you that you don’t have to be afraid to
Beth is a Doctor of Physical Therapy at Arrow Physical Therapy in Seattle, WA. She
graduated from the University of Oklahoma and since then has travelled and worked in
multiple physical therapy settings in the Northwest. In 2016, she began personal training
and coaching group classes at CrossFit Twenty Pound Hammer in Ballard. She has a
passion for combining physical therapy and physical fitness to help others work through
injuries and become more resilient human beings.