Ask Stew: Recommended Workout Adjustments for an Arm Injury

When you injure a section of your body, it will take some time to regain your full capabilities. You can, however, work with other muscle groups and body parts that are not injured, depending on the severity of your injury. While some detraining is expected in the injured area, you have no reason to get completely deconditioned in other areas of fitness. Here is a question from a reader who says he broke his arm and has a cast below the elbow:

I broke my arm a few days ago. What advice do you have to not go crazy with this cast on my arm? Any variations of workouts you recommend? Thanks Rubin

Rubin, sorry to hear about the injury. Did you know that by working the uninjured arm, you can reduce atrophy in the injured arm? One of the biggest concerns for people wearing a cast is that the muscles under it will shrink from inactivity. Here are some pieces of advice to help you see less atrophy and strength loss, as well as keep you from going crazy doing nothing:

First, you may want to allow some time for the initial trauma of the injury to subside. Allow a few days to a week to avoid excessive arm movement, such as running (with arm swings) or walking too much. Keep the arm still and elevated for the first few days. You can start unilateral training with the uninjured arm as soon as possible. Give yourself a few more days before adding in leg days and running/rucking cardio events. Instead, start with stationary bike cardio.

How Unilateral Training Works

Research indicates that exercising the healthy limb can help maintain muscle mass and strength in the immobilized or injured limb. This approach is considered an effective and practical method for initiating early intervention in the rehabilitation process. This is also called “cross-education.”

Cross-education refers to the phenomenon in which training one side of the body leads to strength gains and reduced muscle atrophy in the opposite, untrained limb.

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This effect is believed to stem from neural adaptations. When you train one limb, signals are sent to both hemispheres of the brain, and it may also involve the activation of the mirror neuron system, according to a study in the Journal of Applied Physiology. 

How to Start with Unilateral Training (and Other Training)

Before starting any new training program, especially after an injury, it’s essential to consult with a health care professional or physical therapist for personalized guidance.

You may initiate exercises on your uninjured side as soon as your provider approves, which can help activate the cross-education effect.

Unilateral exercises include single-arm bicep curls, single-arm wrist curls (forearm exercises), single-hand grip exercises, single-arm overhead presses and single-arm triceps extensions. These will specifically help your injured arm reduce the atrophy while in a cast. Once your arm feels better with movement, you can add banded chest flies with both arms (without using the hands) to develop your chest. Keep the weight light and reps in the 10-15 rep range to engage muscle hypertrophy (anti-atrophy) training.

Don’t Skip Leg Day

There is no reason why you cannot continue doing leg day, especially if you do calisthenics, although you may need to use machines or a special barbell for weighted squats, called a “safety squat bar.” Barbell dead lifts are out, but you can hold a heavy kettlebell in your good hand and do squats, dead lifts, weighted lunges and Romanian dead lifts.

Cardio

You can start with stationary biking and elliptical (no hand movement), but you may want to avoid arm swings at first. Eventually, arm swings will no longer cause pain, and you can add walking, rucking, running and other more challenging cardio options. Wear a sweatband over your cast to help prevent sweat from forming and rolling down your arm. However, if you don't get a waterproof/water-friendly cast, your arm will likely stink. Eventually, you can even swim with a waterproof cast.

Check out more workout ideas at the Military.com Fitness section. There are many ways to keep moving, even with an arm or leg injury. When you cannot work the upper body as usual, try unilateral training, and focus more on leg strength. Keep up with the cardio as well. The goal is to keep moving and prevent serious deconditioning of multiple areas of fitness while you heal. 

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