Weight Lifting Injuries: What To Do When You Think You’re Injured

Let me guess… something hurts?

Maybe your shoulder? Or your elbow? Or your knee? Or your lower back? Or your forearm? Or your hip? Or your hamstring, quad, chest, back, biceps, triceps, neck, ankle or some other commonly-injured part of your body?

Maybe the pain you’re feeling is a muscle… or a joint… or a tendon… or a nerve… or a disc? Maybe it’s caused by a specific thing you’re doing? Maybe it’s caused by a specific thing you’re not doing? Maybe you just slept on it funny the night before?

Or maybe it’s 100 other things with 100 other causes and 100 other solutions. Yeah, probably.

But whatever the hell it is, one thing is certain: you’re injured, it sucks, and you want to get back to 100% as fast as humanly possible.

As someone who has been in that position before with a variety of common weight lifting injuries over the last 14 years, I feel your pain. I’ve also felt the other stuff you’re most likely feeling (or soon will). You know… the confusion, frustration, annoyance, desperation, hopelessness and all of that fun stuff.

So the question is, what the hell are you supposed to do? Honestly, I have no idea. All I can do is walk you through what I’ve found to be The 9 Phases Of Being Injured. Ready? Here we go…

Phase 1: Ignoring it… For Now

Do you know how many times I’ve been in the middle of a workout and thought “hmmm, my elbow felt a little funny on that set” or “hmmm, it felt like I might have tweaked my shoulder on one of those reps” or “hmmm, my knee feels a little strange after that exercise” only to go on to train these same body parts again a few days later and everything is perfectly fine?

Probably dozens of times.

I don’t know what it is and I don’t know why it happens… but I do know that I have occasionally felt some very minor pain or weirdness somewhere during or soon after a workout that went on to become absolutely nothing at all. Whatever it was instantly disappeared and never returned again.

Now don’t misunderstand me here. I’m NOT suggesting that you ignore injuries or train through pain.

I’m just suggesting that rather than immediately freaking out or making huge changes to your workouts or (probably worst of all) driving yourself completely crazy by Googling possible causes until you inevitably connect your minor shoulder pain to cancer, herpes or ebola… maybe just chill out and give it a few days.

There’s a possibility that it’s nothing and you’ll be perfectly fine by the next workout.

Phase 1.5: Ignoring Too Much, For Too Long

The thing about Phase 1 is that it needs to come with two very important rules.

  1. First, that whatever pain you’re temporarily ignoring is something that at the present time is fairly minor. So some slight muscle, joint or tendon pain, or something similar. Anything more serious than that and you should jump straight to Phase 5. (Note that this rule comes into effect automatically during all future phases.)
  2. Second, that you only let Phase 1 last for a short period of time, typically about a week or so.

So as long as you’re following these rules, you’re successfully going through Phase 1 and will successfully move on to Phase 2.

But if you are NOT following these rules, you are instead here in Phase 1.5, which is a phase that guarantees you’re being a big stupid idiot.

Basically, you’re either ignoring something that is already too major to be ignored, or you’re just ignoring something that is minor for far too long which means you’re training through pain and gradually making it worse and worse over the coming weeks/months until it eventually reaches a point where it becomes something major enough to physically prevent you from letting this stupidity continue any longer. Yes, that was a really long sentence.

In case it’s not obvious enough, this is the phase you need to avoid at all costs. Seriously.

Instead, you want to move straight to…

Phase 2: Making Some Minor Adjustments

Let’s say you successfully went through Phase 1 and gave the issue a few days or a week (depending on how your workout split and frequency is set up) to see if it would magically disappear by itself with no additional action taken on your part.

If it did… awesome! You can pass go. You can collect $200. And you can most likely go about your normal training like you normally would while still always being cautious and safe (especially if the issue came about in the first place due to something like your form or overall programming being worse than it should be).

If it didn’t magically disappear, however… then you can not pass go. You can not collect $200. What you can and must do instead is skip directly over Phase 1.5 (the “big stupid idiot” phase) so that you end up right here, in Phase 2.

And what happens here is Phase 2 is pretty simple. You try making some minor adjustments to your training in an effort to avoid the stuff that hurts the most by replacing it with stuff that hurts less or (ideally) not at all.

