How to Train Around Injuries Without Losing Progress

Injuries happen. What separates those who maintain long-term progress from those who fall off entirely is how they respond.

The default response is all-or-nothing. Something hurts, so training stops completely. Weeks pass. Momentum disappears. The habit breaks. Starting over feels harder than it should.

There's a better way. Most injuries don't require complete training cessation. They require intelligent modification.

This guide covers the most common injury scenarios for men over 35 and provides systematic approaches to training around them. Not through them. Not ignoring them. Around them.

The Fundamental Principle: Earn the Right to Load

Before any specific injury discussion, understand this principle: pain is information, not an obstacle to overcome.

The fitness culture glorification of "training through pain" has destroyed more bodies than it's built. Pain exists to protect you. Ignoring it usually makes things worse.

The goal isn't to suppress pain signals and keep loading. The goal is to find pain-free ranges, movements, and loads that allow continued training while the injured area recovers.

You earn the right to add load by demonstrating pain-free competence at lighter loads first.

Shoulder Issues

Shoulder problems are nearly universal in men who've trained for any significant time. The shoulder joint sacrifices stability for mobility, making it vulnerable to accumulated stress.

Common Presentations

Anterior shoulder pain: Often related to biceps tendon irritation, shoulder impingement, or rotator cuff strain. Typically aggravated by pressing movements, especially with a barbell.

Posterior/lateral shoulder pain: May indicate rotator cuff issues or referred pain from the neck/upper back.

AC joint pain: Point tenderness at the top of the shoulder where clavicle meets acromion. Often aggravated by pressing with arms close to the body.

Training Modifications

For pressing movements:

Barbell pressing (bench and overhead) locks your hands and shoulders into a fixed position. This often aggravates existing shoulder issues.

Switch to dumbbells or neutral-grip implements. These allow your shoulders to find a more natural position through the range of motion.

Modification ladder (from most to least demanding on shoulders):

1. Barbell bench press (most demanding)
2. Dumbbell bench press
3. Neutral-grip dumbbell press
4. Floor press (limits range of motion at bottom)
5. High incline pressing (more overhead, less horizontal)
6. Landmine pressing (angled press, very shoulder-friendly)
7. Push-ups with hands turned out (least demanding)

Start at the level that's pain-free. That's your current ceiling. Work there until it's easy, then test the next level.

For pulling movements:

Pulling is usually less problematic than pressing for shoulder issues, but wide-grip pulling can aggravate certain conditions.

If wide-grip pull-ups or lat pulldowns hurt:

• Switch to neutral-grip or chin-up grip
• Use suspension trainer rows (allows rotation through range of motion)
• Try single-arm cable or band rows

What to add:

Shoulder issues often improve with increased rear delt and external rotation work. These strengthen stabilizing muscles that are typically underdeveloped.

Add to every session:

• Face pulls or band pull-aparts (3 sets of 15-20)
• External rotations with light band or cable (2-3 sets of 15 each side)
• Prone Y-T-W raises (2 sets of 10 each position)

This is prehab and rehab simultaneously. It costs five minutes per session and often resolves nagging shoulder issues within 4-6 weeks.

When to Push vs. When to Rest

Push (train through with modifications):

• Discomfort that warms up and decreases during the session
• Mild soreness that doesn't affect daily activities
• Pain that stays at 2-3/10 throughout movement and doesn't worsen

Rest (take that movement out entirely):

• Pain that worsens during the session
• Sharp, catching, or locking sensations
• Pain above 4/10 even with modifications
• Pain that persists more than 24-48 hours after training
• Any loss of range of motion compared to the other side

Knee Issues

The knee is a hinge joint stuck between the hip and ankle. Problems in either neighboring joint often manifest as knee pain. This is important: knee pain isn't always a knee problem.

Common Presentations

Anterior knee pain (patellofemoral): Pain under or around the kneecap. Often worse with squatting, stairs, or prolonged sitting. Very common in men over 35.

Medial/lateral knee pain: Pain on the inside or outside of the knee. May indicate meniscus issues, ligament stress, or referred pain from tight muscles.

