By Adam Son
How to Keep Training With an Injury, Rebuild Confidence, and Come Back Stronger
As I write this, I’m walking around in a boot with a broken bone in my foot.
A couple weeks ago, I came down on someone else’s ankle while playing basketball. I felt a pop, immediately had excruciating pain, and watched my foot and ankle start swelling almost immediately. Imaging eventually confirmed a navicular fracture.
Suddenly, a lot of things I normally do without thinking became significantly more complicated: training, working, walking around the gym all day, driving, golf, playing sports, and even basic everyday tasks.
Injury has an interesting way of shrinking and slowing your world very quickly, and one of the first questions most active people ask is, “So…what can I still do?”
I’ve already caught myself thinking about everything I can’t do right now. I can’t play basketball. Golf is out for the moment. Lower-body training suddenly looks very different. Walking around the gym all day is a task in itself. That’s frustrating, and it’s also normal. But as a coach, I know spending the next several weeks focused exclusively on what I’ve lost isn’t going to help me physically or mentally.
We tend to treat injury as an all-or-nothing proposition. You’re either healthy and training, or you’re injured and resting. But those aren’t the only two options.
Sometimes rest and protection are absolutely necessary. A broken bone needs time to heal. A repaired tendon or ligament may need to be protected. There are injuries, surgeries, and medical conditions where loading a particular tissue would be inappropriate or downright stupid. I’m certainly not training my broken foot as though it isn’t broken.
But protecting an injured area doesn’t necessarily mean shutting down the rest of your body.
An injury changes the plan. It doesn’t necessarily stop the plan.
Protect What Needs Protecting. Train What Doesn’t.
That’s essentially the approach I’m taking with my own training right now. My foot needs to heal, so I’m respecting the restrictions I’ve been given. I’m not interested in delaying that process just so I can say I “trained through it.”
At the same time, I still have two arms, another leg, a trunk, and plenty of muscles, joints, and movement patterns that can safely be challenged. So instead of asking myself, “Can I work out?” I’m asking a much more useful question: “What can I safely train today?”
Depending on the injury, that might mean upper-body strength training, seated exercises, supported movements, training the opposite limb, modified conditioning, mobility work, or exercises specifically prescribed as part of rehabilitation. The exact answer will be different for everyone, and medical or rehabilitation restrictions come first.
The underlying philosophy is simple: protect what needs protecting while maintaining as much safe physical capacity as possible everywhere else. That’s not ignoring an injury. It’s respecting the injury without unnecessarily allowing it to dictate everything else you do.
There can also be a real cost to prolonged inactivity. Research on immobilization and disuse consistently shows losses in muscle strength, muscle mass, neuromuscular function, and cardiovascular fitness. Interestingly, strength can decline faster than muscle size alone would predict, which tells us that the nervous system is an important part of what we lose during periods of disuse, not just muscle tissue.
That doesn’t mean “never rest.” It means inactivity has a cost too, and once movement or training is medically appropriate, there can be value in preserving what we’re still capable of doing.
There’s another loss that’s harder to measure: confidence.
If you’ve experienced a significant injury, you may remember the first time you tried something again. Maybe it was the first step without the boot, the first squat, the first run or jump, or simply the first time you stood on the injured leg without holding onto something.
The tissue may be healed enough to do it, but that doesn’t mean you trust it yet. That’s why recovery isn’t only about rebuilding tissue. It’s also about rebuilding capacity and trust.
Can Training the Uninjured Side Help?
One of the more fascinating areas of injury and rehabilitation research is something called cross-education, or cross-transfer. When we strength train one limb, most of the obvious adaptations happen in that limb, but some of the improvement in strength can transfer to the opposite, untrained side.
This appears to happen primarily through changes in the nervous system rather than because the untrained muscle somehow grows without being trained. That becomes especially interesting during periods of immobilization.
A recent systematic review and meta-analysis found that resistance training the non-immobilized limb helped attenuate strength loss in the opposite immobilized limb compared with immobilization alone. The effect on preserving muscle size was much smaller, and the researchers cautioned that the available studies vary in quality and methodology. Other research examining clinical populations and experimental immobilization also supports a cross-education effect on strength, although the size of that effect varies.
So let’s be clear about what this does not mean. Training my healthy leg isn’t secretly training my broken foot. It doesn’t make the fracture heal faster, it doesn’t replace rehabilitation, and it certainly doesn’t give me permission to violate the restrictions placed on my injured side.
What it does tell us is that maintaining safe training elsewhere in the body may have benefits beyond simply giving us something to do while we’re injured. Training what you can may help preserve more than doing nothing at all.
It’s one reason I’m continuing to train my healthy leg while my foot heals, and it illustrates an important distinction between training around an injury and training through one.
Training through an injury can mean ignoring medical restrictions, repeatedly aggravating damaged tissue, hiding symptoms, or forcing yourself to continue an activity simply because you don’t want to stop. That’s not what I’m advocating.
Training around an injury means adapting. Maybe a standing exercise becomes seated, a bilateral movement becomes unilateral, a barbell exercise becomes a machine, or the weight and range of motion temporarily change. Sometimes we simply train a completely different part of the body.