Here are some examples:

  • Let’s say flat barbell bench pressing hurts. In this case, try doing flat dumbbell presses instead. Or decline barbell presses. Or floor presses. Or push-ups.
  • Let’s say some type of dumbbell pressing (flat, incline, overhead, etc.) hurts. In this case, try doing that same dumbbell pressing exercise with a neutral grip instead.
  • Let’s say chin-ups hurt (underhand grip). In this case, try doing pull-ups (overhand grip) instead. If that hurts, try a neutral grip (palms facing each other).
  • Let’s say dips hurt, and you’re using them primarily as a triceps exercise. In this case, try doing literally any other triceps exercise instead.
  • Let’s say barbell skull crushers hurt. In this case, try doing it with dumbbells using a neutral grip instead. If that still hurts, try doing an overhead triceps extension instead. If that still hurts, try cable push-downs with a rope attachment instead.
  • Let’s say a machine exercise hurts. Try the barbell or dumbbell version of that same exercise instead. Or vice-versa.
  • Let’s say lifting 100% of your usual working weight on some exercise hurts. Try doing that same exercise with maybe 70-80% of that weight.
  • Let’s say ANY exercise hurts. Try doing any other similar exercise instead.
  • Let’s say there is an issue with your form. Have someone who knows what they’re doing look at it, or shoot some video of yourself and compare it to what proper form should look like. And then, correct whatever needs correcting. Details here: How To Learn Proper Form

Basically, determine what aspects of your training seem to be causing the most pain to the injured body part, and then make some minor modifications to those things with the goal being to find what will allow you to continue training in a manner that a) doesn’t make the injury worse, and b) allows it to improve.

If you can do that, you win. But if you can’t, then…

Phase 2.5: The Internet Diagnosis

Now let’s say you successfully tried Phase 2 for a bit, but found that those minor adjustments alone aren’t enough. The pain is still there just the same (or has gotten a little worse) and every minor adjustment you’ve tried caused similar amounts of pain.

What now?

Now is when you move on to a phase that has the potential to be great or horrible, and it’s completely optional even though it’s pretty much 100% guaranteed to occur. In fact, chances are it has already occurred before this point. And that is of course the phase where you turn to the trusty internet to help you diagnose your injury and figure out what the hell you need to do to train around it and/or fix it.

And there are plenty of different ways this can go.

In a perfect world, you’d quickly come across something or someone that actually helps you, and you’d go on to use that information to get back to 100%. Believe it or not, this is a real scenario that actually DOES occur sometimes.

Just not every time.

Because as I mentioned earlier, this is the phase where you can very easily drive yourself insane. Not just by somehow connecting a minor muscle/tendon/joint injury to some kind of serious life-threatening illness, but also just because every damn injury has the same damn symptoms!

Sure, there are important subtle differences and proven tests that will allow a qualified professional to figure out what the true problem is and accurately differentiate between similar causes of pain.

But we’re not qualified professionals.

We’re dumbasses on the internet searching around in hopes that we’ll accidentally stumble upon something constructive.

Or dumbasses posting on some fitness forum in hopes that some other unqualified dumbass can tell us something useful (“Sup bros, my shoulder/elbow/knee/lower back/etc. hurts when I lift. What could it be?” 2 minutes later… “Sounds like AIDS, brah.”).

Or, after you’ve exhausted all of those “resources,” dumbasses getting in touch with someone who they trust and feel might be knowledgeable about their injury.

For many people, I’m this guy. And while I’m flattered that I fit this description for you, the honest truth is that it’s just impossible to give any kind of injury advice or diagnosis over the internet based on what is often a pretty generic description (“it hurts when I bench press, wtf?”).

And much more importantly, while I do have a good amount of experience with and knowledge about certain injuries (primarily involving shoulder and elbow pain), I will gladly admit to mostly just being a more experienced version of the exact same clueless dumbass you are.

Which is all my way of saying that when you go wandering into the depths of the internet in hopes of identifying and solving your injury problems, you might sometimes find something that legitimately helps you (again, it DOES happen… there is some high quality info out there) OR you might just as easily find something that leads to you making things much worse.

The exciting part? Most people won’t be able to tell the difference.

Phase 3: Making Some Major Adjustments

So you tried making some minor adjustments for a little while, and they didn’t seem to help at all. The next logical thing to try is making some major adjustments. This is that phase.

Now instead of trying to replace one pain-causing exercise with a similar exercise that hopefully doesn’t cause pain or at least causes less pain, it’s time to just stop doing that type of exercise… period.

Basically, whatever type of exercise is giving you any sort of problem, stop doing it altogether for a while.

Let me give you two real life examples…

  1. There was one point where my shoulder bothered me on every overhead pressing exercise, including all of the typically “safer” variations of them that I experimented with in the “minor adjustments” phase. However, lateral raises always felt fine. So, in terms of shoulder training during that period of time, lateral raises became the only shoulder exercise I was doing. The rest of my training for other body parts remained exactly the same. This adjustment not only allowed my injury to heal, but it also allowed me to continue making a surprising amount of progress (including to my shoulders). The exact workout routine I used at this point is actually included in Superior Muscle Growth (it’s “Version 5” of The Muscle Building Workout Routine).
  2. Similarly, there was another point where all vertical pulling exercises for the back (pull-ups, lat pull-downs, etc.) bothered my elbow, yet most horizontal pulling exercises for the back (various types of rows) felt fine. So, during this period of time, I replaced the vertical pulling exercises in my training with horizontal pulling exercises (and to keep more emphasis on the lats like my intended exercises would have, I did rowing exercises with a narrow neutral grip, elbows tucked in close to my sides, and the weight pulled more toward my hips/lower stomach rather than my upper stomach/chest.

