Can Strength Training Help You Recover From Injuries?

Athletes often persist with training despite the pain, reluctant to back off long enough to recover. It may seem counterintuitive to strength train while recovering from a painful injury, but with the right guidance, it can have profound effects and allow you to recover stronger. Can you begin a strength training program while still injured? And can strength training help prevent injuries?

Serious and recreational athletes alike face the risk of an injury sidelining them from the sport they love. Often, these committed individuals push through the pain and hope that the healing process will proceed without time off. However, some injuries tend to hang on and get progressively worse or even relapse soon after an initial improvement. Injury prevention programs include resistance training to strengthen muscles and joints, but boosting these neuromuscular connections can also help you recover. To understand how strength training can help during the recovery process, we need to start with understanding how exercise affects the neuromuscular wiring that tells muscles to contract.

Signaling pathways in nervous system

The central nervous system (CNS) — the brain and spinal cord — manages awareness and coordinates movement with the peripheral nervous system (PNS) which comprises the sensory neurons and motor neurons. The sensory neurons pick up signals about your environment while the motor neurons carry messages to the muscles to help you respond to these environmental stimuli. A great deal of work has connected exercise with improved brain health. Newer research on animals has also found that exercise is associated with central nervous system functions like circadian rhythms affecting the sleep cycle, energy balance, resistance to stress, and hormone secretion. Exercise can also induce healing at the cellular level. While the CNS is largely unable to self-heal, the PNS is remarkably plastic, meaning that it has regenerative capacity. The PNS can stimulate nerve regeneration following injury up to a rate of 1 mm per day, bridging gaps of up to 1 cm.

Strength training and nervous system

A new study in the Journal of Neuroscience sheds light on how strength training triggers changes in the CNS. Important changes to central motor pathways in the spinal cord of female macaques respond to strength training. The changes in the monkeys’ spinal cords persisted even during a two-week washout period without strength training. Learning to lift weights also stimulates the release of nerve growth factors to help form new neural pathways to carry these messages back and forth between the PNS and the CNS.

Moderate exercise is also associated with myelin sheath regeneration — the insulation surrounding nerves — which allows for better signal conduction out to the motor nerves which control your muscle fibers. Resistance training to promote healing is not just for younger athletes. A study among older adults with type 2 diabetes found that resistance training improved symptoms of peripheral neuropathy, nerve conduction, blood sugar, and arterial stiffness.

Resistance training and early injury recovery

While an injury may have you sidelined from participating in vigorous sports, you can still incorporate resistance training as you recover. Using kettlebells or resistance bands allows you to target specific muscle groups without leaving home. For runners, walking may seem like an unsatisfying workout, but adding weight to a backpack (“rucking”) builds muscle and endurance. Body weight training can improve balance, and coordination, and burn calories. Yoga improves flexibility and can help you appreciate your body in a more holistic way — runners often think about their lungs or legs in isolation! Finally, sleep and hydration are vital to the body’s repair machinery.

The neuromuscular changes stimulated by resistance training will help the nerves to recruit and fire muscle fibers, pulling them into action. All of these structural changes can help make the wiring to your muscles more efficient. You will be able to regain your range of motion and lift heavier weights before you even notice a difference in muscle mass. After several weeks of doing squats and deadlifts, it is possible to feel more power in your stride as your brain recruits muscles along your lower extremities including quads, glutes, hip flexors, and hamstrings to help with weight-bearing activities. As your core strength improves, you will likely feel less back pain.

Can strength training help prevent injury?

Working with a personal trainer who understands your training goals can put you on the right track to prevent an injury. A meta-analysis of Nordic hamstring exercises showed that incorporating this movement into a training plan can reduce the incidence of hamstring injury in soccer players by 51%. Soccer players should focus on preventing hamstring injuries by scheduling injury prevention training early in the week to reduce soreness on match days.

For runners, weight training provides a connection between the brain and the muscles, which allows for more muscles to be recruited during each stride. Getting the glutes to fire means your hamstrings do not have to do all the work. Recruiting the entire posterior chain during each stride will help you run stronger and avoid overloading knee and hamstring tendons. Basketball players need to protect their knees and ankles so they can handle rapid acceleration and deceleration while dribbling and jumping. A typical game involves these joints handling a great deal of torque, and resistance training can strengthen the tendons holding these joints together. Building a scaffold of strong muscles helps offload strain on individual ligaments and supports the joints during fast movements with changes in direction.

Combining strength training and cardio

Research has long supported resistance training to improve overall athletic performance, but recent studies on the neuromuscular characteristics of joints provide new insights into force generation. The stiffness of the muscles and tendons in the leg helps runners recycle the energy applied to the ground in each stride. Better leg-spring stiffness is thought to be related to running economy — the ability to go faster with less energy.

Given that combining endurance and strength programs could improve performance and reduce injury, a recent randomized trial among 30–40-year old runners found that a combined strength and endurance training program achieved significant improvements across eight measures in body composition, strength, and endurance parameters. The combined program achieved a better-running economy than the endurance-focused program.

Taken together, strength training has a solid evidence base in injury prevention, but as we learn more about neuromuscular connections, it is clear that it plays a key role in recovery as well. Working with a personal trainer can set up good habits to prevent injury, and a physical therapist can provide critical insights on how to incorporate weight training in recovery.