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10 Rehab Hot Takes I Forget Aren't Common Sense

#1 Rehab is just training in the presence of injury

It often doesn’t need to be more complicated than that. Rehab and training both emphasize the same core principles of physical activity and progression. The primary goal remains to restore function, manage pain, and prevent further injuries. Rehab is simply maintaining these primary goals, but with a heightened awareness of the injuries' impact. This perspective simplifies rehab by framing it as a continuation of physical conditioning, with modifications to support healing and gradual return to normal activity levels. 

#2 Graded exposure is your best friend

I say this often, but treating an injury can be broken down into these three categories: Find aggravating factors, regress until less aggravating, and slowly progress. By identifying activities or movements that trigger pain/discomfort, you can regress to a less intense version of these activities that are less aggravating. Use this as a baseline, then increase in intensity or complexity, allowing your body to adapt without causing it further harm. This approach helps in building tolerance, reducing fear of movement, and ensuring steady progress towards full recovery. If this seems simpler than you thought, that’s okay. Keep it simple.

(Ex. If your aggravating factor is squatting, modify the activity to squatting to a box. Continue to add weight when squatting to the box to progress to exercise.)

#3 If beauty is in the eye of the beholder, then so are rehab modalities

If you think ice and dry needling fixed your ankle last time, it will probably work again. The effectiveness and appeal of different rehabilitation methods are subjective and vary from person to person. Just as beauty is perceived differently by individuals, the best rehab approach depends on the unique needs, preferences, and responses of each patient. This highlights the importance of personalized rehabilitation plans that consider individual differences and preferences for optimal recovery.

#4 Pain does not always mean injury

Things can get pissed off without worsening or injuring an area. Pain is a complex experience influenced by physical and psychological factors. While it can signal an injury, pain can also result from factors such as inflammation, stress, or nerve sensitivity without an actual injury. Understanding this helps managing pain more effectively by considering all the different messages that pain level could be trying to send. 

#5 People sleep on the power of more ROM

ROM = Range of motion. Most people are stuck quarter repping the weight their whole lives and never see any progress. Getting a huge stretch on your lifts is rarely a bad thing. Adequate ROM is not just crucial in rehab, but also daily activities and maintaining joint health. Limited ROM leads to compensatory movements, increasing the risk of injury and causing pain or discomfort. Emphasizing ROM in training and rehab is important to enhance flexibility, support better movement patterns, ultimately contributing to improved physical performance.

#6 Your hips/spine being out of place is unlikely to be your issue

There are few statements from your PT that are as cliche as this one. We LOVE telling patients their hips/spine are out of place. It is unlikely that they are truly out of place and if they are that doesn’t mean too much. Focusing on strengthening, flexibility, and proper movement patterns usually addresses underlying problems more effectively than seeking adjustments or worrying about alignment. This perspective encourages a more functional approach to pain management and rehabilitation. 

#7 Relative motion is KING

When things get moving relative to other things we are cooking with gas. Proper relative motion helps distribute forces evenly, preventing overuse and reducing the risk of injury. It promotes coordinated movements and supports optimal muscle activation. By stressing relative motion, rehab can effectively address dysfunctions, pain and enhance performance.

#8 You can still get hurt with perfect form

I have seen too many people get injured with perfect form. Good form doesn’t make up for crappy programming. Injuries can result from things outside of form like muscle fatigue, overtraining, insufficient rest, limited ROM, etc. Injury prevention also requires attention to overall physical conditioning, recovery, and proper load management. 

#9 Stretching is probably good for you

The same people who say stretching is bad, will say you should slow eccentrics for the stretching benefits. Just say you don’t like stretching.

#10 Balance is huge

Yoga moms need to strength train. Powerlifters need cardio and yoga.

Big Cat Physical Therapy services the North Canton/Akron area, and specializes in return to sport rehab. Please contact us if you have any questions or if you’d like to schedule an evaluation!


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