Make the move from rehab to ‘prehab’

Rehab is something we’re all familiar with. Sporting injuries are common and require a programme of physiotherapy and sometimes medical attention to allow you to get back on track. It can be a lengthy and painful process. But a new practice is emerging, which allies itself to the mantra ‘prevention is better than cure’. The process is called ‘Prehab’.

Prehab assesses and addresses any potential limitations athletes might have before embarking on a programme of training or exercise. While it is impossible to make yourself 100 percent resistant to injury, you can minimise your risk by understanding your current musculoskeletal health and working to improve functional movement related to your sport.

Sports such as triathlons involve making the same movements and exercises repeatedly over long stretches of time, so it makes sense to have an understanding of what impact this is having on your body and ways to minimise any negative impacts. Repetitive motion injuries are extremely common in sports like triathlon but can also be minimised with appropriate action.

As well as protecting yourself from potential injury, prehab gives you a thorough understanding of your body and its limitations with the ultimate goal of improving performance and, let’s face it, this is something we are all interested in.

There are a few things you can do on your own to help prevent injury. Here are a few of the most important:

1. Get a check-up

If you aren’t used to competitive sporting events or intensive exercise it’s wise to first check with your doctor to ensure there are no underlying health issues preventing you from participating. By Ensuring you are not rushing into a major new course of training without being aware of potential issues or risks is the first key step to avoiding injuries down the line.

2. Warm up and cool down

If you’ve got the all clear from your doctor, the next thing to remember is to start every training session with a warm up to prepare your body for the activity ahead and reduce the chance of injuries.

For low-impact activities like swimming or cycling, this could be as simple as completing a gentle swim and cycle before starting your session. A good warm up is all the more important for higher impact activities such as running. Allow yourself 15 minutes to warm up with three five-minute sessions moving from a gentle walk to a jog and then slowing back down to a mid-paced walk.

After your training session it’s important you cool down with a similar routine, allowing your heart rate to lower while keeping your blood flowing. This will help eliminate lactic acid and prevent muscle cramps.

Stretching is extremely important at the end of every session to prevent cramp and keep your muscles supple. Start with a gentle static stretch and build the time of holding that stretch. Don’t bounce because you could pull a muscle or damage the tendons.

3. Get enough sleep

It’s hard to overstate how important it is to get a proper amount of good quality sleep. It really is a vital part of avoiding injuries. If you’re tired you can be more likely to make mistakes and potentially end up hurting yourself in the process.

Poor sleep can also have other knock-on effects like increasing stress, which can in turn impact your performance when training or competing and again make injuries more likely.

So: don’t take pride in staying up late, working long hours and skipping sleep. If you need to get up early, go to bed early.

4. Plan for rest and recovery

An important aspect of prehab is planning sufficient rest and recovery into your training programme. Too many people plan diligently for training, social activities and work, but don’t factor in time for relaxation – it just fills the gaps.

Put time aside to read, listen to music or other restorative activities like meditation. A good rest and recovery plan should also include some excellent nutrition, at Nuffield Health we have experts who can help you with your daily diet, and sports specific nutrition to improve how you recover.

5. Strength training

Athletes train hard in the gym to become more robust. A stronger athlete is less likely to get injured, and more likely to go faster. Strength training is important to keep the bones, tendons and joints strong and prevent injury.

Try to fit in two sessions of strength training per week and leave at least one day between the strength sessions to recover. A Nuffield Health personal trainer will be able to help you with a specific programme, designed for your specific needs.

Make sure to always listen to your body. It’s better to miss a session and continue next week, rather than push yourself too far when strength training and become injured or ill and not be able to train at all.

6. Have a body management programme

Good athletes also know how to manage their bodies well. If something is stiff or tight, they know how to remedy it. This is a key aspect of prehabilitation.

A body management programme may include some self-massage work on a foam roller or ball, some specific stretches and perhaps some control work. This could be a warm-up for training or they gym, or it could be something for when you’re in front of the TV at home.

7. Be prepared for the elements

Being prepared for the elements isn’t restricted to the day of the particular event you are training for. For outdoor events in particular, training in a variety of different conditions can help ensure you are used to the different scenarios you may find yourself up against. This can make it less likely you will be wrong-footed by something like the weather and find yourself injured.

Don’t overdo it though. In every training session you should dress appropriately for the conditions, always take plenty of water with you and stop your session if you feel like you might be over-heating or conditions are too poor.

8. Train well by training smart

Don’t become over-trained and make sure you have some structure in your programme. Junk miles slow your progress and will drain your body. Consider having a variety of training intensities, split with rest periods or recovery sessions. Think about what your goal is this week, month and year to keep your training focused. You can monitor your training state in a number of ways, but make sure you’re feeling stronger with training, not weaker!

9. Get a plan tailored to you

While these simple principles on prehab provide good general advice, there isn’t one standard blueprint for how everyone’s body should move and function, so it’s important to fit your prehabilitation work to your individual needs and goals.

If you're concerned about a persistent pain, or want to ensure you avoid injury by training in the best way for your body, our physiotherapists can help.

Last updated Thursday 19 November 2020