Rehab has a knack for under-dosing, under-loading, and under-performing their patients. This article explores the idea of rehab difficulty and hopefully sheds some light on the process.
The Goal
We first need to define the goal. What do you want to return to? For some it may be hitting dingers, others it may be running their first 5k, others it may be lifting their grandchild pain free. Regardless of your injury we need to define what we want to get back to as that sets the stage for everything we do.
The Injury
Second we need to reframe how we view injuries. You got injured because you were exposed to something you were not prepared for. You did too much, too soon, after doing too little for too long. Your injury tells us we have a weak link, and that weak link got exposed.
The Demands
In order to get back to our goal, we must meet or exceed the demands of said goal. If your goal is to get back to football or basketball, we should eventually be moving at speeds, durations, and loads similar to the intensity of your sport.
My good friend came up with this analogy and I really think it helps conceptualize this idea. Let's say your goal is the intensity of Rock and Roll music, your rehab is often the intensity of Smooth Jazz. Smooth Jazz may be a good place to start initially, but if we never get back up to the intensity of Rock and Roll in rehab how will we be prepared for it? We need to expose our patients to Rock and Roll if they are going to get back to it.
Smooth Jazz
Even in the Smooth Jazz phases where we are careful about not aggravating an acute injury, we can add challenge to ensure we are not detraining or getting weaker. Too many people get hurt, "rehab" and come back only to get hurt again, because they never were challenged! My goal 99% of the time is for each patient to leave having broke a sweat in some way. Because movement is medicine!
Intensity
Here are a some tips to move an exercise from Smooth Jazz to Rock and Roll.
Isometric holds - holding a position (wall sit) till failure can be a great place to start especially when more dynamic exercises are painful.
Add load - simply adding weight is great.
Add range of motion - going deeper or further on an exercises is great for getting strong in vulnerable ranges of motion.
Add speed - speeding up a movement is a great way to add some intensity.
Don't let rehab be easy. To overcome an injury we need to expose the injured area to greater intensities than the initial injury. If you are not being pushed, find a new PT!
Till next time.
BIG CAT OUT🦁
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