Posterior knee pain: Pain behind the knee. Less common, may indicate hamstring or calf issues.

Training Modifications

For squatting patterns:

Many men over 35 have accumulated years of poor squatting mechanics. The answer isn't to stop squatting - it's to find squat variations that are joint-friendly while still providing training stimulus.

Modification ladder for knee issues:

1. Back squat (often most problematic)
2. Front squat (more upright torso, often better tolerated)
3. Goblet squat (even more upright, lighter load)
4. Box squat (controls depth, reduces bounce at bottom)
5. Heel-elevated squat (shifts stress posteriorly)
6. Split squat / Lunge variations
7. Leg press with controlled range
8. Terminal knee extensions (least demanding)

Start where you're pain-free. If goblet squats hurt, try box squats with a higher box. If those hurt, try split squats. Find your floor.

Key technique modification: For anterior knee pain, maintaining a more vertical shin angle often helps. This means pushing the hips back more and keeping the knees from traveling far forward.

The heel-elevated squat accomplishes this mechanically by shifting load to the posterior chain while maintaining an upright torso.

For hip hinge patterns:

Romanian deadlifts, conventional deadlifts, and hip hinges are typically well-tolerated with knee issues since the knee stays relatively stable while the hip does the work.

These movements often help knee issues by strengthening the posterior chain (hamstrings, glutes) that supports knee function.

What to add:

Terminal knee extensions strengthen the VMO (inner quad muscle) which often deconditions with knee issues. A simple band around a post, looped behind the knee, provides resistance for the final 20-30 degrees of knee extension.

Add 2-3 sets of 15-20 reps daily if dealing with anterior knee pain.

When to Push vs. When to Rest

Push (train through with modifications):

• Stiffness that improves with movement
• Mild discomfort that doesn't alter your gait
• Pain that allows full range of motion, just with some discomfort

Rest (take that movement out):

• Swelling in or around the knee
• Locking or giving way sensations
• Pain that causes limping
• Pain that increases throughout the session
• Any acute injury (sudden onset during activity)

Back Issues

Lower back pain affects approximately 80% of adults at some point. For men over 35 who train, it's nearly universal. The good news: most back pain improves with intelligent training, not rest.

Common Presentations

Non-specific low back pain: The most common type. Diffuse ache in the lower back without shooting pain down the legs or specific point tenderness. Often related to deconditioning, poor movement patterns, or accumulated fatigue.

Discogenic pain: May include radiating symptoms into the buttocks or legs. Often worse with flexion (bending forward) or prolonged sitting.

Facet-related pain: Often one-sided, worse with extension (arching back) or rotation. Point tenderness over the spine.

Training Modifications

The critical distinction: Non-specific low back pain typically improves with movement and loading. Disc-related or nerve-involving pain requires more caution and often professional evaluation.

If you have shooting pain, numbness, tingling, or weakness in your legs, stop training and see a professional. That's beyond modification territory.

For non-specific low back pain:

For hinge patterns:

The conventional deadlift is often blamed for back issues, but a proper hip hinge is usually therapeutic for backs. Problems arise from poor technique, excessive load, or training through fatigue when form breaks down.

Modification ladder:

1. Conventional deadlift from floor
2. Rack pull or block pull (reduced range of motion)
3. Trap bar deadlift (more upright torso)
4. Romanian deadlift (controlled eccentric, no floor start)
5. Hip hinge with kettlebell or dumbbell
6. Cable pull-through (constant tension, no spinal loading)
7. Hip bridge progressions (supine, unloaded)

Find your pain-free entry point and build from there.

For squatting patterns:

Squatting with back pain often comes down to bracing and positioning. A weak or poorly-timed brace allows spinal flexion under load.

Modifications that help:

• Front squat or goblet squat (forces upright torso, prevents excessive forward lean)
• Box squat (controls depth, prevents relaxation at bottom)
• Belt squat if available (loads legs without spinal compression)
• Leg press as temporary substitute

What to add:

Core stability work is essential for back health. But "core work" doesn't mean crunches. It means training the ability to resist movement under load.

