Would you like to take control of sports injuries?
Ken Johnson explains how coaches can be proactive in the
prevention of sports injuries.
Athletes of all levels can avoid many sports injuries with
Prehabilitation (Prehab). Even though there is an inherent risk in all athletic
activities, many injuries can be avoided. The percentages increase toward a
greater likelihood of staying healthier and performing better with a strong
Prehab program.
What is Prehab?
Prehab is a personalized exercise program that continually evolves
involving strength and conditioning exercises for specific muscles that help to
reduce injury BEFORE an injury occurs. It provides sports-specific
focused exercises and activities for athletes' needs. The philosophy is simple:
prevent injuries. The development and execution of an effective training
program can be complex. The practice of Prehab and its success relies on an athlete's ability to commit to prevention. The development of the program
needs to be progressive and periodically re-evaluated to change with the
athlete's needs.
Who Should Prehab?
Athletes of all levels should include a Prehab program in their
training. The more advanced the athlete, the greater the need for a Prehab
program. As an athlete's body matures within a sport, their body adapts to the
physical demands of training. Too often adverse movements and the daily
stresses of training cause negative effects on their bodies. This limited
training technique may cause tightness of muscle groups, imbalances of
strength, coordination, or muscle stabilization. These imbalances occur
naturally with activity and are reinforced with each workout. These imbalances
are often the root of many training injuries and may predispose athletes to
a greater risk of injury during training and competition.
What should be in a Prehab Program?
A personalized Prehab program should address total body balance
and consider sports-specific needs. It balances the range of motion, strength,
coordination, and stabilization. Comparing left to right, front to back, and
upper to lower body is the basic premise. Exercises and sports-specific skills
and drills are focused on an athlete's weaknesses. A non-contact ACL sprain is
a serious knee injury that often occurs when the knee is extended and rotated
at the same time, which can happen during landing from a jump and during falls.
The risk of this injury can be reduced by having strong quadriceps and
hamstrings muscles. The squat is an excellent functional exercise for the
quadriceps, and the leg curl will strengthen the hamstrings.
The majority of Prehab programs should focus on coordination and
stabilization of the hips, stomach, and back "core". Core instability is common
and is often due to the lack of a proper training program. Many athletes and
coaches use traditional protocols of upper and lower body lifting or basic
sprinting and lifting routines, outside of regular practice drills. This leaves
the core without a direct focus or training routine.
A Prehab program should be continuously updated to match the
athlete's progress. Activities in a Prehab routine can be a subtle, focused
exercise or a complex sequence of movements designed for dynamic stabilization
or to improve an athlete's skill. Adding dimensions of skill, one on one competition, or scoring values can stimulate an athlete's focus and improve the
success of a program. Using tools from traditional sports and physical therapy
programs can add options. Tools like a foam roll, balance boards, and weighted and
exercise balls can also make a program unlimited in design.
When Should an Athlete Prehab?
As indicated, Prehab should be practiced before an injury places
an athlete on the sideline and into a sports rehabilitation program.
Unfortunately, it often takes an athlete and staff many injuries to decide to
initiate a Prehab program. Depending on an athlete's training cycle, Prehab can
be done within a practice session or as an independent workout. Three or four
exercises in a warm-up or cool down, a few exercises while resting or waiting a
turn in practice, or a detailed tedious workout focusing on an athlete's
weaknesses. Full workouts can be designed for off days or active rest days.
Mini Prehab workouts are great for team travel and recovery days. In any case,
a Prehab program should be a regular part of an athlete's training routine.
Who Designs a Prehab Program?
Athletes should be screened for imbalances. Objective
measurements of active range of motion and strength, biomechanical
observations, past medical history, present health status, and input from
support staff should all be considered when designing a program. This screening
should be performed by a qualified professional. A licensed healthcare
professional, such as an Athletic Trainer, Athletic Therapist, Sports Therapist,
or Physical Therapist with additional sports training, can design a program.
These practitioners should have experience with a variety of high-level sports,
i.e. football, wrestling, swimming, decathlon, "New generation" golf, and in
my case, Olympic level gymnastics, and women's bobsled. Experience with these
sports can be beneficial to developing Prehab programs. It is important to note
that a hands-on practitioner would benefit the athlete most. Participating
practitioners should have the physical ability and skill to interacti with
the athlete during a session. The ability to challenge and motivate an athlete
is the difference between success and failure tor a tailored Prehab
program. Knowledge of the chosen sport, the athlete's needs, and open
communication are the keys to success with Prehabilitation.
Article Reference
This article first appeared in:
- JOHNSON, K. (2004) Would you like to take control of sports injuries? Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 14 / July-August), p. 1-2
Page Reference
If you quote information from this page in your work, then the reference for this page is:
- JOHNSON, K. (2004) Would you like to take control of sports injuries? [WWW] Available from: https://www.brianmac.co.uk/articles/scni14a1.htm [Accessed
About the Author
Ken Johnson, a Sports Therapist in the USA, specialises in Sports Injury prevention, management, evaluation, and rehabilitation. Team 2004 Medical, ATHOC, Athens, Greece / Boxing.