Helping a Client Return to Exercise after Injury

Returning to exercise after a sports-related injury can be a trying time for an active person. Viewed in a positive light, it can be a time to try new ways of performing familiar exercises and gain new insights in the process.

Before beginning training after an injury, it absolutely essential that the client be given clearance by his or physician. 

The task for the trainer is to design an exercise that fits within the framework of a rehabilitative program. To do so, it is important that the trainer have an understanding of the nature and extent of the injury or injuries, what any physical therapy has been designed to accomplish, and what restrictions the client may be under as a result.

According to the National Institutes of Health, the most common sports injuries include:

  • sprains
  • strains
  • knee injuries
  • swollen muscles
  • shin splints
  • fractures
  • dislocations

Recovery is the Priority

After an injury, the body’s main priority is recovery, which makes adding muscle mass, takes a backseat to repairing support tissue for the injured area or areas. This basic should be kept in when designing and then implementing a training regime.

A sports-related injury means taking time off at least some time from the game, and for many clients, this means being put his or her game. It can be easy for a client’s enthusiasm for exercise wane and to become discouraged when he or she realizes it will likely take some time to return to the level before an injury. To combat this, it’s important for the trainer to help the client stay focused on the end goal by emphasizing the importance of looking at fitness from a long term perspective.

Full recovery needs to come first, and it can be counterproductive to return too soon to the number of sets and reps a client may have been using before the injury.

Unilateral Armament

In a strict anatomical sense, isolating a muscle is not possible. But training unilaterally is not only possible, it is typically recommended for a sport injury client. One guiding principle when beginning a client’s post rehabilative training is to train each limb separately.

When guiding clients through bilateral exercises such as bench press or squats, the stronger side will take over the movement and try to compensate the weaker side. Unfortunately, this tendency only reinforces the strength imbalance that typically comes injury. Here, it is important work the weaker limb just as hard as the stronger one in order to address the strength imbalance. 

Develop a training regime that fits the client’s schedule. If the client is attending a rehabilitation program, that almost certainly means that he or she has had to modify his or her normal schedule. And he or she may have checkup appointments with a physician or therapist that compete with time for training. For the trainer, this can mean exercising some additional flexibility with regard to appointment times, perhaps by times outside of normal “office” hours.

Develop exercises that strengthen their injured area safely and effectively. It’s not uncommon for a client returning to exercise after a sports-related injury to want to attempt what in the view of the physician, the physical therapist, and the personal trainer may be too much too soon. A client’s safety is a priority for the trainer, as there is the possibility of undoing whatever corrective work was done.

Patient: “Doctor, It hurts when I do this.”

Doctor: “Don’t do that.”

Apart from the smille, snicker, or even outright laugh that familiar exchange may elicit, it also contains a touch of wisdom applicable to returning to training after an injury. Try light to moderate resistance that works the joints and muscles without entering ia range that causes discomfort or pain. If the client has experienced a strain or pain within a certain range of motion (such as the fully extended or fully contracted portion of a curl when exercising biceps), a straightforward solution is to avoid that part of the motion. If the client cannot perform at least a partial rep without experiencing pain, he or she should not yet be exercising the injured area.

With resistance exercises, equipment that allows a range of motion to be set, such as the Smith machine, power rack and cable machines can allow for experimentation that will likely be necessary to find the right combination of resistance and range to be both safe and effective. Fortunately, ligaments and tendons respond to the same stimuli as muscles. Using progressive intensity from one workout to workout is what builds these supporting elements. Just remember to have the client start slowly.

Be Supportive

A trainer can find him or herself facing an additional challenge in the case of a client returning to exercise from injury that transcends the purely physical: It’s common for anyone who has been kept away from his or her favorite activities to experience feelings of boredom, frustation, depression and/or anxiety. Becoming active again and staying fit can go a long way to alleviating those feelings for most clients, as can having the support of an understanding, knowledgeable and committed trainer.



2. Return To Play Criteria. The American Orthopaedic Society for Sports Medicine.

3. Brewer, Britton W. “Psychology of sport injury rehabilitation.” Handbook of Sport Psychology, Third Edition (2007): 404-424.

4. Norris, Christopher M. Sports injuries: diagnosis and management. Butterworth Heinemann, 2004.

5. Wiese-Bjornstal, Diane M., et al. “An integrated model of response to sport injury: Psychological and sociological dynamics.” Journal of Applied Sport Psychology 10.1 (1998): 46-69


These resources are for the purpose of personal trainer growth and development through Continuing Education which advances the knowledge of fitness professionals. This article is written for NFPT Certified Personal Trainers to receive Continuing Education Credit (CEC). Please contact NFPT at 800.729.6378 or [email protected] with questions or for more information.