Strength Training During Rehab: Five Myths Worth Retiring

Almost every week someone repeats a rule about lifting that stopped matching the research a long time ago. Five of them come up often enough to be worth answering properly.

Here are the five myths, and what the evidence actually supports in each case.

Myth one: lifting stunts growth in children

This is the most persistent one, and it comes up in almost every conversation with a parent about a young athlete's program.

The 2017 review Resistance Training in Youth: Laying the Foundation for Injury Prevention and Physical Literacy, by Zwolski, Quatman-Yates and Paterno in Sports Health, states that the evidence has dispelled myths and addressed previous concerns regarding prepubescent resistance training. The 2009 position statement from the National Strength and Conditioning Association holds that properly prescribed and supervised resistance training is safe and advantageous for children and adolescents.

Those two conditions carry weight. Properly prescribed means the program suits the child's age, size, and experience. Supervised means a qualified adult is watching technique and controlling the load. A structured session with a coach is a different activity from a teenager copying a maximal lift from a video.

The stronger finding runs in the opposite direction to the myth. The Sports Health review reports that resistance training reduces sports-related injuries, both overuse and acute, by up to 66 percent based on meta-analysis, and by up to 68 percent for female athletes specifically. Those are upper-end figures from pooled data, so treat them as the size of the opportunity rather than a promise for one child.

Growth plate injuries are a genuine concern in young athletes, and they are worth understanding properly rather than avoiding all loading. Our article on growth plate injuries in youth athletes covers how they actually present.

Myth two: children should wait until they are older to start

The Sports Health review sets out readiness markers rather than a fixed age. Children can begin structured resistance training when they are emotionally mature enough to follow directions and show proficient balance and postural control, typically around ages 6 to 7.

That is younger than most parents expect. The reasoning becomes clearer with the next finding: prepubescent children show greater training-induced gains in strength and motor skill than adolescents, which the review attributes to higher neural plasticity. Younger children improve mostly by learning to coordinate and use the muscle they already have.

The practical implication is that early training should be about movement quality. Squat patterns, hinging, landing, single-leg control, and simply learning to follow a session. Load can be added later on a foundation that already exists.

A related risk in this age group is doing too much of one sport rather than doing any strength work at all. Our article on early sport specialisation and overuse injury covers what the volume of a single sport does over a season.

Myth three: you must fully rest an injury before loading it

Protecting an injured area in the early days after an acute injury is standard practice. Extending that into weeks of complete rest is where the problem starts.

Tissues respond to the demands placed on them. Muscle, tendon, and bone all lose capacity when nothing is asked of them, and the deficit has to be rebuilt before a return to sport. A long period of full rest leaves a person less prepared for the activity that injured them in the first place.

Current rehabilitation practice reintroduces load in a graded way, guided by symptoms and by which tissue is involved. The correct starting load for a hamstring strain is different from the one for a tendon problem or a bone stress injury, which is why the plan should follow an assessment rather than a general rule.

Returning to lifting after a back episode is where this myth causes the most avoidable delay. Our guide to returning to lifting after back pain walks through how that progression is structured, and our article on deadlift technique covers the movement itself.

Myth four: soreness means damage

Soreness after unaccustomed exercise is a common response. It usually appears across the muscle group that worked, feels dull and widespread, is worse when the muscle is stretched or first used, and settles over the following days. In a 2025 randomised trial of percussion massage published in Frontiers in Public Health, muscle soreness peaked at 24 hours after exercise in all groups studied.

Injury pain has a different character. It tends to be sharp, localised to one spot, often tied to a specific moment during the session, and it gets worse rather than settling. Swelling, a feeling of giving way, or pain that stops you walking normally all belong in that second category.

The practical distinction is direction of travel. Soreness that improves each day is doing what soreness does. Pain that is worse on day three than day one deserves an assessment.

Myth five: light loads are useless

The useful question is what a training phase is for. Early rehabilitation often uses lighter loads to restore control, confidence, and tolerance before heavier work is appropriate. That phase is doing real work even though the numbers look small.

Strength and muscle size also respond to different programming choices, so the load that suits one goal may not suit the other. Our article on hypertrophy versus strength goals in rehab covers how those targets differ and when each one belongs in a plan.

For the youth population specifically, the Sports Health review describes the most effective prescription as 2 to 3 sets of 8 to 15 repetitions at 60 to 80 percent of one repetition maximum, across 6 to 8 exercises. That is a moderate load with controlled volume, which suits both the safety picture and the goal of building skill.

Load also matters for bone health across the lifespan, and the same principle of appropriate loading applies at the other end of the age range. Our guide to safe strength training with osteoporosis covers what changes when bone density is the concern.

When to get it looked at

Pain that is sharp, localised, and worsening after a training session is worth an assessment rather than another week of hoping. The same applies to any joint that gives way, swells quickly, or cannot bear weight normally.

Some situations need a physician rather than a physiotherapy booking. A deformity after an injury, an inability to weight bear at all, numbness or weakness in a limb, chest pain during exertion, or a head injury with confusion, vomiting, or worsening headache all require medical assessment. For anything sudden and severe, Lions Gate Hospital emergency is the right destination. In a young athlete, pain located directly over a growth area that persists for more than a couple of weeks should also be assessed rather than trained through.

If you are unsure whether your current program is loading the right amount for where you are, an assessment can set the starting point. You can see what we treat or reach the clinic here.

This article is general information, not personal medical advice. A regulated practitioner can confirm whether the patterns described apply to you.

Sources

• Resistance Training in Youth: Laying the Foundation for Injury Prevention and Physical Literacy (Sports Health, 2017)
• Youth resistance training: updated position statement paper from the National Strength and Conditioning Association (2009)
• Effects of percussion massage on muscle soreness recovery (Frontiers in Public Health, 2025)
• College of Health and Care Professionals of BC public registry

This article is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary, and assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Care at Medstar Sport Physio & Health is provided by practitioners registered with their respective British Columbia regulatory colleges.