Injuries In The Gym: From Prehab to Rehab

This article  is written by Fred Ashford, who is a competitive Masters 2 (over 50) powerlifter who has set M2 records in the raw bench at 479lbs and raw deadlift at 655lbs.

Injuries; the scourge of any powerlifter, weight lifter, and bodybuilder.

This is a subject near and dear to my heart.

In 29 years of lifting I’ve only experienced three injuries, but they were doozies:

  • Torn Pec – 2009
  • Rupture and Full Avulsion of Left Quad Tendon – 2011
  • Detached Distal Bicep Tendon – November 2013

I came roaring back from the first two injuries to set PRs in my 50s last November. Today, 21 weeks post-op from the bicep tendon, I’m back at around 80% of my previous strength level.

I don’t say this because I possess some sort of recovery superpower which is far from the truth; I’ve read thousands of pages and consulted with hundreds of lifters, trainers, and physical therapists.

These lessons learned have helped tremendously in preventing and bouncing back from injury. Lets look at these separately.

Preventing Injuries

First and foremost, the number 1 tool in the ol’ “don’t get hurt” toolbox is form. Lifting with proper form on every rep of every lift of every session is paramount to remaining healthy. I’m not going to go into detail of the big three and proper form, but check out Cutty’s “build a bigger” series on the side menu for some great tips.

It would be easier to learn to ride a bike by reading a book than to master the squat, bench, or deadlift through an article. The very best method for learning good form is finding a highly qualified coach and working with him or her.

Although this is easier said than done; it is extremely difficult finding a qualified powerlifting coach. Flip through YouTube and you’ll find a litany of lifters from the ridiculous to the elite extolling their powerlifting virtues on the net for all to see.

And.. and… (I said “and” twice because this is really important)… just because someone can lift an ass-load of weight doesn’t make them an effective coach.

Making finding a coach even more difficult is that there isn’t a powerlifting coach school that the gurus go to and earn their credentials.

So how does one find a good form coach? Ask.

Don’t just ask “who is a good coach” but ask “who has impeccable form?” Lifters know.

Don’t ask “who’s the strongest, best, most resilient…” simply find out who has great form. Once you find those lifters, ask who coached them.


I would be remiss if I didn’t point out the worst method to master powerlifting form: Posting your videos on a powerlifting forum and asking complete strangers to critique your form.

Remember opinions are like assholes and everyone has them and most stink. – Cutty Unless you know who is critiquing your form, take their advice with a grain of salt.

Programming To Prevent Injury

Establishing a solid program can sometimes be more art than science. Yes, there is a lot of “bro” science out there establishing ‘the very best’ lifting program on the net… pause for sarcastic effect… again, a butt-load of folks out there telling you how to lift.

In this case I would go to the best lifters. Well, let me preface that, the best lifters who have staying power. These gents have survived the test of time and continue to improve.

Search and find the drug free champion lifters who most emulate your frame and age and discover their programming. There are several solid programs out there including the Cube/Westside, 5/3/1, BIG, 10/20/LIFE, and so on. Read up on them and develop a workout plan and run with it.

Every program is just a starting point so listen to your body and adjust as you grow with the program.

The most significant program change you can make that will help prevent injuries is lengthening the recovery time between workouts.

Now that your form is dialed in and you have an effective program, ensure you are getting plenty of rest and time for recovery, eat to fuel your body, and spend time relaxing and having fun away from the barbell.

Bouncing Back From Injuries

In the unfortunate event you experience an injury, your lifting career is far from over.

There are several steps you can take to get back into the gym and back on track to competition.

1.) Know the difference between “injured” and “hurt.” Lifters that come from an athletic background understand that pain is associated with intensity. Pain isn’t necessarily a precursor to an injury. Being hurt or sore will simply require more recuperation (read: rest or food) to recover. However, if the pain is something that isn’t subsiding within two or three weeks or in a few cases where the mechanical chain is interrupted, severed, ruptured or detached; you’re injured.

2.) Once you’ve determined that you are injured, seek medical advice. Don’t ask your gym buddies, your spouse, brother-in-law, or the self-proclaimed internet gurus what they think; go to the doctor. This is why they went to school for umpteen years and subjected themselves to internships.

3.) Understand the diagnosis and research it prior to any medical intervention (if it isn’t an emergency procedure). Listen, surgeons want to operate because that’s what they do. Not every injury, even those that interrupt mechanical function require surgery to return to lifting. Two of the world’s strongest men experienced the same injury; a detached bicep tendon. One opted for surgical repair (Brian Shaw) and the second opted for rehab without repair (Terry Hollands). Both are top 5 competitors in the world today.

4.) Follow your doctor’s orders to a point. If you opt for medical intervention, follow the rehab protocol until the injury is completely healed. This may take some time; healing time is much different at 43 than at 17. Make sure your medical specialist has ensured your injury is indeed healed. Most physicians will advise you to stop lifting since if you’ve injured it before, it can happen again. My last surgeon wrote in my summary that he strongly discourages me from lifting heavy. I strongly encouraged him to save his paper and go fix a softball player, golfer, or someone else looking for an excuse to quit.

5.) Find those who have successfully rehabilitated the same injury. You’ll be surprised the amount of support on the internet you will get. There’s a board for quad tendon ruptures (on a ski site, of all places), a distal tendon repair site, a meniscus site, a rotator cuff site, and so on. Do a deep dive on research and develop the rehab protocol you feel most comfortable with if you decide against medical intervention. Don’t shy away from physical therapy at least in the beginning. Find that specialist who understands the sport and your injury; they are out there.

6.) After successful rehab, build your base strength back up; don’t rush the weights. Set long-term goals and ensure you are not over-compensating on the other lifts. Progress slowly, be smart, and focus on getting strong from head to toe. The best way to do this is develop this program early in your recovery; it will serve as a reminder to go slow.

Injuries are not inevitable, but when they do occur know it’s not the end of the world. Approach your recovery with some forethought and you’ll be back in the rack in no time.

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