Training Through Injuries: A 45-Year Journey

When you have been training for over four decades, injuries are not a matter of if but when. The question that separates lifelong lifters from those who fade away is not whether injuries will occur, but how they respond when they do. After 45 years under the bar, six major surgeries, and countless minor setbacks, one truth has crystallized: the barbell is never the enemy. Ego is.

The Reality of Long-Term Training

Research published in the British Journal of Sports Medicine estimates that up to 70% of recreational powerlifters will experience a significant training-related injury over a five-year period. Among competitive lifters, that number climbs higher. A 2023 systematic review found the overall injury incidence in powerlifting ranges from 1.0 to 5.8 injuries per 1000 hours of training. The shoulders, lower back, and knees bear the greatest burden.

But here is what the statistics do not capture: the vast majority of these injuries are manageable. They do not require complete cessation of training. They require intelligence, patience, and a willingness to adapt. That distinction has defined this 45-year journey.

Bilateral Carpal Tunnel: The First Test

The first major test came with bilateral carpal tunnel syndrome. Both wrists, both hands—the very tools that connect a lifter to the bar. The numbness started gradually during the late 1990s, progressing from minor tingling during heavy sets to persistent weakness and pain that affected everyday life. Surgery was inevitable.

Bilateral carpal tunnel release involves cutting the transverse carpal ligament to relieve pressure on the median nerve. Recovery means weeks of limited grip capability. For a lifter whose training revolves around gripping heavy barbells, this felt like a death sentence. But it was not.

During recovery, training shifted to machine-based movements that did not require active grip: leg press, hack squat, leg extensions, leg curls. For upper body, isometric holds replaced dynamic movements. Light resistance bands provided stimulus without loading the healing wrists. The key insight: maintaining lower body strength during upper body recovery preserved overall training momentum and mental health.

Shoulder SLAP Repairs: Rebuilding the Foundation

If carpal tunnel was a storm, bilateral shoulder SLAP repairs were a hurricane. Superior Labrum Anterior to Posterior tears affect the ring of cartilage that surrounds the shoulder socket. They are common in overhead athletes and lifters who perform heavy pressing movements over many years. Both shoulders required surgical repair within a two-year window.

The first surgery forced a complete rethinking of pressing mechanics. Traditional flat bench pressing became impossible for months, and even after clearance, the old technique no longer worked. The solution was not to abandon pressing but to rebuild it. Floor presses limited range of motion to safe zones. Swiss bar pressing with neutral grip reduced shoulder stress. The incline was actually more comfortable than flat pressing—a counterintuitive discovery that now informs programming recommendations.

Research from the American Journal of Sports Medicine shows that approximately 75% of overhead athletes can return to their pre-injury level of sport after SLAP repair, but the timeline is typically 6 to 12 months. For strength athletes, the research suggests similar return rates, though the definition of "pre-injury level" may need adjustment. Absolute numbers may change, but training quality and consistency can absolutely be maintained.

Hip Replacements: Redefining What's Possible

The bilateral hip replacements represented the most significant surgical challenge. Total hip arthroplasty involves replacing the femoral head and acetabular socket with prosthetic components. Traditional posterior approach surgeries come with movement restrictions: limited hip flexion, no internal rotation past neutral, and cautious loading for months. The anterior approach, used in this case, allowed somewhat faster rehabilitation, but returning to heavy squatting and deadlifting still required extraordinary patience.

A landmark 2022 study in the Journal of Arthroplasty examined strength athletes who returned to training after total hip replacement. The study found that 85% returned to some form of resistance training, and approximately 60% returned to heavy compound movements within 12 to 18 months. The keys to successful return were gradual progressive loading, excellent physical therapy compliance, and modified movement patterns.

Post-hip replacement squatting started with box squats to a high target, gradually lowering depth over months as confidence and tissue adaptation allowed. Conventional deadlifts were replaced with trap bar deadlifts, which reduce hip flexion demands. Over time, sumo deadlifts became the preferred style—wider stance, more upright torso, less hip flexion stress.

