Preventing Re-Injury: Strength Training Guide 2025

Recovering from a spinal injury is a major milestone for athletes—but there’s always the lingering worry of re-injury. Before beginning any post-recovery strength program, athletes must go through medical clearance and functional assessments to make sure they’re ready. A reduction in pain isn’t a good enough assessment for training. The following must first occur: 

• Comprehensive Assessment and Personalized Rehabilitation Plans — to assess an athlete’s injury and body mechanics to customize a rehabilitation plan. 
• Restoring and Enhancing Range of Motion — to reduce stiffness and improve loss of flexibility from injury. 
• Strengthening Muscles and Correcting Imbalances — targeted strength training for both the affected muscle and supporting muscles. 
• Neuromuscular Re-education — to enhance coordination and balance. 
• Biomechanical Analysis and Correction — assessing and correcting an athlete’s moving patterns to promote safe movements. 
• Education on Re-Injury Prevention — educating athletes on self-care, proper techniques, and body mechanics. 

Understanding Re-Injury Risk Factors in Spine Injuries

Re-injury refers to the act of injuring oneself in the same place as a previous injury. Data suggests that the lower back accounts for 64.8 percent of all weightlifting injuries, underscoring the vulnerability of the spine when strength and stability are insufficient. 

Studies of collegiate ice hockey players recorded 323 spine-related injuries over 6 years, emphasizing the prevalence of back and neck injuries even among elite athletes. These findings illustrate the importance of targeted spinal strength training as a recovery and prevention technique. 

Some key risk factors for re-injury include: 

• Incomplete Rehabilitation — returning to sport before a full recovery can increase the likelihood of re-injury and weak muscles. 
• Muscle Imbalances — re-injury risk increases when overcompensation of uninjured muscles occurs.
• Improper Movement Patterns — improper movements may put unnecessary stress on body parts, making them susceptible to injury.
• Psychological Factors — cautious movements due to fear of re-injury may increase injury risk. 

Building Your Foundation: Phase 1 Strength Training (Weeks 1–6)

Always consult with a professional when you’re thinking of beginning a new training program. 

After physical therapy (PT), the goal of advanced foundational training is to improve strength, balance, and flexibility beyond what you accomplished in PT. These exercises will help prepare you for the demands of everyday activities while helping prevent the risk of re-injury. In Phase 1, the following should occur: 

• Enhancing Proprioception — these exercises prevent future falls and injuries by improving how well your body can sense how it moves and is positioned. 
• Building Muscular Endurance — strengthening your body so it can handle activities for a longer duration. 
• Improving Functional Movement Patterns — exercises that focus on quality movements to promote safety and efficiency. 

Evidence shows that structured strength programs during early recovery significantly improve back muscle stiffness symmetry and reduce fatigability while keeping pain and disability at minimal functional levels. 

To prevent re-injury and promote muscle repair, training sessions should be short and paired with adequate rest. At this stage, recovery is important for long-term outcomes. 

Developing Resilience: Phase 2 Strength Training (Weeks 7–12)

Once pain is minimal, athletes can work to increase resistance and movement in their routine. When adding weight to your training, it’s important to start slow and increase load in increments. This could include increasing weight or repetitions, or changing up movements so they’re more complex. 

During incremental progression, be aware of how your body feels with added weight during training. While some discomfort is normal, if you experience any swelling or sharp pains, it’s a good idea to decrease the amount you’re lifting. 

Phase 2 introduces the following: 

• Exercises that work more than one muscle at once, like squats, deadlifts, and pushups 
• Bodyweight exercises
• Correct form takes precedence over weight 
• Core strengthening
• Gradual increase in intensity 
• Adequate rest and recovery time
• Adapting nutrition 

Research shows that back extension strength increases sharply after 8 weeks of structured strength training. However, adherence to programs like these remains a challenge, meaning that realistic goals need to be set for athletes. 

Return to Performance: Phase 3 Strength Training (Weeks 13+)

Phase 3 focuses on getting the body ready for competition while maintaining spinal safety. This includes: 

• Gradually increasing intensity with sport-specific drills 
• Improving coordination to prevent future falls 
• Gradually increasing training time without experiencing setbacks 

Continued monitoring and recovery maintenance are critical during this phase to prevent re-injury. Important tips when you’re working to return to peak training include: 

• Don’t overtrain or skip rest days 
• Warm up and stretch prior to intense exercise 
• Eat a balanced and nutritious diet 
• Engage in core strengthening (crunches, planks) 
• Wear proper athletic gear (shoes)
• Healthy sleep habits
• Be aware of how you’re feeling and stop if you experience pain 
• Seek professional support or treatment if needed 

Essential Exercises for Spine Injury Prevention

Regardless of where you’re at in your training, there are several exercises you can do to prevent future spine injuries.

Physical exercises include:

• Exercises like planks, deadbugs, and anti-rotational holds strengthen your core while maintaining spinal alignment. 
• Dynamic stretching and mobility drills can improve flexibility in the hamstrings, hip flexors, and the thoracic area. 
• Focus on quality and correctness for jumping, lifting, and landing. 

Also, make sure to include protein and anti-inflammatory foods in your diet while staying hydrated and incorporating rest days into your routine.

Speak With Dr. Hooman Melamed Today

If you’re an athlete experiencing back pain, recovering from an injury, or looking for new ways to prevent re-injury, the Spine Pro may be the place for you. Dr. Melamed and his team at The Spine Pro are dedicated to helping athletes achieve reduced pain and a better quality of life through a wide range of customized programs. 

Take the first step toward relief today. Call 424-21-SPINE or click here to schedule your appointment.