Get Bigger Even With Injuries
by Ben Bruno T-Nation
Here's what you need to know...
Sometimes you have to put your health ahead of your PR goals, but that doesn't mean you can't train hard and make progress.
Take the right actionable steps and you can make your training less painful while still building muscle and strength.
I'm banged up. I've had a back surgery, two knee surgeries, and a shoulder that gets cranky from time to time. But I'm also a meathead at heart, and as such, my training goals are the same as most of yours. I want to get stronger, I want to build muscle, I want to look good, and I want to be athletic.
My area of expertise is joint-friendly strength and muscle building, with extra emphasis on the strength and muscle building part. When most people hear joint-friendly training, they immediately think of rehab and conjure up images of all sorts of wussy training methods and people with no muscle.
It doesn't have to be that way.
The first six tips focus on achieving the proper mindset, which is more than half the battle when you're beaten up. The remaining tips will focus more on actionable steps you can take to make your training more productive and less painful.
1. You still must train hard and get stronger
Banged up or not, there's no way around this one if you want to build any appreciable muscle. Sorry.
Many different training programs have proven to work for getting people bigger and stronger, but the common denominator amongst all successful lifters is that they've trained hard for years.
This not only underscores the importance of effort but also consistency, meaning if your current methods are hurting you, they aren't conducive to your long-term success, even if you like what you're doing or it's worked well for other people.
2. Focus on what you can do, not what you can't do
Losers use injuries as excuses to be lazy and feel sorry for themselves. Winners find ways to work around their injuries.
Rather than lament about the exercises they can't do, they find exercises they can do and put their effort towards getting really, really good at them. And there's (almost) always something you can do.
Rather than sulk about how badly it sucks that you can't bench because your shoulder is jacked up, think of it as an opportunity to work on your legs and attack your workouts with enthusiasm.
3. Don't do anything that hurts
This seems so blatantly obvious that it shouldn't need to be said, but it bears repeating because it's constantly ignored.
Muscle pain so long as it's not too severe is fine, and probably inevitable if you're training hard. Joint pain isn't.
If an exercise causes you joint pain, either while you're doing it or afterwards, first evaluate your form and make sure you're doing the exercise correctly. If you are and it still hurts, drop that exercise from your arsenal, no matter how much you might like it or how important you think it is. Period.
4. There aren't any exercises that you must do
If you're a powerlifter then you have to squat, bench, and deadlift. If you're an Olympic lifter then you have to do the snatch and the clean and jerk.
If you're not competing in anything, though, then there aren't any mandatory lifts. As long as you're getting strong on compound exercises, you're going to be just fine. The key is to find a few key exercises that don't hurt and make them your bitch.
Too often people get caught up in thinking they have to do a certain exercise in order to see results. For example, squats. There's this pervasive idea that you have to do heavy squats to get big legs.
Now you certainly can build big legs from heavy squats. Huge, in fact. But what about the guy with a bum knee or a bad back? What's he supposed to do?
Usually you'll see one of two things. Either he'll try to tough it out and work through the pain which inevitably leads to more pain and eventually missed training time due to injury or you'll hear him say something like, "My back starts to bug me when I get up around 225 so I just keep it light."
The second scenario may be better from a health standpoint, but you aren't going to build a whole lot of muscle if you aren't pushing yourself and focusing on getting progressively stronger over time, no matter how "good" of an exercise it is. Half-assed light squats are a lousy muscle-builder.
This guy would be much better off from both a health and muscle-building standpoint by finding an exercise he could do without pain and getting brutally strong on it.
You shouldn't marry yourself to exercises. Find what works best for you.
5. Find your own main lifts
I get irked by the powerlifting ideology that's seeped into general fitness that the squat, bench press, and deadlift are "main" lifts while everything else is relegated to "assistance" or "accessory" exercises, although I do very much like the idea of having main lifts in your program.
Think of these as your "big rock" exercises, meaning if you only did those exercises you'd still derive most of the benefit of your program. These lifts give your program consistency and continuity, and they also help serve as a barometer to let you know you're getting stronger.
I'd recommend picking four exercises: one upper body push, one upper body pull, a knee-dominant exercise, and a posterior chain exercise.
For a powerlifter, those main lifts would obviously be the Big 3 plus something like a barbell row. If you got really strong on those four exercises, you're also going to get pretty damn muscular.