Daily additions for back health:

• Dead bugs (2-3 sets of 8-10 each side, controlling rib position)
• Bird dogs (2-3 sets of 8-10 each side)
• Pallof press or variations (anti-rotation, 2-3 sets of 10 each side)
• Plank progressions (starting position, 30-60 seconds)
• Carries (farmer's walks, suitcase carries)

These train the core to stabilize the spine - the actual function it needs to perform during training.

The McGill Big Three: Stuart McGill's research identified three exercises that effectively train spine stability with minimal spinal stress: curl-up (modified crunch), side plank, and bird dog. These form a solid maintenance routine for anyone with back history.

When to Push vs. When to Rest

Push (keep training with modifications):

• Mild stiffness that improves with movement
• Dull ache without radiating symptoms
• Pain that stays constant (doesn't worsen) during session
• Pain that's been present for weeks and hasn't progressed

Rest and seek evaluation:

• Radiating pain into buttocks or legs
• Numbness, tingling, or weakness in legs or feet
• Loss of bowel or bladder function (seek immediate care)
• Pain following acute injury (sudden onset)
• Pain that progressively worsens over days/weeks

The System for Training Through Any Injury

Here's a framework that applies regardless of the specific injury:

Step 1: Identify Pain-Free Movements

Test every major movement pattern. Find what you can do without pain.

Cannot back squat? Can you goblet squat? Front squat? Split squat? Leg press?

Cannot bench press? Can you use dumbbells? Floor press? Push-ups? Landmine press?

Something is almost always available. Find it.

Step 2: Train Those Movements Hard

The pain-free movements aren't just placeholders. They're your training. Attack them with the same intensity and progressive overload you'd apply to your normal program.

If goblet squats are your current ceiling, goblet squat 3-4 times per week with progressive loading. You'll build strength and maintain the movement pattern.

Step 3: Add Appropriate Prehab/Rehab

Address the underlying issue. Rotator cuff work for shoulder issues. VMO work for knee issues. Core stability for back issues.

This is done in addition to training, not instead of it.

Step 4: Periodically Test the Next Level

Every 1-2 weeks, test the next progression. Can you do a light dumbbell bench press now? Try it. Pain-free? Add it back in.

Progress is earned in small increments. Don't skip levels because you're impatient.

Step 5: Maintain Perspective

An injury that sidelines one movement pattern doesn't sideline everything. If your shoulder hurts, train legs and core hard. If your knee hurts, focus on upper body and hip hinge.

Maintain training momentum even if the specific exercises change.

The Identity Piece

Here's what separates those who successfully navigate injuries from those who spiral:

Men who train through injuries with intelligent modifications maintain their identity as someone who trains. The habit continues. The self-concept stays intact.

Men who stop entirely begin to identify as "injured." They become someone who used to train. Resuming requires rebuilding both the habit and the identity.

Don't let an injured shoulder turn you into a non-trainer. You're a person who trains, currently with a shoulder modification. That's a completely different psychological position.

Show up. Do what you can. Maintain the system even when the specific exercises change.

When to See a Professional

This guide helps you train around injuries, not diagnose them. See a qualified professional (sports medicine physician, physical therapist, orthopedist) when:

• Pain persists beyond 2-3 weeks despite modifications
• Symptoms are worsening rather than improving
• You have radiating pain, numbness, or weakness
• There's significant swelling, bruising, or obvious deformity
• Pain significantly impacts daily activities or sleep
• You're unsure what's going on

Intelligent training around injuries requires knowing what you're dealing with. When in doubt, get evaluated.

The Long Game

At 35 and beyond, you're not training for the next competition. You're training for the next forty years.

An injury setback that costs you six weeks of modified training is irrelevant on a forty-year timeline. An injury made worse by stubbornly training through it could sideline you for years.

Train hard. Train smart. Modify when needed. The goal isn't maximum intensity today. The goal is consistent training for decades.

Injuries will come. Your response to them determines whether they're temporary detours or permanent roadblocks.

Choose the detour. Keep moving forward. The destination hasn't changed.