Phase 4: Taking A Short Time Off

Uh oh…  the major adjustments didn’t help either. Now what?

Now it’s time to give the old “take a week or two off” suggestion a try. And that’s what Phase 4 is.

So, take a week or two completely off. Don’t worry, you won’t lose muscle.

And when I say “completely off,” you really have two slightly different options:

  1. You stop training completely.
  2. You stop training the half of your body where the injury is located. For example, if your elbow hurts, take 1-2 weeks completely off from training upper body, but continue training lower body. If your knee hurts, stop training lower body, but continue training upper body. HOWEVER, while this option seems better than #1 because it still allows you to train something during these 1-2 weeks, there is an important warning to keep in mind. And that is that there’s overlap here that might not be entirely obvious. For example, a shoulder injury could be significantly worsened as a result of holding the bar in place for squats. Hell, just picking up plates to load up the leg press could be problematic for an upper body injury. From the other perspective, plenty of lower body injuries can be worsened during upper body training (e.g. stability during bent over barbell rows, leg drive during pressing exercises, etc.). So yeah, this option sounds much better, but there is potential for it to be counterproductive.

Whichever option you decide to go with, my only other suggestion would be to avoid constantly “testing” the injured body part to confirm that is still hurts during this time off. Just try to rest and relax and forget about it.

And if there happens to be something that you can do that might help that injury heal better/faster/even at all (e.g. soft tissue work, rehab exercises, etc.), it might be a good idea to do it. Then again, it might not be.

Why? Because we’re mostly all just clueless dumbasses who don’t actually know with absolute certainty if the “helpful” rehab exercise we stumbled across is truly helping us, or if it’s the opposite of what we should actually be doing and therefore only making things worse.

For example, there was one time where the rehab exercise I was doing was THE KEY to me getting back to 100%. Then there was a time where something else I was previously doing for that exact same injury ended up being something I later realized only made it worse.

All part of the fun of being injured, I guess.

Phase 5: Doctor Time

Now you’d think this right here would have been Phase 1. Something hurts? Go see a doctor. Makes sense, right? I don’t disagree.

But this is an article that is based in reality, and the reality is that going to the doctor for every little pain you feel is going to be overkill in most cases.

More reality: most people hate going to the doctor (and/or can’t afford it), so they’re typically not going to go no matter when I suggest it in this article.

Worst reality of all: based on my own personal experience with seeing various doctors for my own weight lifting injuries as well as the experiences I’ve heard from countless other people who have done the same… the unfortunate truth is that many doctors are completely fucking useless in every way imaginable.

No offense to the good doctors that might be reading this. Assuming of course you actually exist.

Let me explain.

First of all, you have your GP/family doctor. These guys are lovely if you need a basic physical or a blood test or have a sinus infection or bad cold or something similar. But if you show up with a typical weight lifting injury (let’s say a rotator cuff issue), the very best you can hope to get from this kind of doctor is a referral to some sort of specialist.

And in my opinion, that is the only reason to ever see this kind of doctor for an injury.

I personally have some great stories I can tell you. For example, I once went to my GP years ago because my shoulder hurt. After first suggesting scoliosis (I shit you not… this dude randomly said the word “scoliosis” out loud to me), he immediately changed his mind and told me to lift my arm above my head while asking “does that hurt?” to which I said “not really” at which point he said something along the lines of “you should do more exercise [motioning an overhead press]… exercise is good for your shoulder.”

Thanks doc, awesome advice! I’ll be sure to come again.

From there you have specialists like physical therapists, sports medicine doctors and orthopedists. In most cases, this will be a huge step up from the uselessness of your GP. However, a huge step up from “useless” might still not be all that great.

See, if you’re really lucky, you might somehow end up in the hands of someone who knows what they’re doing. Someone who will properly diagnose the injury and clearly explain exactly what needs to be done to allow you to keep training (if it’s at all possible) while getting you back to 100% as soon as possible. They’ll also be able to explain what caused it in the first place, how to avoid it in the future, and basically provide you with the answers you need to leave their office feeling confident and hopeful.

And then there’s the other 90% of the time.

Alright, maybe 90% is an exaggeration. But as someone who has consistently walked out of the offices of highly qualified specialists feeling nothing but annoyance and disbelief at the often surprising lack of knowledge that was displayed (and also as someone who has heard the EXACT same thing reported by tons of other people dealing with their own injuries), it sure as hell does feel like 90% sometimes.