But if those lifts don't jibe well with you, they could just as easily be something else and you'd still get great results. Remember the previous rule.
Say you chose more joint-friendly replacements for each of the previous exercises instead of squats you did front squats or Bulgarian split squats; instead of deadlifts you did trap-bar deadlifts; instead of the bench press you did a neutral-grip low incline dumbbell press, and instead of barbell rows you did dumbbell rows or weighted chin-ups.
If you progress to where you're crushing those lifts with impressive weights, you're also going to be damn muscular too.
Takeaway: Any exercise can be a "main lift" if you treat it as such, meaning you make it priority in your program and focus on getting really strong at it.
6. Redefine strength in your own terms
Getting stronger is (or at least it should be) a ubiquitous goal amongst all serious lifters. It's also vague. In some sense, strong is strong; it's one of those things that's hard to define but easy to spot.
But just like different people have different conceptions of an appealing physique, being strong means different things to different people.
It's very common, though, to define strength with one-rep maxes on the bench, squat, deadlift, power clean, etc. That's fine of course, but if you're banged-up, those aren't going to be particularly smart goals to chase.
Instead, redefine strength for you in terms of the exercises and rep ranges you can handle.
For example, using the exercises from the previous example, maybe you shoot to work up to 300 for 8 on front squats, 550 for 8 on trap-bar deadlifts, 130 for 8 on low incline dumbbell presses, and 8 chin-ups with 75 pounds around your waist.
Whatever your personal bias towards certain exercises, you can't tell me that's not strong. And for the banged-up lifter, those may be safer goals to shoot for. Again, don't focus on the exercises exercises are interchangeable. Instead, focus on the concept of setting strength goals on lifts and rep ranges that you can safely pursue and don't just get caught up in chasing one-rep maxes.
7. Live in moderate rep ranges
To limit joint stress, spend the bulk of your time training getting strong in the 6-12 rep range (with some occasional higher-rep work sprinkled in), but don't go much below 5-6 reps. My joints feel best in the 8-12 range, so that's what I do primarily.
Going a bit higher on the reps isn't taking the easy way out if you push yourself, and getting strong in moderate rep ranges is not only easier on the joints, it's also probably most effective for building muscle anyway.
8. Get more from less weight
Heavy weight is dangerous. I don't care what exercises you're doing. You could be doing the most "joint-friendly" exercises in the world, but if you're using a lot of weight, they're dangerous.
When you're strong, any exercise is dangerous.
I often praise single-leg exercises as being a safer alternative to back squats if you have a bad back, but heavy single-leg work certainly comes with its own risks, too.
Dumbbell presses may be easier on the shoulders than barbell presses, but picking up really heavy dumbbells and trying to get them into place is a risky proposition in its own right and I certainly wouldn't call 120-pound dumbbell presses "shoulder-friendly" by any stretch, although they may be less stressful on the shoulders than heavy barbell presses.
What's more, when I talk about exercises like squats, deadlifts, and bench presses not being "joint-friendly," I'm really only talking about doing those exercises with heavy weights. There's nothing inherently dangerous about the movements themselves. My back feels fine when I squat 225 and deadlift 315, but as I've gotten stronger and can handle a lot more weight than that, my back hurts.
The same thing happens even with supposed joint-friendly exercises. 300-pound Bulgarian split squats aren't exactly comfortable either, and try putting 135 pounds on your waist for chin-ups and tell me how your elbows feel. I can tell you not good.
So as you get stronger and even the "safe" exercises start to bother your joints, it makes sense to find ways to get more from less weight. Techniques like 1.5 reps, slower eccentrics, paused reps, and increasing the range of motion (provided it's pain-free) will require you to drop the weight from what you'd normally be able to handle, thereby mitigating the joint stress while still providing a good training effect.
Alternatively but similarly, you could also "pre-exhaust" using lighter, joint-friendly exercises first in the workout and then do your heavy barbell work at the end.
For example, you might start a lower body workout with sliding leg curls, follow it up with a single-leg exercise (or vice versa) and finish up with a bilateral squatting or deadlifting variation. Or for upper body, you might start with a dumbbell bench press and finish up with a barbell overhead press.
9. Do barbell lifts no more than once a week
There's no question that the heavy barbell lifts are fantastic for building size and strength, but they're also the most stressful exercises on the joints.
