Training With a Bad Back, Dodgy Knees or an Old Injury

Life’s Peachy FIT | For Our Members & Community

Karen has a back.

Everyone has a back, obviously, but Karen has a back, the way people say it, with a small grimace. Hers started with a lifting-a-toddler-out-of-a-car-seat moment eleven years ago and has never fully gone away. Most mornings are fine. Some aren’t. She’s been told to “be careful with it” by enough people that being careful has become her main form of exercise.

She’s 47, hasn’t trained in a decade, and the sentence she says most often about the gym is “I can’t, because of my back.”

We hear a version of that sentence almost every week. Sometimes it’s a back. Sometimes knees, a shoulder, a hip, an ankle that’s never been right since netball. The sentence is always sincere, and it’s almost always wrong. Not because the injury isn’t real. Because “I can’t train” and “I can’t train the way I imagine training” are two very different claims, and only one of them is true.

Hurt is not the same as harm

The most useful idea in modern pain science is a simple one. Pain and tissue damage are related, but they’re not the same thing. Pain is the nervous system’s alarm, and after an injury, especially a long-standing one, that alarm often becomes more sensitive than the tissue underneath warrants. A back that hurts when you bend is not necessarily a back that’s being damaged when you bend. Often it’s a back that has learned to expect damage and is warning you early.

This matters because the instinctive response to a sensitive alarm is to stop doing the things that set it off. Stop bending, stop lifting, stop loading. For a week or two after an acute injury, that’s reasonable. Over years, it’s the worst thing you can do. Muscles that aren’t loaded weaken. Joints that aren’t moved stiffen. The structure around the sore spot gets less capable of protecting it, and the alarm gets touchier, not calmer. The careful approach slowly produces the exact fragility it was trying to avoid.

The evidence on this is now overwhelming, particularly for backs and knees. Clinical guidelines for persistent low back pain in Australia and internationally put graded exercise and strengthening near the top of the list, ahead of rest, and ahead of most passive treatments. For knee osteoarthritis, structured strengthening consistently outperforms rest and often matches or beats anti-inflammatory medication for pain and function. The joint that hurts usually isn’t the problem. The weakened muscle around it is.

What “training around it” actually means

None of this means you walk in and deadlift. It means the training is designed around where you’re at, which is a different thing from avoiding training entirely.

Here’s how that works in practice at LPFIT.

It starts in the intro conversation. Before you do a single session, you sit down with our Member Success team and tell them about the back, or the knee, or the shoulder. What happened, how long ago, what sets it off, what you’ve been told. This isn’t a screening to keep you out. It’s the information the coaches need to keep you in.

Every session has an injury check built in. Before the main work, the coach asks the room about injuries and adjustments. You don’t have to raise your hand awkwardly. It’s part of the structure, every time.

Every movement has a version for you. The program might say barbell deadlift. For Karen, in week one, it says hip hinge with a light kettlebell to a raised block, for a range her back is comfortable with. Same pattern. Same muscles. A load and a range she can own. Over weeks, the block gets lower and the weight goes up, at the pace her back allows, not the pace the program on the wall suggests. This is what coaching is for.

The coach is watching. Not in a hovering way. In a “that looked different from last week, how’s the back?” way. Adjustments happen in real time, and you don’t need to know what to adjust, because that’s our job.

We work alongside the people who treat it. We have great relationships with local chiropractors, physiotherapists & allied health professionals. If you’re already seeing a physio, tell us who. If you’re not and we think you should be, we’ll say so. Training and treatment work far better together than either does alone.

The three things that usually get better

When people with long-standing niggles start training properly, three things tend to happen, roughly in this order.

First, the fear drops. Within a few weeks of loading the sore area in a controlled way and having nothing bad happen, the alarm calms down. People often describe this as the injury “feeling less fragile,” which is exactly what’s happening. The tissue hasn’t changed much yet. The nervous system’s opinion of it has.

Second, the structure around it strengthens. Glutes, hamstrings and trunk for backs. Quads, glutes and hip stability for knees. Upper back and rotator cuff for shoulders. This takes six to twelve weeks and is the part that produces lasting change. The joint gets a support system it hasn’t had in years.

Third, daily life gets easier in ways that have nothing to do with the gym. Getting out of the car. Picking things up. Sleeping through. This is the bit people actually joined for, and it usually arrives without them noticing the exact moment it happened.

When you actually shouldn’t train

Honesty matters here. There are situations where the answer is not “come in and we’ll scale it.”

If an injury is acute, in the first days after it happened, with swelling, sharp pain, or any loss of function, see a doctor or physio first. If pain is getting worse over weeks rather than better, or comes with numbness, weakness, or symptoms that don’t match the movement, that needs assessing before it needs training. And if a medical professional has told you specifically not to load something yet, follow that advice and tell us, so we can work around it.

Everything else, which is most backs, most knees, and most old injuries, is a coaching problem, and coaching problems are solvable.

What happened with Karen

Karen started with the raised-block hinge and a lot of scepticism. The first thing she noticed, around week three, was that she’d stopped bracing before she bent to pick up her bag. Week eight she deadlifted a bar from the floor, which she describes as “the first time I’ve picked something heavy up on purpose in ten years.” The back still has days. They’re fewer, they’re milder, and she doesn’t organise her life around them anymore.

She still says “I’ve got a back.” She’s stopped saying “I can’t.”

Got a back, a knee, or an old injury you’ve been training around (or not training because of)?

Come in for a free intro session and tell us about it. We’ll build your first sessions around what your body can do right now, not what you’re worried it can’t.

LPFIT Byford & Canningvale https://www.lifespeachyfit.com/contact

www.lifespeachyfit.com | hq@lifespeachyfit.com

This article is general information, not medical advice. If you have an injury, see a health professional before starting a new training program, and tell your coach what they said.