And I have plenty of fun stories I can tell you here, too.

Like the one time I went to an orthopedic surgeon (who specializes in sports injuries involving the elbow) who suggested a cortisone shot – something that treats inflammation – for medial epicondylitis – an elbow injury that at that stage is tendonosis (not tendonitis) and therefore is not inflammatory.

Or the time a physical therapist showed me a specific rehab exercise I needed to do. He told me to start with a 1lb weight, gradually work up to 2lbs a few weeks later, and 3lbs a few weeks after that… and NEVER EVER EVERRRRR go heavier than 3lbs. Funny thing about that… it took going up to 25lbs for that exercise (at the advice of another, better doctor) to actually be useful for me and become the thing that got me back to 100%.

I can keep going.

So I guess the best way I can explain this phase is like this. See a doctor, ideally one who specializes in whatever type of injury you think you have, and keep your fingers crossed (unless your fingers are where the injury is… then maybe try a rabbit’s foot instead).

If they end up being useful, consider yourself lucky and hang on to their number for dear life. If, however, they end up being useless, get a second opinion. If they’re also useless, try a third. And if they’re useless (or you don’t have insurance and this insanity is getting too expensive)… you move on to Phase 6.

Phase 6: Hopelessness

Ah yes, hopelessness.

You’ve given it time, made minor adjustments, major adjustments, removed entire categories of exercises, took a couple of weeks completely off, saw a doctor or two (or three) and are no better off at all.

Nothing has changed. Nothing has improved. You’re not any more clear on what you need to do to fix it or train around it. Things are just horrible and seemingly hopeless.

So maybe you get a little pissed off and think “You know what? The hell with doctors! I’m going to solve this thing myself and become my own damn doctor!” at which point you go back to searching the internet in one hardcore last ditch effort to find something that you somehow missed the previous 400 times you went searching that will contain the useful problem-solving information you’ve been seeking.

And when that doesn’t work…

Phase 7: Taking A Long Time Off

The most time I ever missed due to injury was about 3 months (although technically I was still training legs once per week at the time, but I was limited to just leg presses/leg curls/calf raises).

And let me tell ya, I hated every second of those 3 months. There were many reasons for this hatred, but somewhere near the top of the list was of course the significant amount of muscle (and strength) that I slowly lost in the process. And for those who don’t keep their diet in check as well (my diet was kept in check), the significant amount of fat that is gained in the process.

I wish there was something better I could tell you about missing more than just a couple of weeks of lifting, but there isn’t. Progress will be lost. And the longer you’re out, the more progress you’re going to lose. It sucks, but it’s just unavoidable.

The slightly good news is that there are things you can do to A) lessen the amount of muscle you lose, B) ensure you don’t gain any fat whatsoever, C) keep yourself as sane as possible during this time, and D) get back to 100% as quickly as realistically possible.

I cover all of this in detail right here: How To Maintain Muscle When You’re Injured

And hey, bonus good news: muscle memory is real and spectacular.

Phase 8: Returning From A Long Time Off

Two ways this can go.

The first is the good way… where you return very slowly and very lightly to the stuff that was causing pain for you to find that… holy crap… it doesn’t hurt anymore! Hooray! It worked! The significant time off worked! And then you just gradually work back up and return to training like you previously were (while being smart enough to make whatever adjustments you need to make to avoid ever pissing off this injury in the future), and everything remains perfectly fine.

YES! Whatever the issue is, it has magically healed itself. This is a good feeling.

And then there’s the bad way. The way where you return after a significant period of time off only to find that virtually nothing has changed. Whatever the problem is… it’s still there. WTF?!?!

And if that happens, it’s time for…

Phase 9: Good Luck

This is honestly not a phase that I have ever been in, so if you’re somehow here… all I can do is wish you the best of luck because I’m completely out of ideas. Sorry.

The Absolute BEST Advice Of All

Ask anyone who has dealt with any kind of weight lifting injury what they would do differently if they could go back, and not a single person will mention any of the stuff this article just covered.

Instead, the only thing they’d mention is going back and doing everything they could to avoid ever being in this situation in the first place.

They’d preemptively improve their form. And use an appropriate amount of weight. And do sufficient amounts of prehab and mobility work. And soft tissue work. And deload more often. And design their workout routine better and smarter with an emphasis on balance and using ideal amounts of volume with an intelligent exercise selection (or maybe just use a workout from Superior Muscle Growth and eliminate all the guesswork… #shamelessplug #butseriously #itstrue). And on and on and on.

Basically, they’d make preventing injuries a primary focus of their training from as early on as possible.

So what’s the moral of this story? I can narrow it down to this:

  • Being injured sucks.
  • I don’t know what you should do about your specific injury.
  • The best possible solution is prevention.

Good luck.

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