Most elite athletes need more than basic therapeutic exercises, even during the first couple of weeks after injury. Therapy protocols are usually aimed at the general population and fail to achieve sufficient neuromuscular stimulus, the key to athletic movement.
I’m not saying athletes need to resume aggressive training throughout the injury process, but research continues to support the need for heavier exercise that can sufficiently stimulate the nervous system.
A 2006 study out of the Institute of Sports Medicine in Copenhagen, Denmark, compared conventional therapeutic exercises with heavy resistance training. The basis behind the study was the nervous system depression that occurs after injuries, and the subsequent risk for reinjury due to this lower global functioning. It makes sense; the body gets traumatized, and the nervous system subsequently shuts down the joints and associated muscles as a form of protection against further injury.
Fortunately, heavier resistance exercises have been shown to be superior in activating the neuromuscular system. This landmark study found the therapy exercise to provide less than half of the activation of heavy strength movements like squatting.
So if you’re an athlete and you’re injured, the answer is to still incorporate basic therapeutic exercises, without neglecting heavier strength movements that do not aggravate the current injury. One of the best examples we use for injuries are isometric pulls to the knee, as these barbell holds allow the athlete to avoid any sudden stretches to the muscle or tendon.
Perhaps more obvious, and concerning, are athletes with an upper-body injury that are quarantined in rehab despite being perfectly fine to perform heavier lower-body movements like a squat. There are many options, but the key is to find a way to include some higher levels of activation, even from the start of the rehabilitation process. You also cannot overemphasize the psychological benefit of resuming some sort of “routine” strength training, which should always involve something heavy.
So get your mind right and find a way to lift something heavy without stressing your injured joint or muscle.