How To Safely Exercise After Injury

22 Oct 2020

How to safely exercise and prevent deconditioning after acute trauma

How to safely exercise and prevent deconditioning after acute trauma   

If you’ve experienced a bad injury or acute trauma, you will know how frustrating it can be to not be able to train. This is especially true when training for any type of competition or event. Habit Health can help you get back on track and support you every step of the way, including diagnosis, a management plan and general conditioning during your recovery. We are here to help you live your best life.

Naturally, it is important after acute trauma to get an accurate diagnosis and management plan for your injury from a healthcare professional. Habit Health physiotherapists can help in making a diagnosis and advise on the most appropriate treatment plan and time frames to recover from a musculoskeletal injury.

In the first few days after an acute injury, the body will go through the first stage of healing, the inflammatory phase. If you’ve had an acute sprain or strain in the past, you might remember that the first 3-4 days are usually the worst in terms of pain, stiffness and swelling. To protect the injured tissue from further damage and avoid any subsequent bleeding, the advice is to avoid ‘HARM’ for 72 hours after any acute soft tissue trauma.

The acronym HARM stands for:

  • Heat - Avoid any heat packs, prolonged hot showers or hot baths.
  • Alcohol - The less the better - that unfortunately includes that post-game drink with the team.
  • Running - Try to avoid this for at least the first few days after acute injury.
  • Massage - This is especially important to avoid in any acute muscle injury.

It is important to avoid all of the above because they can lead to vasodilation, a widening of the blood vessels, and therefore increase the risk of bleeding in the injured site.

To reduce bleeding, swelling and pain, management after injury should also focus on practising PRICE which stands for:

  • Pause - After an acute injury, such as a rolled ankle or sprained wrist, take a break from the sports field if you are playing and give yourself a chance to assess the possible damage once the adrenaline from the incident has settled somewhat.
  • Rest/Optimal Loading - How long to rest after an injury depends on the kind of injury sustained. Seek advice from one of our physiotherapists to help you determine the most appropriate time frame for a fast recovery and prevent unnecessary deconditioning.
  • Ice - Applying ice after an acute injury can reduce pain, limit swelling and reduce bleeding. Icing can be applied for 10-20 minutes, using a wet towel as a barrier between the ice pack and skin. After each icing interval, take a break from icing for at least the same duration.
  • Compression - Just like icing, compression can reduce swelling that forms after acute tissue injury. Ask your physio for Tubigrip for comfortable, easy-to-apply compression. Sizing is important to combine the best compression effect without restricting blood flow.
  • Elevation - Elevate the injured limb by using a sling for upper limb injuries or elevate the leg above hip height, for example, on a chair.


Once you have received a diagnosis and management plan for your acute injury from a physio or GP, including avoiding HARM and practising PRICE, adjust your training programme for the period of your recovery. It will most likely look quite different from the usual, but this doesn’t mean you can’t still work on your fitness and conditioning goals. 

Seek advice from a Habit Health Physio and Personal Trainer to help with a training plan that will work for you and your goals.

When I see a client in the clinic with an acute injury, I often hear that they think they have to stay away from training altogether until their injury is fully healed and recovered. Fortunately, most of the time this does not have to be the case. There is a multitude of options for keeping up with your fitness and training goals even if you have to rest and protect an injury.

General training ideas for a lower limb injury (ankle, hip or knee):

  • Nothing is holding you back to still complete your upper body training. You can easily substitute clean and jerks and some body-weight exercises like burpees with more seated machine-based strength training, or barbell and dumbbell seated and lying exercises in the meantime.
  • After a lower limb injury, substituting running with cycling, swimming or rowing for endurance training can help to avoid impact. The best option depends on the specific injury and a physiotherapist can provide advice on this.
  • Another great option for rehabilitation of a lower limb injury is hydrotherapy training in the pool. This allows early agility, technique and coordination training with less than your body weight to help protect your healing injury from impact.

General training ideas for upper limb injuries (shoulder, elbow, wrist and hand):

  • Try stationary cycling for your warm-up and endurance training. Although running is not upper limb specific, the jolting movements can be quite uncomfortable early on after any injury.
  • If you usually perform squatting and lunging with extra weight like a barbell, this can be difficult to perform after acute upper limb injury. Instead, using slower movements and sustained positions, such as isometric holds throughout the squatting or lunging movement, can lead to higher training load without the need to hold weights.
  • Higher loads for the lower limb can be achieved with seated machine-based exercises, for example, on the leg press or knee trainer.

Keeping up with your usual routines, regularly going to the gym, or substituting sport-specific training with conditioning sessions in the gym or at home will make it that much easier to return to full training once your injury has healed. 

Did you know that you can book directly with a Habit Health physiotherapist? No referral is needed.
We also provide ACC funded consultations. Book a physio today.