The answer is almost always yes.
Not recklessly. Not by ignoring pain or pushing through something that needs rest. But in the vast majority of cases — a bad back, a dodgy knee, a shoulder that’s been troubling you for months, an old injury that never quite healed — you can train. You just need to train differently.
This is one of the most common questions Julian Ernst hears at Tempo Performance PT in Fitzrovia. Someone comes in with an injury — or the memory of an injury — and the first thing they want to know is whether training is even possible for them.
It almost always is. And in many cases, the right kind of training is exactly what the injury needs.
Why Most People Stop Training When They Get Injured — and Why That’s Often the Wrong Decision
When something hurts, stopping feels like the safe option. Rest it. Wait for it to heal. Come back when it feels better.
For acute injuries — a fresh muscle tear, a broken bone, a recent ligament rupture — rest is absolutely the right initial approach. But for the vast majority of injuries that bring people into the Tempo Performance PT studio in Fitzrovia — chronic back pain, recurring knee problems, shoulder impingement, postural issues — complete rest is often the worst thing you can do.
Here’s why.
The muscles surrounding an injured joint provide stability and protection. When you stop training entirely, those muscles weaken. A weaker muscle means less support for the joint — which means the injury becomes more vulnerable, not less. The pain often persists or worsens despite the rest, because the underlying cause — muscular weakness and imbalance — is being made worse by inactivity.
The research on this is consistent. For most chronic injuries and musculoskeletal pain conditions, progressive loading — carefully applied exercise — produces better outcomes than rest alone.
What Is the Difference Between Pain That Means Stop and Pain That Means Modify?
This is the most important question in injury rehabilitation — and the answer requires an honest assessment of the type of pain you’re experiencing.
Pain that means stop: Sharp, sudden pain. Pain that increases significantly during an exercise. Pain accompanied by swelling, instability, or inability to bear weight. Pain following a recent acute injury — a fall, a collision, a sudden movement.
Pain that means modify: Dull, aching discomfort. Stiffness that eases with movement. Chronic pain that has been present for weeks or months. Discomfort that remains at the same level or reduces during exercise.
The first category requires medical assessment before training continues. The second category is almost always manageable with appropriate exercise modifications — and often improves significantly with the right training programme.
At Tempo Performance PT in Fitzrovia, Julian Ernst assesses every client’s injury history before building their programme. The goal is never to train through pain — it is to train around it intelligently, building the strength that ultimately resolves it.
The Most Common Injuries That Bring Clients to Tempo Performance PT
Can You Train With Lower Back Pain?
Lower back pain is the single most common injury-related issue Julian Ernst works with at the Fitzrovia studio. It affects approximately 80% of adults at some point in their lives and is one of the leading causes of absence from both work and exercise in London.
The good news is that lower back pain responds extremely well to the right kind of strength training.
The majority of lower back pain is not caused by a structural problem in the spine. It is caused by weakness — specifically, weakness in the glutes, hamstrings, and deep core muscles that are supposed to support the lumbar spine. When these muscles are weak, the lower back takes on load it was never designed to handle alone.
The solution is to strengthen the supporting muscles. Romanian deadlifts build hamstring strength. Hip thrusts and glute bridges build glute strength. Dead bugs and pallof presses build deep core stability. Performed correctly and progressed gradually, these exercises do not aggravate lower back pain — they resolve it.
What to avoid with lower back pain: loaded spinal flexion — crunches, sit-ups, and bent-over rows with a rounded back. These movements place compressive load on already sensitised spinal structures and should be avoided until the underlying weakness is addressed.
Can You Train With Knee Pain?
Yes — and again, the right kind of training is often the solution rather than the problem.
Knee pain during exercise is almost always a symptom of weakness elsewhere — specifically the quads, glutes, and hip stabilisers. When these muscles are weak, the knee joint compensates — taking on load and stress it was not designed to manage alone.
The most common knee pain presentation in Julian Ernst’s Fitzrovia clients is patellofemoral pain — pain around or behind the kneecap, typically worsened by squatting, stairs, or prolonged sitting. This responds very well to targeted quad strengthening — specifically terminal knee extensions, step-ups, and leg press work that loads the quad without placing excessive stress on the knee joint itself.
What to avoid with knee pain: deep squats and lunges with significant load until quad and glute strength is established. These movements are not permanently off the table — but they should be introduced gradually once the supporting musculature is strong enough to handle them.
Can You Train With a Shoulder Injury?
Shoulder injuries are among the most complex to train around — the shoulder joint is the most mobile joint in the body, which makes it inherently less stable and more injury-prone.
The most common shoulder presentations at the Tempo Performance PT studio in Fitzrovia are rotator cuff impingement, shoulder instability, and the cumulative effect of years of poor posture — rounded shoulders, forward head position, and a compressed subacromial space.
All of these can be trained around — and all respond well to targeted strengthening of the rotator cuff, rear deltoids, and scapular stabilisers. Cable external rotations, face pulls, band pull-aparts, and scapular retractions are the foundation of most shoulder rehabilitation programmes.
What to avoid with shoulder injuries: overhead pressing and wide-grip bench pressing until rotator cuff strength and scapular stability are established. These movements place significant load on compromised shoulder structures and should be introduced gradually.
Can You Train With a Hip Flexor Injury?
Hip flexor strains are common among London professionals who spend long hours sitting — the hip flexors are in a chronically shortened position for eight to ten hours a day, making them vulnerable to strain when suddenly loaded.