The Mental Game

Perhaps the most underappreciated aspect of training through injuries is the psychological toll. Research in the Psychology of Sport and Exercise journal consistently shows that injured athletes experience elevated rates of depression, anxiety, and identity crisis. For lifelong lifters, the gym is not just exercise—it is identity, community, and therapy.

During each recovery period, training had to serve a dual purpose: physical rehabilitation and mental health maintenance. Even when the training looked nothing like "real" lifting—resistance band work, bodyweight movements, rehabilitation exercises—the act of showing up to train preserved psychological well-being. The routine of preparation, training, and recovery maintained normalcy during abnormal times.

One of the most valuable lessons learned: celebrate the process, not just the numbers. When a 135-pound box squat represents months of rehabilitation after hip replacement, it is every bit as meaningful as a 500-pound competition squat from decades earlier. Redefining success from absolute numbers to relative progress is essential for long-term training adherence.

Practical Framework for Training Around Injuries

After six surgeries and countless smaller setbacks, a clear framework has emerged for training through injuries. This is not theoretical—it has been tested under real conditions over 45 years.

First, get accurate diagnosis. Many lifters try to train through problems they do not understand. A proper medical diagnosis informs every subsequent training decision. Self-diagnosis leads to self-destruction.

Second, identify what you can do, not what you cannot. After every surgery, the immediate instinct is to catalog losses. Instead, catalog available movements. After shoulder surgery, legs and core remained fully trainable. After hip surgery, upper body became the priority. There is always something productive to train.

Third, modify before eliminating. Before removing an exercise entirely, explore modifications. Reduce range of motion, change grip width, alter stance, lower the load, slow the tempo. A modified squat is infinitely better than no squat at all.

Fourth, progress gradually and systematically. Post-injury progression should follow a clear protocol: pain-free range of motion first, light loads with higher repetitions second, gradual load increases third, and return to normal programming last. Skipping steps leads to reinjury.

Key Principles for Injured Lifters

Drawing from 45 years of experience and current research, several principles consistently protect long-term training.

Pain is information, not a challenge to overcome. The old "no pain, no gain" mentality has caused more premature retirements than any injury. Sharp pain during a movement means stop. Dull, persistent pain means investigate. Post-training soreness is normal; joint pain is not.

Volume management matters more than intensity. Research consistently shows that excessive training volume—not heavy loads—is the primary driver of overuse injuries. A 2021 meta-analysis in Sports Medicine found that rapid increases in training volume (more than 10% per week) significantly increased injury risk. Progressive overload should be patient and systematic.

Mobility work is not optional. Fifteen minutes of targeted mobility work before each session is a small investment with enormous returns. Hip flexor stretches, shoulder dislocations with a band, thoracic spine rotations, and ankle mobility drills prepare tissues for the demands ahead. After 45 years, this pre-training ritual is non-negotiable.

Build redundancy into programming. Never rely on a single movement pattern. If the barbell back squat becomes problematic, safety squat bar squats, front squats, belt squats, or leg press can maintain lower body stimulus. Having alternatives already practiced and familiar means injuries cause detours, not dead ends.

Recovery is training. Sleep, nutrition, stress management, and active recovery are not supplementary—they are foundational. After 40, recovery capacity diminishes. Honoring that reality with adequate sleep (7-9 hours consistently), sufficient protein (research suggests 1.6-2.2g per kilogram of body weight for strength athletes), and programmed deload weeks prevents the cumulative fatigue that leads to injury.

The Long Game Perspective

Forty-five years of training have produced an inescapable conclusion: the greatest strength is not measured by any single lift, but by the ability to continue training year after year, decade after decade. Injuries are not failures—they are the tuition paid for a lifetime in the iron game.

The lifters who endure are not the ones who avoid injuries. They are the ones who refuse to let injuries end their journey. They adapt, they learn, they modify, and they continue. That is the long game. And it is the only game worth playing.

Every scar tells a story of resilience. Every modified exercise represents a problem solved. Every day back in the gym after surgery is a victory. This is what 45 years under the bar teaches: the iron is patient, and it will always be there. The only question is whether you will be too.