As such, limit yourself to doing them no more than once a week for each exercise. If you're looking to work the involved muscles more than once a week recommended in most cases the other workouts should be composed of more joint-friendly alternatives, allowing you to reap the benefits of higher frequency training while still sparing your joints.
Take shoulders for example. Maybe you military press once a week and then do something like a dumbbell press or landmine press another day, and maybe even lateral raises a third day.
For chest, you might bench once and do dumbbell presses or weighted push-ups the other days. For hamstrings, you might do Romanian deadlifts one day and sliding leg curls or glute-ham raises the rest of the time. For quads, you might squat or front squat one day and do single-leg variations or belt squats the other days.
Everything in moderation.
10. Increase the reps for your warm-up sets
When pure strength is the goal, nothing will shortchange your efforts and sap your strength more than doing a lot of reps in your warm-up sets.
But for banged-up folks just looking to build muscle, doing more reps can actually be very helpful. For one, it helps ensure that you're adequately warmed up. Moreover, the added volume fatigues the muscles and ensures that you won't be handling as much weight during your top sets, so the very reason it's a bad idea for strength makes it a good idea for the banged-up lifter.
A good rule of thumb is to keep the reps in your warm-up sets the same as what you plan on hitting for your top set, meaning if the goal for that exercise is to work up to a top set of 10 reps, you'd then do 10 reps in each warm-up set as well.
Shoot to have a nice sweat and even a nice little pump going before you reach your working sets.
11. Straight sets over ramping up
I've spent almost my entire career ramping up to a top working set with progressively lower rep warm-up sets. Recently though, I've been transitioning to doing straight sets for my working sets and my joints are feeling great.
So if I'm doing five sets of eight, I keep the weight the same for all five sets. If I complete all the reps, I bump the weight up a little bit the next time. I also do eight reps in each warm-up set as I work up to my top weight for the day, for the reasons laid out in tip number 10.
I think ramping up is superior when training for pure strength, but straight sets allow you to get a good training effect with lighter weights.
12. Good form is paramount
What constitutes good exercise form is a polarizing topic.
On the one hand you have the form police that think that anything less than textbook form is unacceptable. These people usually aren't very strong or muscular because it's damn near impossible to move any substantial weight with picture-perfect technique.
On the other hand, you've got guys that don't care about form and throw caution to the wind in the name of getting stronger. On the surface it's hard to argue with this crowd because a lot of these dudes will actual be strong and boast impressive physiques, but if you talk to them more, you'll usually learn that most of them deal with a slew of niggling injuries and justify it to themselves by saying that injuries are just part of the deal.
You may be able to get away with bad form for a while, but it'll always catch up to you eventually. I used to be in that second camp, and like most, I learned that lesson the hard way and now believe that good form is important.
Good form doesn't mean perfect form, though. A 600-pound deadlift will never look like it does with 135.
So how much leeway should you give yourself?
I'm an academic guy so I like to think of things on a grading scale. For most people I think B+ form is a good starting point. That'll still allow you to keep getting stronger while staying healthy. For the banged-up guy though, tighten it up to an A- to be safe.
13. Don't be afraid to take a week off
A lot of minor tweaks turn into injuries because guys ignore the initial warning signs and refuse to take time off.
Instead, they'll either try to push through the pain in hopes it'll magically go away, or they try to combat the pain by getting all gung-ho with rehab exercises.
We all know how the first strategy works: it doesn't.
The second strategy is better and certainly well-intentioned but also misguided. The vast majority of lifting-related injuries boil down to overuse, so if you step back and think about it, it doesn't make a whole lot of sense to fight overuse with more use, does it?
For example, if your shoulder is sore from pressing too much, doing a bunch of mindless rotator cuff work might not be the best solution right off the bat. That may be something to think about a few weeks down the line when the pain has subsided to help shore up your shoulders against future injury, but if more people just took a week off completely, many of those strains and pains would go away on their own.
One of the situations where I see this the most is with lifters that suffer from elbow pain. They'll start to develop a slight twinge from too much barbell pressing, chin-ups, and/or grip work, and then compound it by fighting the overuse symptoms with aggressive rehab protocols.
I've done that myself, and it got so bad at one point that I couldn't even open jars and shake hands without excruciating pain until I was eventually forced to take 5-6 weeks off of any upper body training.
