Lower-Body Injury Cross Training

Jerod Keene is an athletic trainer who works with Sport Clubs and UHS.

As an athletic trainer, I often come across patients with lower-body injuries who would like to continue endurance training while attempting to avoid exacerbating their injury. Indeed, this can be a difficult task considering that most methods of endurance exercise involve using one’s legs. How can we get our heart rates up to the desired level for prolonged periods of time without using our legs? How can we maintain, or even improve our maximal oxygen uptake? I have had to help many athletes attempt this and realized that I should just write a blog post for the next time someone needs help continuing their cardio training while dealing with a lower-body Injury.

During this post, I am going to talk about different ways to exercise while dealing with a generic lower-body injury. DISCLAIMER: what I describe below are guidelines. Any athlete attempting to exercise with a lower-body injury should still consult with their healthcare provider prior to engaging in any of the exercises described below.

Before diving into specifics, it’s worth defining the goals of endurance exercise. If your intention is to exercise at or near your aerobic threshold, you would want to exercise at 70-80% your maximum heart rate (max heart rate can be calculated to be 220-current age). If you do not have a heart rate monitor you can use rate-of-perceived-exertion (RPE) to attempt to translate what your heart rate could be. The chart below can help clarify what intensity is appropriate for each workout.

RPE.                      % MHR.               Intensity

3-4.                         60-70%.              Aerobic

5-6.                         70-80%.               Aerobic Threshold

7-8.                         80-90%.               Anaerobic Threshold (LT)

9-10.                       90-100%.            Intense activity / Maximum

For this scenario, I am going to assume our injured athlete is in a removable walking boot. They can stand, but cannot run, bike or use the elliptical.

  1. Pool training: the pool offers a vast number of options for endurance training without weight bearing. Below is a list of exercises one can try:
    • Treading water: If the athlete has access to a deep water pool, treading water can be incredibly exhausting, especially if the athlete has a limited aquatic background. Attempt treading water for 3 sets of 2 minutes. Adjust these times accordingly based on difficulty. An ideal goal is 4 sets of 4 minutes with 1 minute of rest in between.
    • Swimming with pull-buoy: The pull buoy is a foam wedge that sits in between thighs while swimming only using the upper body. 45-60 mins.
  2. High-Intensity Interval Training (HIIT): The primary component of HIIT is to continue to exercise at a high intensity (70%-90% maximum heart rate) for an extended period of time (45-60 mins) with minimal or “active” rest.
    • The easiest way to design a HIIT training session with a lower-body injury is to include a number of circuits that are cycled through for 20-30 minutes. Below is a short list of exercises that could be compiled into a circuit. Obviously, with some injuries, some of these particular exercises may not be plausible. I would suggest taking 4-5 of these exercises and attempt to go through 3-4 cycles of about 1 minute at each circuit.
    • HIIT exercises (1 min each):
      1. Push-ups
      2. Crunches
      3. Standing shoulder press with dumbbells
      4. Bent-over rows
      5. side/front planks
      6. Standing punches with light dumbbells
      7. Bent Over row with dumbbells
      8. Russian situps
      9. Pull-ups
    • This list is just a few examples of HIIT exercises. Practically any type of exercise can be integrated into a HIIT workout. The most important part is to maintain high intensity (7-9 RPE) while limiting rest.

Cross-training while injured can be difficult. Hopefully, these guidelines can help you stay fit during your recovery. As mentioned before, these are simply guidelines and should be implemented with the guidance of a healthcare professional.