10 Tips For Rebuilding Fitness and Strength After Long-Term Injury, Illness or Atrophy

December 26, 2019

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Maybe it’s an injury that took months to overcome. Maybe it’s an illness that left you bedridden (or demotivated). Maybe it’s simple disuse and neglect that dragged on and on—or lasted your entire life until today. Or maybe you read my recent post about claiming health in later life and want to get back on the road to vitality. For whatever reason, almost everyone will be forced to recover and rebuild their fitness and strength after an extended period of inactivity. But there’s a wrong way and a right way to do it.

Here are some tips for doing it the right way:

1. Do Anything You Can

Isometric contractions in the hospital bed (only if allowed by your doc, mind you). Single leg squats when standing up from the couch with your good leg. Bicep curls with the one arm that isn’t incapacitated. Whatever movement you can muster, get moving.

While it’s definitely “better” to train your entire body, training just a single body part or limb is better than doing nothing. It sends a signal to your body that you haven’t thrown in the towel, that you still need your metabolically-expensive muscle mass.

2. Motion Is Lotion—but Only If It’s High Quality Motion

The quicker you can get back to normal movement, the better. Normal movement, not normal speed. Quality over everything. For instance, say you sprain your ankle. The best thing you can do to recover is to start walking on it with good technique. Once you can walk with good form, however slow you go, get walking. Walk without a limp, even if it’s 1 MPH. Walk without a limp, even if you have to use crutches or a cane to bear some of the load. Don’t roll onto the outside of your bad foot. Don’t splay that foot out like a duck to avoid the pain.

The point is moving—and moving well.

3. Eat Tons Of Protein

Inactivity increases the protein requirement. When you’re on bed rest (mandatory or self-imposed), your protein metabolism shifts toward that of an older person’s—lower efficiency, higher substrate requirements to attain the same result. You need more protein just to stay on top of daily maintenance. Plus, since you’re actively healing and recovering and laying down or repairing tissue, you need extra protein to handle the extra processes.

Eat a good 1 gram protein per pound of lean body mass as you prepare for your return to activity. Consider including whey isolate, as it’s an easy additive source of protein that’s been shown to improve recovery after bed rest and surgery.

4. Learn To Distinguish Between Pain and Soreness

When recovering from an injury or just getting back into exercise, you want to avoid pain. Sharp pains in the joints, strains in the tendons that you feel for days after, a pulled muscle—these are not okay.

But you will and should feel discomfort. Muscle soreness after a session is fine. It’s normal. Burning in the muscle during a session is fine. It’s normal. Pain is not. Avoid pain.

5. Go For Walks

Regular walking is a powerful signal of “abundance” to your body. It tells your body that you’re still in the game, that you’re engaged with the world and have places to be. Walking is also the simplest, most fundamental way to get the blood flowing, get your joints lubricated, and apply a low-level stimulus to your musculoskeletal system. Pretty much everyone can walk.

If you have access to hills, even better. Walk up and down hills as often as possible. A brisk uphill walk is a legitimate way to build strength and endurance.

Work your way up to 5 times a week of 30-45 minutes. Throw on a weighted vest or throw some books in your backpack to add resistance.

6. Do Bear Crawls

Slow bear crawls are a great way to loosen up your joints and prepare your shoulders and hips for more complex, weighted movements. They’re actually a good exercise in their own right, especially if you haven’t done them since you were a baby.

Do these several times a week, preferably in the morning or before workouts, for a few minutes each day. Crawl forward, backward, sideways in a controlled fashion, making sure you feel the movements.

7. Do Balance Work

One basic way to improve balance (or just get more comfortable in unstable positions) is to stand on one foot and slowly sweep the opposite foot across in front of and behind you. Switch feet and do this every day for a couple minutes, or whenever you have down time—standing in line, for example.

You can also buy a 2×4 from the hardware store, place it on the ground, and practice walking forward and backward along it. You get the benefit of balancing on a narrow surface without the risk of falling to your doom.

8. Start With Bodyweight Exercises

Basic movements: knee flexion (squat, lunge, split squat), hip hinge (deadlift, kettlebell swing, trap bar DL), push (pushup, overhead press, dip), pull (pullup, chinup, row variations). You can do just about all of them with bodyweight, with the only one that’s really hard to do without external weights being the hip hinge.

Grab the Primal Blueprint Fitness ebook. It’s free and provides a step-by-step progression for all the movements, from total beginner doing pushups on the wall and assisted pull-ups to experienced lifter doing feet elevated pushups and weighted pull-ups.

9. Consider Finishing With Bodyweight Exercises.

Bodyweight exercises are totally sufficient for most people. It’s all about the amount of work you’re willing to do and the amount of effort you’re willing to give. In fact, I made the case in this post that you could build incredible strength and general fitness simply using bodyweight exercises plus some weighted resistance for the lower body (perhaps, say, my new favorite exercise: the trap bar deadlift and its many variations).

10. Take Fish Oil or Eat Fatty Fish.

The benefits of seafood on recovery and bounce-back-ability are multifold:

First, seafood is a great source of bioavailable high-quality protein—protein you need to recover from whatever sidelined you.

Second, the long chain omega-3s have a potent anti-inflammatory effect that can improve your recovery and speed up your return to normal activity. They reduce pain and inflammation without curtailing the healing process. One study even found that high dose omega-3 intake increased physical activity, maintained physical function, and reduced the incidence of joint replacement in older adults.

Third, the long chain omega-3s also increase muscle protein synthesis, particularly in older adults (presumably with higher baseline inflammation levels). In other words, they make physical activity more anabolic. They improve your ability to build muscle, muscle that you’ve probably lost being injured and inactive.

That’s it, everyone. These are the tips and methods I’ve used to get myself back on my feet after a long layaway, and to help others do the same. If you have anything to add or questions to ask, do so down below. I’d love to hear what worked (and what didn’t) for you. Thanks for reading.