You have pain and a nagging injury that is keeping you from exercising and your family doctor, physiotherapist, chiropractor, and random people on reddit threads are telling you that you have to stop exercising because of it. All you are hearing is that exercise is hurting you and you should rest and stretch instead - but you don’t want to do that.
Exercising is what keeps you healthy. Exercising is what keeps you sane. You get more than just the physical benefits from going to the gym. That time is when you get to socialize with your friends, think and self-reflect, or unwind from the day - it is time for you! Those messages about stopping impact you harder because what you are hearing is that you have to give up your you time and give up doing something you love.
Luckily the people telling you to stop are wrong, and I am here to give you a framework to keep you exercising, keep you in the gym, and keep you doing what you love and NOT giving up on your you time!
This framework can be applied to any exercise and will get you back on track while overcoming your pain.
I'm coining it the WMBP framework
- Find exactly WHAT is painful with the exercise
- MODIFY the exercise
- BREAK the exercise into its parts
- Slowly PROGRESS
Before I get into it, thank you to everyone who voted for the title on instagram.
First you need to figure out exactly what is bothering you with the exercise.
Is it only a certain range of motion? After a certain weight? After a certain amount of reps/sets? Only when you are moving fast? The list goes on and it may be a combination of things. But you need to critically assess exactly what is painful about the movement so that you can use that information in the next step.
I am going to use squats as an example and pretend that I notice my knee is painful when I squat to full depth with more than 405lbs. This is a great example of two things being painful with it. I can squat below 90 degrees with less than 405lbs but the problem is that is below my normal working weight, and I can squat more than 405lbs but I cannot squat to depth without it being painful.
Now that you have information on what is painful about the exercise, you can modify it accordingly.
This keeps you working towards your goals as well as giving you feedback on your progress. If you completely remove the exercise from your training during rehab then you may not be sure that you are on the right track. Your body will also be less prepared for the movement when you do add it back in. From personal experience, this is discouraging and takes a toll psychologically since coming back to the movement feels like absolute garbage and like you have lost so much progress.
The mental aspect that comes with continuing to do your goal exercise in a modified way cannot go understated. It is such a large part of rehab and exercise.
Applying this to my squat example, I will do full depth pause squats with 375lbs. This limits the load at depth so my knee is not bothered, and adding in a pause raises the difficulty of the exercise to make the lighter weight closer to my working weight. And to ensure that I don’t become untrained to having heavier weights on my back, I will do half squats or high box/pin squats with 450lbs. This keeps my body and mind prepared to handle the heavier weights that are often used in my training, allowing for a smooth transition back.
Modifications are great, but one of the limitations is about how hard you can push those exercises.
If the exercise is broken down into its components then it is easier to push those muscle groups close to failure comfortably. This is where the magic really happens and you can actually make some gains and work on some weak points while you are rehabbing.
I’m going to break down the squat. It is a hip hinge, a knee extension, and some dorsiflexion of the ankle (bringing the foot closer to the shin). So I need back strength, glute strength, quad strength, and a little bit of calf strength but mainly sufficient ankle mobility.
To work these I will do RDLs for the back and glutes, knee extensions for quad strength, and full range of motion calf raises for both calf strength and ankle mobility. The knee extensions may also need a range of motion modification, but typically I find them more comfortable due to the decreased absolute load on the knee, and they can still be taken to failure with less range of motion. Other considerations are to work on my adductors and abductors as well. I am already doing that in my regular program so I will just continue working those as normal.
The goal exercise is now modified and the accessory movements are all programmed in, now it’s time to slowly work back to the goal exercise.
Just like with regular training, you want to progressively load the modified squats and the chosen accessories. If you aren’t progressively loading them, then you won’t be strong enough when you come back from rehab and your training weights will go down, or you could be missing out on making gains and coming back stronger. The extra consideration for progressing would be on comfort and tolerance to the activity rather than actual strength. You can use the 3 light system to gauge that and I have made a video on that here which you should watch after reading this.
To progress the modified squat I will slowly add weight to the full depth pause squats, and remove the pause to allow myself to add even more weight. I will also slowly lower the box/pins over time for the heavier half squats until they are getting close to depth, then I will remove the pins and start squatting to depth
The important thing is that I slowly do these progressions over time and not all in 1 or 2 workouts.
Rehab doesn’t mean you have to stop
The WMBP framework shows you that just because you have an injury or pain, it doesn’t mean that you should stop exercising. In fact, if your rehab involves a healthcare practitioner telling you to stop exercising, then that is not rehab. The goal of rehab should be to get you back to your goal exercise, sport, or activity. And in order to do that you need to challenge and prepare your body to handle the activity again - not just relieve pain.
Not only does this framework help to prepare your body for the goal exercise, but the impacts that it can have mentally are astounding. It can help to give you control over your pain and injury, ease depression and anxiety around feelings of not being able to do what you want, and give you feelings of hope to not only get back, but get back stronger and more prepared than ever. Your body is resilient and adaptable; pain and injury don’t have to stop you.
If you want to make sure that you can always come back from injury then save this, print it off, or burn it into your memory.
Thank you for reading!
*This is an informational resource and not medical advice, please consult your healthcare practitioner for diagnosis, treatment, and guidance.