When we see Roger Federer floating around the tennis court or Serena Williams returning to competitive play after her first baby, we rarely stop to think of what they do off the court to ensure they stay on it — injury free. You can be certain Prehab is playing a key part in their routine.
Let’s get one thing straight. Prehab is not a Warm Up.
A warm-up is a series of exercises you undertake before sports and exercise to ensure your muscles are ready to contract and relax at speed. The effects of a warm-up programme are designed to be immediate and its aim is primarily to prevent traumatic injuries like sprains and strains.
In contrast, Prehab is a programme you perform on a regular basis 2 – 3 times per week. It is about identifying areas of vulnerability for injury in an individual due to weakness, imbalance and altered biomechanics.
There are three groups of people who should be undertaking a Prehab programme:
The comeback kids
Those who have sustained a previous injury, have returned to activity and want to minimise their chances of having another injury.
Weekend warriors and team players
Those people who undertake regular sport and activity that makes them vulnerable to injuries associated with overuse and misuse of their body. This includes people training for endurance activities or people who play 1 sport more than 2 – 3 times a week as a hobby while undertaking a desk-based job the rest of the week. The people we commonly see are training for the playing rugby, football or tennis.
Primed and ready
Those who are considering surgery and want to give themselves the best chance of a successful outcome. Anyone considering a hip or knee replacement, anterior cruciate ligament (ACL) surgery, a hip or knee arthroscopy or shoulder surgery for a cuff repair should undertake a Prehab programme to maximise their muscle strength and control. The stronger muscles are prior to surgery, the quicker the recovery afterwards, and, in some cases, the effect of the programme eliminates the need for the surgery!.
A Prehab programme is a series of exercises designed specifically for each individual. They are generally designed to prevent overuse injuries. Overuse injuries occur over time and start off as subtle niggles and pains before increasing in frequency and intensity. These symptoms are often ignored or dismissed by people. It is not uncommon to hear people say “I thought I could run it out” or “I just ignored it for a while, thinking it would settle down”. They are the result of repetitive micro-trauma to the tendons, bones, and joints caused by excessive stress or strain on certain areas of the body.
Common examples include shoulder pain in swimmers and tennis players, tennis elbow, Achilles tendon problems, shin splints, stress fractures of the bones and low back pain. Ironically — they often occur if an individual has not undertaken an effective rehabilitation program after an injury leaving them vulnerable to reinjury of the same area or joints above and below which are now coping with more stress and strain
There are some generic Prehab programmes about — specifically the FIFA 11+ which is designed to prevent injury in young Footballers, but there are few generic programmes for adults that are specific to certain activities or injuries.
At Pure Sports Medicine there are several steps in the process of designing a Prehab programme:
1. Identifying your sport, activity and goals
This ensures we book you in to see the right clinician — someone who knows your sport, understands the injury risks, the requirements from your body and what is key to performing at your best
2. An individual assessment of your training programme and your goals, followed by an assessment of your functional abilities: flexibility, balance, movement control, strength and endurance.
This highlights areas of vulnerability in your body and allows the clinician to construct a programme to address these areas.
3. Programme implementation
Your clinician will take you through each step of your programme, explaining the rationale for every exercise so you understand why it is important, where you should feel your body working and how to do the exercise correctly. Good technique is essential which is why we spend an hour teaching the exercises and reviewing the programme.
4. Programme review
To ensure your level of performance improves and your programme adjusts to changing demands, all Prehab programmes are reviewed at 12 weeks.
All of these assessments are an hour long. A follow-up appointment is required to review the programme because the correct technique is essential to restoring good biomechanics and there may be additional time required to develop a complete programme.
If you’re interested in Prehab sessions find our more or book your appointment here.