The question isn’t, “How do I force myself to keep doing exactly what I did before?”
It’s “How can I maintain the intent of training while respecting the limitation I have right now?”
Rebuilding Capacity After an Injury
One of the concepts I talk about frequently with clients is load versus capacity. Everything we physically do places some amount of load on the body. Walking, running, squatting, jumping, carrying groceries, and standing at work for eight hours all require our bodies to tolerate different levels and types of stress.
Load isn’t inherently bad. Our bodies need it. Appropriately applied mechanical loading is part of how muscles, bones, tendons, and our nervous system adapt to the demands placed upon them.
Problems can occur when the load we’re asking the body to tolerate exceeds its current capacity. After an injury, that capacity may temporarily drop. Something you could easily tolerate six months ago may suddenly be too much, but that doesn’t necessarily mean you’ll never do it again. It simply means your current capacity and the demands you’re placing on your body aren’t matched yet.
A big part of rehabilitation and post-rehab strength training is gradually closing that gap. Maybe today you can tolerate ten pounds and eventually it’s fifteen, then twenty. Maybe today you can walk for five minutes and eventually it’s ten, then twenty, then an hour. Maybe today you can balance on one leg while holding onto something; eventually you don’t need the support, and from there we introduce movement, resistance, or a more challenging environment.
That’s the basic process: exposure, adaptation, and progression.
It’s the foundation of training, and once an injured tissue is appropriately healed and cleared for loading, those same principles can become an important part of rebuilding function.
What About Pain During Exercise?
This is where things become more complicated. Pain matters and shouldn’t simply be ignored, but pain also isn’t always a perfect measurement of how much tissue damage is occurring.
I’ve written much more extensively about this in Pain Doesn’t Mean You’re Broken, but one of the important concepts is that pain is information. It gives us something to pay attention to, investigate, and respond to. It doesn’t automatically mean every movement that produces any discomfort must be permanently eliminated.
Context matters enormously. A healing fracture is different from chronic tendon pain. A surgically repaired ligament is different from an achy knee. New numbness, significant weakness, instability, severe swelling, or neurological symptoms are different from ordinary muscular soreness.
That’s also why I’m hesitant to give people a universal number on a 1–10 pain scale and tell them everything below it is safe. It doesn’t work that way.
When someone has been appropriately evaluated and cleared to exercise, there are several things I pay attention to when we’re training around an issue. What happens during the exercise? Is the discomfort stable, or does it progressively increase? Does movement suddenly change? Is there instability, sharp pain, weakness, or another concerning symptom?
Then I want to know what happens after the exercise. Do the symptoms settle, or have we clearly aggravated the area? How does it feel a few hours later? What about the next morning and over the following day or two?
If someone is dramatically worse after every training session, that’s useful information. We may be exceeding their current capacity and need to change the dose.
This is why I don’t love automatically eliminating movements whenever something hurts, but I also don’t believe in blindly pushing through pain. Before deciding, “You can’t do that,” we can often adjust the load, range of motion, tempo, sets and repetitions, frequency, stability demands, position, equipment, or the exercise itself.
Sometimes a surprisingly small modification is the difference between “I can’t do this” and “Here’s how I can do this right now.”
And right now matters, because what you can tolerate today doesn’t necessarily determine what you’ll be capable of six months from now.
Start With What You Can Do
This may be one of the biggest lessons I’ve learned over the last 13 years working in fitness. When something goes wrong, people naturally focus on what they’ve lost.
I’ve caught myself doing exactly that. I can’t run. I can’t play basketball. I can’t golf right now. I can’t train my lower body the way I’m accustomed to.
But from a training standpoint, I want to turn the question around: What CAN I do?
Can I train my upper body? Can I train the opposite leg? Can I perform a supported version of a movement? Can I work on my trunk? Can I use a machine? Once medically appropriate, can I work on balance or stability? Can I maintain some cardiovascular fitness through another modality? Is there something I’ve neglected for years that I suddenly have an opportunity to improve?
An injury creates limitations. There’s no point pretending otherwise. But those limitations don’t have to define the entire training process.
One of my clients has shown me just how far that philosophy can eventually take someone.
From Being Afraid to Stand on One Leg to a 370-Pound Leg Press
As I’m navigating my own injury right now, I’ve found myself thinking about one of my clients, L.P., and the progress I’ve watched her make over the last several months.
About a year and a half ago, L.P. suffered a serious ankle fracture after falling down her front steps during an ice storm. The injury required surgery to repair and stabilize the ankle, followed by months of physical therapy.
Eventually, the fracture healed, she completed formal physical therapy, and her surgeon cleared her to return to physical activity.
On paper, things looked great.
But being medically cleared and feeling physically and mentally confident are two very different things.
She still dealt with some intermittent swelling, tenderness, and lost mobility in the ankle. More importantly, after everything she’d been through, trusting that leg again wasn’t automatic.
When we started working together, balancing on one leg, even for a short period, was difficult. And it wasn’t simply physically difficult. It was scary.
