The Importance of Strength Training in the Rehabilitation Process

The belief that strength training could make your injury worse

Is held by both people in the general population and even by some rehabilitation professionals, that participation in a strength training program that progressively increases the load over time is something that people should avoid after a bone or soft tissue injury (involving muscles, tendons, or ligaments). This belief likely originates from safety concerns regarding the relatively high forces that healing tissues are exposed to during progressive strength training programs. However, current research suggests that progressive strength training facilitates the repair and regeneration of both bony and soft tissues. A review of the literature on progressive resistance exercise was done by the Physical Therapy and Rehabilitation Journal that showed the effects of structured resistance training on patients with a variety of injuries. The authors concluded, “Progressive Resistance Exercise (PRE) is a safe and efficacious intervention for many patients with a muscle force deficit contributing to their motor disability in physical therapy.”

Yes, exposing your injured tissue to gradually increasing forces is good for you.

This makes intuitive sense when you think about it. What is the result of a soft tissue injury? Decreased muscular force production. What is the result of progressive strength training? Increased muscular force production. While it could be argued that this explanation is overly simplistic (and it is), it’s also not wrong. People tend to create a clear separation between regular training and what physical therapists might call therapeutic exercise. When in fact the physiological processes that lead to muscle growth are very similar to those that lead to muscle repair and regeneration. The process that is fundamental to both tissue rehabilitation and tissue growth is called “mechanotransduction.” This big fancy word describes the amazing process whereby the sensor cells in your muscles are able to convert mechanical tension into cellular signals that instruct the muscle to generate more muscle proteins to promote healing and growth.

What am I supposed to do with this information?

My simple recommendation is that strength training should remain a part of your routine (ideally at least twice per week) whether you are healing from an injury or not! While the basic training variables like exercise selection, intensity, load, and frequency may need to be manipulated after an injury (Hopefully by a licensed Physical Therapist) it should not be taken out entirely. And for those of you who are not currently doing any strength training, whether you are trying to repair damaged tissues, look better, or just improve overall health, the best time to start was yesterday!

Happy Training,

Stephen Healy, CPT, CSCS Zero Doubt Club

Work Cited

Nicholas F Taylor, Karen J Dodd, Diane L Damiano, Progressive Resistance Exercise in Physical Therapy: A Summary of Systematic Reviews, Physical Therapy, Volume 85, Issue 11, 1 November 2005, Pages 1208–1223, https://doi.org/10.1093/ptj/85.11.1208