Training around a hip flexor injury means temporarily avoiding exercises that load the hip flexor in a lengthened position — lunges, split squats, and hip extension movements. Upper body training, cycling, and swimming are all typically manageable. Hip strengthening through glute-dominant movements — hip thrusts, clams, and lateral band walks — builds the surrounding musculature that supports recovery.
How a Personal Trainer in London Helps With Injury Rehabilitation
The difference between training around an injury with a qualified personal trainer in London and attempting to do it alone is significant.
Without guidance, most people make one of two mistakes. They either stop training entirely — losing fitness, muscle mass, and motivation while waiting for an injury that may never fully resolve on its own. Or they attempt to train through the pain without modification — aggravating the injury and extending the recovery timeline.
A qualified personal trainer who understands injury rehabilitation builds a programme that threads the needle between those two extremes. Training the body productively — maintaining and building fitness, strength, and muscle — while protecting the injured structure and actively supporting its recovery.
At Tempo Performance PT in Fitzrovia, injury rehabilitation is a core part of what Julian Ernst does. Every client with an injury history receives a full movement assessment before their programme is built. Exercises are selected and modified specifically around the injury. Progression is gradual and monitored.
The results are consistent. Fernando — an online coaching client — resolved ongoing shoulder pain from an operation within 16 weeks of working with Julian, improving all his major lifts by 10–25%. Katie recovered from a shoulder injury and returned to full training capacity. These are not exceptional cases — they are the standard outcome when injury rehabilitation is approached intelligently.
Do I Need to See a Physiotherapist Before Starting Personal Training With an Injury?
For acute injuries — anything that happened recently, involves significant swelling, instability, or inability to bear weight — yes. See a physiotherapist or sports medicine doctor before beginning or resuming training.
For chronic injuries — pain that has been present for weeks or months, that has been investigated and cleared of serious pathology — a qualified personal trainer with experience in injury rehabilitation is often the most practical next step. Physiotherapy addresses the acute phase. Strength training builds the resilience that prevents recurrence.
The two are complementary — not alternatives. At Tempo Performance PT in Fitzrovia, Julian Ernst works alongside physiotherapists where appropriate, integrating their recommendations into the training programme.
Training With an Injury in London — Practical Advice for Busy Professionals
One of the most common barriers Julian Ernst hears from injured clients in London is not the injury itself — it is the belief that an injury means no training at all, and therefore no point in starting or continuing.
This is almost never true. Even with a significant injury, there is almost always something you can train. An injured knee does not prevent upper body training. A shoulder injury does not prevent lower body work. Lower back pain does not prevent most forms of upper body pressing.
The concept of training around an injury — rather than training through it or stopping entirely — keeps fitness levels maintained during recovery, often accelerates the recovery itself, and prevents the loss of muscle mass, motivation, and habit that makes returning to training so difficult after a long break.
How Long Does It Take to Recover From an Injury With Personal Training?
Recovery timelines vary enormously depending on the injury, its severity, and how long it has been present. What the research consistently shows is that appropriate progressive loading — guided by a qualified rehabilitation personal trainer in London — produces faster and more complete recovery than rest alone for the majority of musculoskeletal injuries.
Most clients at Tempo Performance PT in Fitzrovia with chronic injuries — back pain, knee pain, shoulder issues — see meaningful improvement in pain levels and functional capacity within six to eight weeks of consistent, appropriately programmed training.
FAQ — Training With an Injury
Q: Can I train with a herniated disc?
A: In most cases, yes — with significant modification. Herniated disc presentations vary enormously. Some are asymptomatic. Others cause significant nerve pain that requires medical management before training resumes. A physiotherapy assessment followed by a graduated strength programme — avoiding loaded spinal flexion — is the appropriate approach for most herniated disc presentations.
Q: Should I train if I’m in pain?
A: It depends entirely on the type of pain. Sharp, acute pain or pain following a recent injury — stop and seek medical assessment. Chronic, dull, aching pain that has been present for weeks or months — modify and continue with appropriate exercise, under the guidance of a qualified rehabilitation personal trainer in London.
Q: Can strength training make an injury worse?
A: Poorly programmed strength training can. Well-programmed strength training almost always helps. The key is appropriate exercise selection, correct technique, and gradual progressive loading — all of which are the foundation of injury rehabilitation personal training at Tempo Performance PT in Fitzrovia.
Q: What is the difference between rehabilitation and personal training?
A: Physiotherapy rehabilitation focuses on restoring function and reducing pain to baseline. Personal training builds on that baseline — developing the strength, stability, and resilience that prevents the injury from recurring. The two phases are sequential and complementary.
Q: Can I do online coaching if I have an injury?
A: Yes. Julian Ernst’s online coaching programmes are fully adaptable to injury — training plans are built around your specific limitations and adjusted as your capacity improves. Read more about online coaching: Online Personal Training
Q: How do I start injury rehabilitation personal training in London?
A: Book a free consultation at Tempo Performance PT in Fitzrovia. Julian Ernst will assess your injury history, current movement capacity, and goals — and build a programme that trains your body productively while actively supporting your recovery.
Q: Is Tempo Performance PT experienced with injury rehabilitation in London?
A: Yes. Injury rehabilitation is a core part of what we do. Clients include people recovering from shoulder operations, managing chronic lower back pain, dealing with knee issues, and rehabilitating from a range of sports injuries. Read our client results for specific outcomes.