That makes complete sense when you think about what she’d experienced. There had been a relatively recent point in her life when walking up and down stairs, using the toilet, getting in and out of a car, and simply navigating normal daily life could feel difficult, intimidating, or even dangerous. Those experiences can change your relationship with your body.
So we didn’t start by seeing how much weight she could lift. We started by rebuilding trust.
We worked diligently on basic balance and stability, using simple movements that allowed her to accumulate evidence that the leg could support her again. As her confidence and capacity improved, we added bilateral strength work using bodyweight movements and bands. Then we progressed the stability challenges, eventually introduced more single-leg movements, and used machines that allowed us to progressively increase resistance in a controlled environment.
Little by little, restrictions started being replaced by opportunities.
The question gradually stopped being “What can’t I do because of my ankle?” and became “What can we try next?”
The weights got heavier and the exercises became more challenging. Her balance improved, her strength improved, and the more evidence L.P. accumulated that her body was capable, the more her confidence changed with it.
Then last week, we were training on the leg press. The weight kept going up, and L.P. hit a 370-pound personal record, with room left in the tank.
That’s an impressive number, but the number isn’t really why the moment mattered.
Not that long ago, simply standing confidently on one leg was a challenge. Now we were loading hundreds of pounds onto those legs by choice because we’d reached a point where her body was capable of handling a completely different level of challenge.
That 330-pound leg press wasn’t simply a gym PR. It represented the distance she’d traveled: from protecting the leg, to trusting it, to strengthening it, and eventually to challenging it.
Somewhere along the way, L.P. didn’t just build gym strength. She built strength and confidence that carry over into everyday life.
That’s ultimately what we’re after.
And selfishly, I think her progress is a pretty useful reminder for me right now too.
I’m standing much closer to the beginning of that process. I’m still in the boot. My fracture is still healing. I’m still figuring out what I can and can’t do, and there are plenty of things I want to get back to that simply aren’t an option yet.
L.P. is a reminder that where you are immediately after an injury doesn’t tell you where you’re going to end up.
When Rehabilitation Becomes Training Again
L.P.’s story highlights something I think we sometimes misunderstand about injury recovery. Getting discharged from physical therapy or cleared by your physician is a huge milestone, but it doesn’t necessarily mean you’re back to where you want to be.
After a significant ankle injury, for example, weakness, stiffness, pain, and limitations in function can persist after the initial injury has healed. Rehabilitation is intended to address those problems and help restore function, but there can still be a considerable gap between “You’re medically cleared” and “I feel strong, capable, confident, and ready to do everything I want to do.”
That’s often where thoughtful training becomes incredibly valuable.
Once someone is appropriately cleared, the goal can begin shifting. We’re no longer simply asking whether the ankle works. We’re asking how strong we can make the person, how much balance and capacity we can develop, which movements we can reclaim, and what they can confidently do in the gym that makes the rest of their life easier.
At some point, rehabilitation gradually becomes training again.
Initially, getting back to “normal” may be exactly what someone wants. You want to walk normally again, get out of the boot, climb stairs without thinking about every step, and return to work, sports, hobbies, and everyday life.
But once you get there, you’re allowed to keep going.
You can become stronger. You can improve your balance, build more muscle, increase your conditioning, and develop confidence you didn’t have before the injury. Sometimes an injury even forces us to pay attention to parts of our bodies and our training that we’ve neglected for years.
I’m experiencing some of that myself right now. I certainly wouldn’t have chosen to break my foot, and L.P. wouldn’t have chosen to break her ankle. But once the injury happens, we get to choose how we respond to it.
Respect the injury and follow appropriate medical guidance. Protect what needs protecting while continuing to train what you safely can. Then gradually build, pay attention to how your body responds, progress when you’re ready, and modify when you’re not.
Most importantly, don’t mistake a temporary limitation for a permanent identity.
Final Thoughts
I’m still near the beginning of my own process. My foot is still broken, and there are things I can’t do right now and things I desperately want to get back to. I’m sure there will be frustrating days along the way.
But I’m not waiting until I’m 100% healthy to start taking care of my body again. I’m protecting what needs to heal and training what I can. Eventually, I’ll start rebuilding the things I’ve temporarily lost.
In some ways, I’m standing much closer to the beginning of the process I’ve watched L.P. work through, and that’s a useful reminder for me too.
Her story didn’t go from broken ankle to 370-pound leg press overnight. There were hundreds of small steps between those two points, and that’s where recovery actually happens: one exercise that goes well, one progression, one small confidence win, one slightly heavier weight, one everyday task that suddenly feels easier, or one movement you realize you aren’t afraid of anymore.
Eventually, you look back and realize just how far you’ve come.
A serious injury deserves to be taken seriously. There are times to rest, times to protect, times to seek medical care, and times when training absolutely needs to take a back seat.
But being injured doesn’t automatically mean becoming inactive.
Sometimes the smartest thing you can do is stop focusing exclusively on everything you can’t do and start asking what you safely can.
Then build from there.
An injury can temporarily change what you’re capable of doing. It doesn’t have to change what you’re capable of becoming.
A plan built around you
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