A big part of sports is avoiding and preventing injuries, as injury prevention is far better than rehabilitation and recovery. This is where prehabilitation comes in. Prehabilitation is a personalized, constantly evolving, and developing strengthening exercise program. The program aims to provide sports-specific targeted exercises and activities to maintain athletes’ physical abilities and mental preparedness for their sport. The first step is for an athletic trainer, sports chiropractor, and physical therapist to examine the individual.

Prehabilitation

Everybody is different when it comes to developing an effective prehabilitation program. Every individual’s program should be progressive and re-evaluated to adapt and adjust to the athlete’s needs. The first step is learning to prevent injuries and following basic injury prevention protocols. Knowing what to do when the body sustains an injury, like home treatment and when it’s time to see a doctor.

Athletes

Athletes of all levels are recommended to incorporate a prehabilitation program into their training. As athletes engage in their sport, their bodies adjust to the physical demands of practicing, playing, and training. Imbalances can happen naturally with normal activity but become more pronounced with each practice, game, and training session and often are the cause of injury. The repetitive movements and regular stresses can cause neuromusculoskeletal symptoms to present. This includes:

• Tightness of muscle groups.
• Pain and discomfort symptoms.
• Stabilization issues.
• Strength imbalances.

Program

A chiropractic therapist will measure the individual’s range of motion and strength, biomechanics, evaluate medical history, and present health status. Individuals with an injury or a condition can also benefit from prehabilitation.

• Each program is personalized and will address total body balance, sports-specific needs, and weaknesses.
• The exercises will balance strength, coordination, range of motion, and stabilization.
• The premise is looking at and comparing movements from left to right, front to back, and upper to lower body.
• Activities can be subtle, focused exercises or a complex movement sequence to stabilize or improve a specific skill.
• Programs focus on strengthening and stabilizing the core, abdominals, hips, and back.
• Instability is common and often presents from a lack of core training, as athletes tend to focus on what parts of the body their specific sport utilizes, leaving the core without a regular training routine.
• A prehabilitation program has to be constantly updated to adjust to the individual’s progress.
• Tools like foam rollers, balance boards, weights, and exercise balls are used.

Training

Prehabilitation should start before any acute or chronic injury occurs, but often it takes a few injuries for individuals to decide to get into a prehabilitation program. Depending on an athlete’s training cycle, prehabilitation can be incorporated into practice or as an independent workout and become part of an athlete’s training routine. A session can include the following:

• Warm-up and cool-down exercises.
• Exercises to perform while resting or waiting during practice.
• A targeted workout on specific weaknesses.
• A complete workout for days off or active rest days.
• Mini workouts for when traveling and recovery days.

For athletes, feeling challenged and motivated can be the difference between success and failure. Working with a trainer, sports chiropractor, and therapists who know sports, understand athletic needs, and communicate well, will contribute to a successful prehabilitation program.

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Improving Athletic Performance

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References

Durrand, James et al. “Prehabilitation.” Clinical medicine (London, England) vol. 19,6 (2019): 458-464. doi:10.7861/clinmed.2019-0257

Giesche, Florian, et al. “Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review.” PloS one vol. 15,10 e0240192. 28 Oct. 2020, doi:10.1371/journal.pone.0240192

Halloway S, Buchholz SW, Wilbur J, Schoeny ME. Prehabilitation Interventions for Older Adults: An Integrative Review. Western Journal of Nursing Research. 2015;37(1):103-123. doi:10.1177/0193945914551006

Smith-Ryan, Abbie E et al. “Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation.” Journal of athletic training vol. 55,9 (2020): 918-930. doi:10.4085/1062-6050-550-19

Vincent, Heather K, and Kevin R Vincent. “Rehabilitation and Prehabilitation for Upper Extremity in Throwing Sports: Emphasis on Lacrosse.” Current sports medicine reports vol. 18,6 (2019): 229-238. doi:10.1249/JSR.0000000000000606

Vincent, Heather K et al. “Injury Prevention, Safe Training Techniques, Rehabilitation, and Return to Sport in Trail Runners.” Arthroscopy, sports medicine, and rehabilitation vol. 4,1 e151-e162. 28 Jan. 2022, doi:10.1016/j.asmr.2021.09.032