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What is prehab and should you do it?

Prehabilitation describes a systematic approach to identifying common injuries within a specific sport or training regime and then designing an appropriate series of exercises that work toward minimizing their incidence. The identification of common injuries would thus lead to exercises targeting to certain body parts, such as the knees, shoulders, and neck that are at high risk when competing in sport. With this proactive approach to sport and exercise, these body parts with be strengthened and conditioned to the excessive amounts of strain that they undergo.


A proposal targeted at rugby explains how a pre-habilitation program that carefully considers the nature and mechanism of the most common injuries in a sport may very well play an important role in not just helping to minimize these injuries but also to contributing an enhancement in performance. These performance enhancements would be seen due athletes being more confident in taking risks and contact associated with rugby, and due to it being necessary that players in any sports discipline get what is commonly referred to as “a run of games” whereby they will be conditioned to the intensity of the game and being more accustomed to the skills required in the game, as opposed to during training which does well to replicate the sport but it, at the same time, very different.


But prehabilitation is also moving out of the realm of sports science and strength and conditioning as it can be applied to regular people who train regularly or need to build strength after an injury to prevent recurrence. The emergence of prehabilitation as a proactive training method, much like warming up and warming down to reduce the onset of DOMS, is specifically geared towards preventing injuries for all individuals before they happen and strengthening muscle groups one-by-one so as to ensure that your workout will be more efficient and effective, allowing you to progress further.


The application of prehabilitation in community-dwelling subjects with osteoarthritis of the knee was seen in a study where the subjects were scheduled for a unilateral total knee arthroplasty (TKA) were recruited from a single orthopedic surgeon's office and were randomized into control (n = 28) or prehab groups (n = 26).


Knee pain, functional ability, quadriceps strength, and strength asymmetry were assessed at baseline (T1), at 1 week before the patients' TKA (T2), and again at 1 (T3) and 3 (T4) months after TKA.


The exercisers improved their sit-to-stand performance at T2, whereas the control group did not change their performance of functional tasks and had increased pain at T2. At T3 the exercisers demonstrated improved sit-to-stand performance. The control patients at T3 exhibited decreases in pain, their 6-minute walk, surgical leg strength and an increase in their nonsurgical leg strength and leg strength asymmetry. At T4 the exercisers improved in their performance of 3 of the 4 functional tasks, decreased all of their pain measures, and increased their surgical and nonsurgical quadriceps strength. At T4 the control group improved their performance on 2 of the 4 functional tasks, decreased all of their pain measures, increased their nonsurgical leg strength, and exhibited greater leg strength asymmetry.


This goes to show how effective prehabilitation training can be as opposed to rehabilitation following the operation. People undergoing prehabilitation would find that even before surgery they can build up the strength of the knee and complete tasks that they wouldn’t have been able to before. This is another breakthrough in the application of strength and conditioning in sports to other areas.


The value of prehabilitation is equally important on a genetic level to people who have a higher injury risk, compared to those who are not as predisposed to picking up injuries and therefore wouldn’t have to implement as intense intervention strategies to prevent these injuries from occurring. A number of genes can highlight an increased risk of injury, namely: GDF5, COL1A1, COL5A1, IL6, IL6R, CRP, TNF, and AG and the different variations in these genes would indicate a higher or normal risk of injury. This isn’t to say that if you are on the high scale that you will definitely get injured but the insights would prove a useful source when making proactive choices to prevent injuries by implementing methods such as prehabilitation exercises before a problem arises.


Prehabilitation has been explained as a means to, for instance, strengthen the muscles supporting your upper back and shoulder rotators. This improves your posture by pulling your shoulder blades back and down. The shoulder joint’s ball and socket will move freely and efficiently, as it was designed to do. You’ll feel the difference in every aspect of your life. In a world where many of us are at a desk all day and live a sedentary life that we need to proactively break away from by attending fitness class, going to gym, and doing exercises such as yoga it is now more important than ever before include prehabilitation into your routine to not only reduce the incidence of injury but also to strengthen your core muscles, build flexibility and stability, and improve your overall balance.

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