You won't lose strength or muscle in a week or even 2-3 weeks but you will after longer layoffs, which is why it's paramount to nip those little strains in the bud.
Just to be clear, though, "time off" just means time off from the affected area and staying away from any exercises that provoke pain. Instead, make the best of the situation and devote the extra training time to another area that you've been neglecting.
14. Switch it up, but not too much
Exercise variety can be tricky. On the one hand, any successful lifter or coach will tell you that your main focus should be getting brutally strong on the basics. And the best way to do that is to practice the basics.
But as your training age increases and you start to get stronger on the basics, you'll inevitably hit a point where you start to stall out on certain exercises and need to introduce more variety into your program to avoid overuse injuries caused by repetitive stress.
It's one of those "damned if you do, damned if you don't" scenarios where either too much or too little variation can slow your progress.
So what's the answer? Well, that really depends. The newer you are to training, the less variety you need and the more you should focus in on a few key exercises. More advanced lifters should change exercises more frequently while still maintaining a sense of continuity.
A great compromise is the idea of "similar but different." That is, keep the exercises consistent but make small tweaks to avoid repetitive stress injuries and keep from stalling.
It could be as simple as switching your grip, changing your stance width a little bit, or using a different bar or training implement. Little changes go a long way.
15. Be proactive with your recovery work
I like to divide recovery into two types: proactive recovery and reactive recovery.
Proactive recovery is the daily upkeep you do to keep yourself performing at your best: eating well, getting enough rest, stretching, soft tissue work, etc.
Reactive recovery is what you're forced to do after an injury. Some form of recovery work is inevitable, but being diligent with proactive recovery work helps stave off the need for reactive recovery work, which is more painful and takes a whole lot longer.
Recovery demands obviously increase with wear and tear, be it injury or age.
While this is by no means a hard-fast rule, a general guideline to abide by is to have your recovery focus be proportional to your age, meaning a 20-year-old kid would devote approximately 20% of his overall training time on recovery modalities warm-up, stretching, soft tissue work, etc. while a 50-year-old guy would devote 50% of his time to recovery methods.
Now this doesn't mean that if a 50-year-old spends an hour in the gym he needs to spend half the time warming up, but let's say he spends 15 minutes warming up and 45 minutes lifting. He'd then want to spend an additional 30 minutes at a different time focusing on recovery work. That might mean an extra 30-minute session of foam rolling and stretching at night while watching TV or scheduling a massage or something else along those lines.
If a 20-year-old kid does a 10 minute warm-up and lifts for 80 minutes, he'd then need to do an extra 10 minute session at some other point throughout the day.
If you're particularly banged up, add ten-or-so years to your age to calculate your recovery needs in the formula.
16. Find a great soft tissue practitioner
I never understood how women get so attached to their hairdresser and are seemingly willing to travel to the ends of the earth to see them until I found an awesome soft tissue guy. Good ones are extremely hard to find, but once you do, show some appreciation by telling all your friends.
Mine has been a godsend to me the past year, both in keeping me healthy and in putting me back together when I don't listen to my own advice.
Self-myofascial release is good, but nothing can replace good hands-on work.
17. Listen to your own advice
This may be the most useful tip of all, which is why I saved it for last.
If someone came to you asking for your advice about how to deal with an injury, I'm willing to wager you'd have some pretty decent advice for him.
Truth be told, it's mostly just common sense. I've received some of the best lifting advice of all from my 90 year-old grandma who's never lifted a weight in her life. I'm talking gems like "Take it easy," "Be careful," and "Should you really be doing that [insert exercise here] with your back/knee issue?"
Of course I never listen because I tell myself that she doesn't "get it," but she might actually get it better than I do.
A lot of dudes will advise their friends to take time off after an injury or avoid exercises that don't seem to agree with them, yet when it comes time to take a week off themselves or nix an exercise they like because they keep getting hurt doing it, it's a completely different story and they stubbornly try to push through it.
If you're a trainer, think about how you'd advise a client with your same ailments. And if you're not, imagine what advice you'd give to a good friend.
Don't Kick Yourself Later
The hardest person to train is yourself. And as I read over these 17 tips, I feel like kicking myself for not heeding my own advice. I almost wish someone else wrote this article so I might actually learn something from it!
Hopefully you did, though. Go heavy, get strong, but stay healthy, and above all else, train smart. You'll never regret putting your longevity ahead of a PR.