Injury Prevention vs. Injury Risk Reduction: A Healthier Mindset

Two Conversations That Reinforced How I Think About Injury

Conversation 1: The Myth of Being Injury-Proof

The first chat was with a relatively new patient seeking strategies to recover from chronic knee and back pain. I have full confidence this gentleman will recover. He’s in good physical condition, but together we identified some blind spots in his exercise routine that are likely holding him back from full recovery.

At one point, I mentioned that I was recovering from a wrist sprain. He was aghast. He assumed that I—someone with a robust exercise routine (ha! I try, but I’m not perfect; nobody is)—would be immune from physical pain and injury. That assumption opened the door to a valuable conversation about prevention.

Physical therapists, trainers, and doctors talk a lot about injury prevention as if it can be achieved 100%. It cannot. Sorry to burst the bubble if you’re living in one that suggests the “right” routine, lifestyle, or mindset can prevent pain and injury forever. It can’t. Pain and injury are part of life. Accidents happen. Illnesses happen. Degeneration happens. And sometimes, pain follows.

There are simply too many unknown variables in health to account for everything perfectly. In my view, this realization was actually unburdening for him. Trying to live “perfectly” would be overwhelming. Knowing perfection doesn’t exist should take some pressure off. And after all—stress is its own cause of pain.

Conversation 2: Fear of Pain Can Be Its Own Limitation

The second conversation was with another new patient—a woman in her early 70s—with ankle pain and a goal to live out the rest of her life without any pain or injury. That’s an understandable goal. But it can also be a daunting one.

In her case, the fear of pain and injury had likely led to an overly cautious lifestyle—avoiding certain activities and exercises altogether. Our conversation landed on a difficult but honest truth: you’re often damned if you do, and damned if you don’t. Too much exercise risk can lead to pain and injury. Too little exercise will also lead to pain and injury—and lower your tolerance for activity over time, causing that threshold to shrink more and more as you age. Avoiding movement doesn’t protect you. It often weakens you.

Optimal vs. Real Life

Health and longevity scientists talk a lot about optimal exercise routines, nutrition, sleep, and mental health behaviors. But the reality is this: we cannot always be optimal. Instead, I suggest adopting a lifestyle that allows for ranges of behavior. I often recommend exercise for pain and injury prevention—and here’s an important clarification. When I use the word prevention, what I really mean is reducing injury risk, not eliminating it.

We do have scientific standards for minimum and optimal exercise volume and variety. But optimal is hard to achieve. Maintaining both the total volume and the variety of activities over time is challenging. Based on what we know from health and longevity research, I usually frame an exercise routine around these core ingredients:

• Cardiovascular/metabolic training
• Strength training, including dedicated core stability work
• Mobility and flexibility training

In general, you want the volume of each of these to be reasonably high and progressively increase—or at least be maintained—as you age.

The Reality Check We All Need

Here’s the truth: it’s hard to fire on all cylinders all the time. Balancing every activity type while also nailing nutrition and sleep quality and quantity is tough. Something usually gives. And meanwhile, we still have lives to live—work to do, family to enjoy, friends to see, books to read, and shows to watch.

So here’s my advice: Do your best. It’s all you can do. There is optimal, but perfection is elusive—and chasing it often causes more harm than good.