What is the REAL reason behind injuries?

Bryan Sa Pimentel
May 4
7 min read

Updated: May 7

One thing that I’ve always been curious about as a health practitioner is, why and how do people get injured?

Dealing with so many injuries throughout the years, I realized that while some injuries were to be expected in certain people, others came out of nowhere.

This got me curious, what is the REAL reason behind injuries?

This weekend at the SWIS Summit 2025, where the most renowned trainers and health physicians, Andrew Coates trainer, writer and speaker, revealed some interesting information about injuries, and it blew my mind.

Ready to hear it?

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Common misconceptions

For the longest time, I always believed that injuries were due to poor form, repetitive motion and weak antagonist muscles. While these reasons hold some validity, there are not “set in stone” , and not the purest causes of most injuries in clients.

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Injury vs Soreness

After strenuous exercise, or exercise after a hiatus from physical activity, it is natural to experience muscle soreness. Typically, muscles are tender to the touch or burn slightly with movement.

In an article written by Rebound Md, it states ” During exercise, we fatigue our muscles, and the effects usually aren’t felt until a day or two afterward. Micro tears in the muscle occur during exercise, which is what causes the dull aches, soreness and muscle weakness. Most people feel a peak of soreness the following day, and the discomfort gradually goes away. A red flag indicator of injury is when discomfort and sharp pain are persistent, whether you’re resting or active.

If the pain persists past one to two weeks, or is immediate and severe, you may have damaged muscles, tissues or joints.” (Baer, 2025)

The main difference here to understand is that soreness occurs from what are considered micro tears in the muscles. This “tearing down” process holds many benefits like Muscle Growth. Muscles regenerate and come back stronger and bigger. However, in the case of an injury, the person can experience a pain that occurs whether the person moves or not.

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The Real Reason(s) why you’re getting injured

(1) Genetics:

Genetics Play a big role in injury process. Speaking of experience, I once had and still have a client who is what is considered hypermobile. Joint Hypermobilia is a condition where the joints range of motion what is out of the normal ranges for most human beings making it susceptible to injuries. In an article written by Mafulli and other, it states” Today, it is accepted that genetics determines the response of an individual to the surrounding environment.” (Mafulli and all, 2013)

(2) History of injuries

Very often we mistake the value of not knowing someone’s medical history. As a coach myself, I undermine the importance of knowing exactly what type of injuries someone had in sport but outside of it too. If someone underwent an injury, the limb or joint will always have some weakness associated with that body part. Make sure to always let your trainer know or to get guidance to know how to train.

(3) Hydration

Staying hydrated will keep your muscles loose and mobile while allowing better blood flow to the training muscles. Not hydrating yourself properly can create muscle stiffness while also creating dehydration.

(4) Sleep

Sleep can greatly affect one’s potential of sustaining an injury. In an article written by Jennifer King, she says” Sleep gives the body a chance to repair and regenerate from the day muscles, tendons, ligaments, bones and growth plates need this time to recover to help prevent overuse injuries.

Sleep also helps with reaction time, which is integral in most sports. If an athlete’s reaction time is slower, it is more difficult to adjust in sports to help prevent injury.

Studies have shown that for teens in grades 7-12, sleeping fewer than eight hours a night can almost double their risk of injury.

Also, if anyone – children, teens or adults – sleeps fewer than six hours a night, their risk of injury is substantially high. “ (King, 2017)

(5) Hypermobility

A condition I spoke about with my client. Joint Hypermobilia is a condition where the joints range of motion what is out of the normal ranges for most human beings making it susceptible to injuries. If a client know’s he or she deals with this condition, it’s important to take precautions when training and playing sports.

(6) Age

As we age are body becomes weaker throughout time. Many older adults can develop physical strength and endurance even in older age compared a person of the same age who doesn’t train. They will, however, be affected by some of the drawbacks of physical overloading, mostly due to the diminished ability of aging body systems to adapt to high levels of loading. Being wary of these limitations can prevent injuries.

(7) Range of motion

Lack of range of motion, (ROM) means the extent or limit to which a part of the body can be moved around a joint or a fixed point. Lacking range of motion can create stiffness in movement which can provoke injuries in an athlete. In a study made in 2018, they identified that growth sprurs in dancer during their teenage years affected range of motion which undoubtedly caused more injuries in these athletes.

(8) Not strength training

Not strength training can effect the body by losing postural strength, physical power and endurance. Resistance training promotes growth of muscle tendons, ligaments, joint cartilage, while also increasing bone mineral content improving skeletal health.

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What can we do if we are injured?

Most people want to stop training when they sustain an injury. Obviously sustaining an injury somewhere around the lower limbs is not ideal when you try to physically get to the gym. In the chances that you have a private chauffeur (lol), it is totally possible to train even when you have sustained an injury by working around the hurt area. Cross Education is physical phenomena that happens when there is strength gain in the opposite, untrained limb following unilateral resistance training. This adaptation proves that training the opposite limb to the one that is injured can not help the healing cycle but even help to build strength.

