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Pain-Free Fitness: Why You Keep Getting Injured (…And How To Fix It)

How to stay pain-free for good, how metabolic health affects joint pain and the role of cardiovascular fitness in longevity

Welcome to Ageless Athlete - a weekly 5-minute dose of science-backed, actionable strategies to keep you strong, fit and pain-free for the long-haul. If this was shared with you, click here to get these tips straight to your inbox every week.

Let’s dive in!

🧐 IN TODAY’S ISSUE:

  • Why your pain keeps coming back & how to stay pain-free for good

  • Heart rate variability and how it impacts well-being

  • How lifestyle & metabolic health exacerbate joint problems

  • Cardiorespiratory fitness & its’ role in longevity

📖 DEEP DIVE

Why does your pain always come back just when you think you’re finally better?

You’re feeling good, enjoying your day, but as soon as you push yourself at the gym, the pain comes back.

This frustrating cycle halts your progress in its’ tracks.

What if you could break free from this cycle and confidently get back to your workouts?

With the right approach, it’s possible to fully recover, build resilience, and stay injury-free.

By the end of this article, you’ll understand why injuries happen, how to approach recovery, and how to better prepare yourself to avoid future injuries.

Let's dive in.

Too many people stay stuck in the pain cycle, but with the right approach you can break free.

Eventually, Rehab Should Feel More Like Training

Traditional rehab helps you manage pain and get back to daily life, but that’s not enough to prevent future pain and injuries.

To fully enjoy your workouts, sports, and hobbies, rehab should eventually mimic the intensity of your regular workouts, building the strength, endurance, and capacity needed to handle your favorite activities without pain.

If you’re recovering from a low back injury, for example, rehab might focus on stretching and gentle core exercises.

However, to lift pain-free, you need full-body strength. This might start with lower-intensity, higher-volume lunges instead of heavy barbell squats to bridge the gap between rehab and training.

Transition from traditional rehab to training-based rehab for complete recovery.

Load vs. Capacity: The Injury Equation

Injuries occur when the load on your body exceeds your capacity to handle it.

The dotted line in the chart represents your capacity—the maximum load your body can safely manage. Staying below this threshold reduces injury risk, while exceeding it increases the potential for pain and injury.

After recovering from a back injury, you may feel fine walking around, but when you hit the gym for deadlifts, bam - the pain comes right back. That's because the load of heavy lifting exceeds your body's current capacity.

To build capacity, you have to gradually increase exercise intensity. Start with lighter weights and higher reps, then slowly increase intensity as capacity improves.

Just like lifting heavier weights makes your muscles stronger, increasing the intensity of your rehab prepares you for the physical challenges of your favorite activities, reducing the risk of re-injury so you can stay active and pain-free.

If you’re hurting, don’t push hard to increase your capacity yet. First, reduce your current load to get below the pain threshold and out of pain quickly. Once your pain is under control, start to gradually increase your overall capacity.

Pain is the balance of stressors on your body (load) and your capacity to handle them. In this example, daily life isn’t a problem but workouts may cause a flare-up.

Respecting Your Limits

Remember that old "no pain, no gain" mentality?

It’s outdated and harmful. Exceeding your body's capacity increases your injury risk significantly.

It’s like driving an old Ford Fiesta as if it were a Ferrari—you might push it to 100 mph for a while, but eventually, it will break down. Similarly, pushing your body beyond its limits leads to a high risk of re-injury.

For athletes and weekend warriors, there's a balance between pushing hard enough to improve performance while avoiding overload that leads to injuries. Go too hard, too fast, and you'll pay the price.

Tune into your body's signals. If you feel pain, stiffness, or discomfort increasing, back off to avoid crossing that injury threshold.

For example, if lifting weights increases your pain, reduce the weight to a more manageable level and gradually build up over time as pain allows.

The Two Phases of Rehab

Rehab isn't a one-size-fits-all process; effective rehab involves two distinct phases:

Phase 1 reduces load to manage pain and promote healing, allowing you to return to daily life. Traditional rehab covers this, getting you functional again. However, this is just the beginning.

