Let’s start with a short story
A view years back I was starting to work with two new personal training clients. The two were friends of each other and were regularly playing tennis together. Interestingly one of them had chronic knee pain, and the other one had chronic shoulder problems. Each time after they had played tennis their condition and pain appeard to be worsening.
We were about to start our training program together, I recommended to both to stop playing tennis during the first stage of the training and to initially focus on low impact resistance training to enhance strength and stability in the affected areas.
The client with the problematic shoulder was eager to follow the new protocol. After a relatively short period we could see the first results of the newly structured training. The pain started to fade, the overall strength and stability had improved. Over the time it was possible to integrate more complex and challenging exercises, and finally that client could go back to play tennis again.
The other person wanted to hear a second opinion first and saw a doctor as well. The client decided to follow the doctors advice instead, which was to stop physical activity all together until the pain would be gone completely. Well, to keep it short, as far as I know, until today the knee has not improved and the person sadly is still waiting for the pain to disappear one day.
“New tissue needs to be moved in order to learn that it is supposed to be muscle tissue.”
Why is physical activity supporting recovery?
At times physical inactivity can be necessary for the healing process, especially during the initial phase of wound healing when inflammation, swelling and pain are at their peak. But this period should always be kept as short as possible.
Already a few days after an injury or wound has occurred, the first connective tissue starts to form. This connective tissue is unspecific at first and needs stimulation to be exchanged with or transformed into the final muscle tissue, tendons, ligaments or even nervous tissue. You could say the tissue needs to be moved in order to learn that it is supposed to be muscle tissue. Passive and active mobilisation will give those necessary impulses for the tissue to be reshaped.
Only it is very important to make sure this activation can be carried out in a range that feels stable in the joint and without causing increased pain. The early connective tissue is still very fragile and can tear easily reversing the initial healing progress, therefore, especially with complex injuries, it is advised to seek the support of a professional for this mobilisation.
Definition of Sport Rehabilitation
The noun rehabilitation originates in Latin and literally means “make fit again”. Correspondingly rehabilitation generally describes an action, process or result of restoration back to a normal or former existing level.
Sport rehabilitation goes a step further and not only aimes for the restoration but also the prevention of physical deficiencies.
The phases of rehabilitation
The initial phases of rehabilitation are usually overseen by doctors or physiotherapists, first focusing on treatments to reduce swelling, pain and inflammations, and later by carrying out passive mobilisation and initial stretching to support the restoration of joint mobility.
Sport rehabilitation usually starts from the following phase of recovery, once movements can be carried out in a normal range of motion and without causing too intense feeling of instability or pain. This phase will be focusing on restoring general muscle strength and muscle endurance as well as coordinational elements. And in the very last phase of rehabilitation sport-specific will be applied.
Injury prevention with sport rehabilitation training
Actually the very same training methods supporting injury recovery can also be utilized for injury prevention. With a training protocol not only focusing on muscle strength but also on developing balance and motor coordination, reinforcing mobility skills and the overall condition of the musculo-skeletal system.
This would mean to minimize the risk of injuries to occur during your main training, injuries which could potentially set you back in your training progress or force you to suspend your main training for a certain period. And this is the last thing we want to happen.
But even more it can help to prevent injuries that could occur in your daily life, in a random situation, like to slip or trip over something and fall. With appropriate training, when a sudden event occurs, you will be prepared to subconsciously react in the right way to quickly find back into a stable and balanced position. This is key to support you to reduce the risk of getting hurt and to prevention that physical deficiencies might occur.
Sport rehabilitation is focusing on two main areas:
Aiming to restore lost functionality, strength or skills after suffering an injury or illness.
Adopting physical exercise and movement therapy to restore normal health within the musculo-skeletal system.
Aiming to prevent injuries, physical deficits or chronical conditions before they occur.
Adopting physical exercise and movement therapy to reinforce the condition of the musculo-skeletal system.
How is sport rehabilitation different to regular fitness training?
Sport rehabilitation and fitness training are not necessarily two completely different things. Sport rehabilitation is rather advancing regular physical exercise protocols, to utilizing them for restoring or maintaining an optimal condition of the musculo-skeletal system. So sport rehabilitation can be seen as an enhanced fitness training protocol in personal training.
Depending on the individual situation of each client, the training elements will be combined specifically to best complement each other. Sport rehabilitation training is also not meant to replace regular resistance training. In fact it is based on resistance training which is complemented with other training elements to develop balance and motor coordination, and to reinforce mobility skills and the overall condition of the musculo-skeletal system. Combining those elements is not only used in rehabilitation but also in athletic training, as this method can benefit not only your recovery but also boost your sport-specific skills to the next level.
The training elements of sport rehabilitation:
Who can benefit from sport rehabilitation training?
As laid out above, sport rehabilitation is an enhanced training protocol for physical exercising that can be beneficial in many different circumstances. This can range from a person who wants to return to a normal health to carry out daily life activities, to an athlete wanting to bring their sport-specific training to the next level. A few examples would be:
- You would like to run frequently but chronic knee pain is holding you back
- You are recovering from a shoulder injury and would like to get back to play volleyball without limitations
- You have chronic back pain and would like to find back to normal health
- You are currently physically inactive and experiencing a lack of balance and motor coordination
- You would like to improve stability, body posture and endurance to prevent injuries of chronic conditions to happen in the future
- You are very focused on weight lifting but regularly injuries are hindering your progression
This is just to name a few. More comprehensively the coverage of options can be defined within following ranges:
RECENT INJURIES OR LONG TERM CHRONIC CONDITIONS
ENHANCE GENERAL HEALTH OR SPORT SPECIFIC SKILLS
REGAIN OR IMPROVE PHYSICAL ABILITIES
Coming back to the episode I was starting off this introduction to sport rehabilitation with. That had happened quite a while ago now, long before I intensified my interest and knowledge in this field. But it was an initial impulse to start to develop my skills in the area of sport rehabilitation. Aiming to help people beyond regular fitness training, to get back to a normal health and to stay healthy, to be able return to their favourite sport or help reaching a new level of performance in their training.