Andrew Coates states in his article “ researchers immobilized the forearms of 16 participants for four weeks and randomly assigned them to a training or control group. The training group performed eccentric wrist flexion exercises three times a week with their free arm while the control group didn’t train at all. After four weeks, the trained group preserved the strength and muscle thickness of the forearm flexors on the immobilized arm. The control group lost strength and muscle thickness. This same outcome was found in several other studies including Farthing et al. (2009).” (Coates, 2025)

In his article, Andrew provides a Push, Pull, Legs program for training with an injured limb. In his workout plan, Andrew advises the trainee to work until failure, and for a beginner athlete to reduce the set by 1. He mentions that this workout program is to demonstrate proper Cross Education to preserve strength and endurance. If you are an athlete, you can adapt and add for more athletic programming adaptations.

Push Day 1

Single Arm Dumbbell Bench Press

4-5 sets of 8-12 reps to 1-2 RIR
60-90 seconds rest for warm-up sets
90-120 seconds rest for working sets
/superset

Single Arm Cable Facepulls

3 sets of 10-12 to 1-2 RIR
60-120 seconds rest

Single Arm Seated Dumbbell Shoulder Press

3-4 sets of 8-12 reps to 1-2 RIR
90-120 seconds rest

Landmine Press

3-4 sets of 10-12 reps to 1-2 RIR
90-120 seconds rest

Single Arm Side Cable Raise

3 sets of 10-15 reps to failure
/superset

Single Arm Overhead Cable Extensions

3 sets of 10-12 reps to failure
60-90 seconds rest

Single Arm Cross Body Rope Cable Pressdowns

3 sets of 12-15 reps to failure
60-90 seconds rest

Suitcase Carry

3 sets of 40 meters
90-120 seconds rest

Pull Day 2

Single Arm Seated Cable Rows

4 sets of 10-12 reps to failure
60-90 seconds rest

Landmine Meadows Row

4 sets of 10-12 reps to 0-1 RIR
60-120 seconds rest

Single Arm Neutral Grip Cable Pulldowns

4 sets of 10-12 reps to failure
60-90 seconds rest

Single Arm Bent Over DB Laterals

3 sets of 10-12 reps to 1-2 RIR
/superset

Dumbbell Curls

4 sets of 10-12 reps to failure
60-90 seconds rest

Leg Day Day 3

Safety Bar Squats

4-6 sets of 5-10 reps to 1-2 RIR
90-120 seconds rest warm-up sets
120-180 seconds rest working sets

Single Leg Romanian Deadlifts

-DB held in the “good” hand for both sides
3-4 sets of 6-10 reps to 1-2 RIR
90-120 seconds rest

Safety Bar Bulgarian Squats or Safety Bar Reverse Lunges

3-4 sets of 5-8 reps per leg to 2 RIR
120-180 seconds rest

Leg Press

3-4 sets of 10-15 reps to 1-2 RIR
60-120 seconds rest

Seated Hamstring Curls

3 sets of 8-12 reps to failure
/superset

Leg Extensions

3 sets of 10-15 reps to failure
60-90 seconds rest

(Coates, 2025)

Conclusion

Injuries are varied and complex depending on the situation and athlete. Understanding what issues can affect you is important for any growth of an athlete. Each of our stories are different, but the results are the same. We cannot prevent 100% injuries, but we now have the solutions to combat them.

Stay Healthy

Bryan Sa Pimentel, ND PT

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References:

Maffulli, Nicola, Katia Margiotti, Umile Giuseppe Longo, Mattia Loppini, Vito Michele Fazio, and Vincenzo Denaro. “The Genetics of Sports Injuries and Athletic Performance.” Muscles, ligaments and tendons journal, August 11, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC3838326/.

Storm, Joyce M, Roger Wolman, Eric W P Bakker, and Matthew A Wyon. “The Relationship between Range of Motion and Injuries in Adolescent Dancers and Sportspersons: A Systematic Review.” Frontiers in psychology, March 22, 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC5874564/#s6.

JE;, Fleck SJ;Falkel. “Value of Resistance Training for the Reduction of Sports Injuries.” Sports medicine (Auckland, N.Z.). Accessed May 7, 2025. https://pubmed.ncbi.nlm.nih.gov/3633121/.

“How Inadequate Sleep Impacts Your Injury Risk.” Hawaii Pacific Health. Accessed May 7, 2025. https://www.hawaiipacifichealth.org/healthier-hawaii/be-healthy/how-inadequate-sleep-impacts-your-injury-risk/#:~:text=Studies%20have%20shown%20that%20for,or%20teen%20has%20trouble%20sleeping%3F.

“Don’t Lose Strength or Muscle While Recovering from a Broken Limb with This Program.” Andrew Coates Fitness. Accessed May 7, 2025. https://andrewcoatesfitness.com/dont-lose-strength-or-muscle-while-recovering-from-a-broken-limb-with-this-program/.

What is the REAL reason behind injuries?

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