What Is Prehab?

You go to a physical therapist to rehab from injury but what about going to a physical therapist for a prehab plan? Prehab, or preventive rehabilitation, is being proactive with your training, as opposed to having to be reactive after an injury occurs.

Prehab will look different for everyone but could look like plyo exercises to reduce the risk of knee and ankle injuries in basketball players, nordic curls to reduce the risk of hamstring injuries in runners, or increasing scapular stability and strength for overhead movements in Crossfitters.

Whether for lack of time or knowledge of what to do, many people miss out on the benefits of prehab. Prehab serves many roles, and doesn’t have to be complicated or extensive. Dr. McGuinness DPT states, “a physical therapist can give you a road map of what to focus on...you don’t need to add another hour to a workout but doing a 15-minute routine two or three times a week as part of your warmup or cooldown can help prevent injuries.” In terms of consistency Dr. McGuiness adds, “Prehab is not one-and-done,” McGuinness says. “Your body is always going to require maintenance work to perform at a high level [so] prehab should be seen as a long-term modification to your training program.”

Prehab helps to increase strength and confidence in positions we may be unstable in, contributes to joint and tendon health, and allows you to identify areas of weakness. At the end of the day, there is no surefire way to prevent injury but we can greatly reduce the risk. Outlined below are the why’s, who’s, and how’s of prehab.

Why?

Rehab restores strength and function following injury. Prehab helps to build the strength and function that minimizes the risk of injury in the first place.

Research has been done surrounding the use of prehab to prevent ACL tears and one prehab training program, designed by the University of Vermont’s Medical School, decreased the risk of ACL tear in skiers by 69% in those who did the program vs. those who did not. Many ACL tears are due to weakness in the hamstring compared to the quad. If we had strengthened the hamstring pre-season and throughout the season, could we have prevented that ACL tear? We can’t know for certain, but increased strength from following a prehab program is never a bad thing.

Who?

WNBL athlete Sara Blicavs describes her prehab plan: “It’s not just normal strength training, we do a lot of heavy lifting and all the basic weight training for basketballers. But there’s also a session dedicated to control, body movement, landing, and strength in the little muscles that you need to be firing at all times. Those are the kind of sessions everyone needs to be doing at some stage, it’s a lot of band work, one-leg work off balance stuff where you’re required to land, be in control and catch the ball on one leg. Doing all this stuff, you have that confidence around your knee.”

While prehab is a crucial part of a professional athlete like Blicav’s training program, it can and should be utilized by anyone engaging in physical activity that wishes to avoid injury. Prehab is also critical in the months leading up to orthopedic surgical procedures, and is often referred to as “preoperative rehabilitation.” Patients go to prehab to gain strength prior to a surgery, thus making for a smoother and quicker recovery, but many patients that undergo preoperative rehabilitation have actually reversed the need for their surgery.

How?

A prehab program can be utilized as a warmup or cool down, or as a separate session in the gym or on an active recovery day. Prehab exercises could even be built into your workout sets, as many of the exercises will complement the work you’re doing in the gym. Supplemental exercises, adjusting recovery and training levels, movement education, and soft tissue work or massage are all components of a prehab program.

Ultimately, “the goal as coaches, athletes, trainers, and physical therapists is to ALWAYS reduce the risk for injury and INCREASE performance capability” (Element 26).

Here at Prime, we don’t just develop rehab plans for injury recovery, we also develop prehab plans for injury prevention. We can help you develop a plan to identify areas of weakness and minimize the chance of injury in your sport or fitness routine. Our newest team member at Prime, Katie Edwards also offers soft tissue work, a beneficial aspect of any prehab plan! Reach out to info@primeperformancerehab.com today to set up an initial consultation.