Phase 2 builds your capacity through targeted training and progressive overload, so you can return to the workouts, sports, and activities you love without fear of injury.

For example, Adam came to me with chronic lower back pain that prevented him from working out and playing with his kids. He had done rehab before, but his pain kept coming back because rehab stopped when he was “good enough.”

We started Phase 1 of his rehab with breathing exercises and mobility work to reduce load, decompress his back and relieve pain.

But once his pain subsided, we got after it in the gym. We started low-intensity strength-training and built up to heavy deadlifts, kettlebell swings, and eventually full-intensity workouts.

Now, he’s pain-free, stronger than ever and enjoys playing with his kids again.

From managing pain to building capacity: the two phases of effective rehab.

TL;DR: Building Superhuman Capacity

Most people stop rehab WAY too early.

They hit 'good enough' for daily life and stop, but this leaves you vulnerable to re-injury because you haven’t built your body’s capacity back up.

To minimize future injuries, continue progressive strength training to build your strength, capacity, and minimize the chances of your pain coming back.

Think of this as your “forever phase.”

For a simple progression that can be applied to any exercise, start here:

Respect your limits and gradually increase capacity over time.

It’s not a quick fix, but it’s the best way to stay fit, strong, and active without constant flare-ups.

So ask yourself:

Are you building capacity for the long haul–or just getting by?

That’s all for this week. See you next Friday.

🧠 SPEED READ

Summary: Heart rate variability (HRV) is a measure of the time variation between heartbeats, controlled by the autonomic nervous system (ANS). A higher HRV indicates a relaxed state and better cardiovascular fitness, while a lower HRV suggests stress. Wearable devices can help monitor HRV, although their accuracy is still under review.

Takeaway: Using HRV as part of your health tracking can motivate lifestyle changes like increased exercise, better sleep, and mindfulness practices. While HRV can offer valuable insights, it should be used alongside other health measures for a more comprehensive understanding of well-being.

Summary: Sedentary behavior and metabolic disorders like diabetes and high cholesterol exacerbate joint issues through chronic inflammation and muscle weakening. This creates a vicious cycle of pain and inactivity, further deteriorating joint health.

Takeaway: Break this cycle by incorporating regular exercise, including strength training and low-impact activities like swimming and cycling. An anti-inflammatory diet rich in omega-3s and antioxidants can also help. Consult healthcare professionals for tailored exercise routines. New medications, such as GLP1, have shown promise in managing metabolic disorders and by extension, in management of osteoarthritis, particularly in the knee and hip.

Summary: Research involving over 122,000 patients shows that increased cardiorespiratory fitness (CRF) is inversely related to long-term mortality (your risk of dying from any cause). Those with the highest fitness levels have the lowest risk of death from any cause, with no upper limit to the benefits observed.

Takeaway: Regular aerobic exercise to boost CRF can lead to significant longevity benefits. Improving fitness levels reduces mortality risk, especially in older individuals and those with hypertension, reducing risks associated with various health conditions.

🏆 WEEKLY WIN: Chronic Back Pain To An Active Life

He had been struggling with severe back pain, nearly immobilized and constantly throwing his back out. With an active lifestyle and three young kids, he couldn’t afford to be inactive. Traditional treatments didn’t help, so he turned to us.

Within a short time, he went from nearly immobile to pain-free.

Here’s how we did it:

  • We diagnosed the root cause of his pain and created a tailored rehab plan.

  • Transitioned from basic rehab to progressive strength training to build capacity.

  • Provided ongoing support with varied exercises to maintain optimal back health.

Now, he enjoys an active life with his kids, free from back pain and fear of re-injury.

🎬 THAT’S A WRAP

Whenever you’re ready, here’s how I can help you:

Free 15-min Discovery Call: Dealing with nagging aches and pains in the Columbus, OH area? Don't let them slow you down any longer. My team has your back (and knees, and shoulders...). Click here to book a free 15-min chat with my team and let’s see how we can get you feeling like your superhero self again!

Keep moving,

Dr. Matt Longfellow PT, DPT, SCS, SFG II