• David Jeremic

Prehab - Delving More Deeply

Updated: Feb 26



There's a lot more to Prehab than was discussed in the previous blog. In this Blog we look at where you should do it and why you should be doing it.


Let's continue!


Understanding what movement is and the role it plays in Prehab is essential. Movement is the relationship between joints and muscles acting and reacting to one another. The conduction of impulses through neural pathways from the brain allows for this relationship, movement, to happen. In the health and fitness world, the reactive nature of muscles is known as the "mind-muscle connection", when performed consciously. Nerves, in this sense, act in similar way to the electrical circuitry of a house. The notable difference is that nerves are malleable, like plastic, and able to adapt to particular situations and are constantly being challenged to do so. Training, in either a physical, mental or emotional sense, leads to strengthening or reiterating these pathways. Physically, the muscles which their respective nerves act on become stronger and the movement being taught becomes more effective and smoother over time. For example, learning a new skill or movement pattern will elicit this mechanism.


you may have come across the common term "muscle memory". Essentially, it means that muscles that have been trained to activate a certain way will be activated faster when called upon. This is relevant to surgery and the "turning down the dimmer switch" effect surgery has on specific neural pathways between muscles acting on a joint, and joints acting on a muscle. It means that the neural pathways which have been effected by the surgery will require more training than otherwise to re-activate the hindered mind-muscle connection(1).


It follows that the better the functional capacity of muscles (strength, range of motion, biomechanics, and balance) reacting to joints, and joints acting on muscles, the better the chance of having optimal post-surgery outcomes.


Unquestionably, Prehab treatment and programs should be tailored to the athlete's sport, and position played in that sport if applicable. Prehab is best prescribed and carried out by a team of appropriate healthcare professionals. Or, in some instances, when the healthcare provider provides multi-modal care (more than just one method of treating an injury/impairment), a single practitioner can provide the range of services needed. At Modern Chiro, we use a multi-modal approach in our care.


From all this, you can see that undergoing Prehab treatment and an appropriate program is of high importance for the training environment, just as it is for the surgical setting. Excellent!


In regards to the training environment, undergoing "Prehab treatment" refers to the athlete receiving tailored manual therapy treatment. The idea behind this is to prepare the athlete for their Prehab exercise program, by increasing range of motion and other important outcome measures. Additionally, it can help to enhance the recovery of the athlete during their Prehab program. Performing a "Prehab program" refers to the athlete undergoing a particular series of exercises and/or drills (approximately 5-15 minutes) which are designed to PREpare the athlete to perform their tasks within their sport. Ultimately, in turn, PREventing them from getting injured.


As the intensity and competitiveness of sport increases, we should consider Prehab treatment and an appropriate program non-negotiable. A Chiropractor can prescribe a Prehab program for athletes of all levels, based on the findings of a personalised musculoskeletal screening. The Program is aimed at addressing the particular findings and correcting them, where possible. Examples of findings include joint stiffness, muscle tightness or poorly activated muscles. Treatment-wise, manipulation, mobilisation and soft tissue techniques may be advised to correct these. Mobility and stability exercises, along with dynamic stretches may be prescribed as part of the program.


We want to PREpare the body as best as we can for the specific task.


Summing up:

- Ideally, perform Prehab before the team warm up or beginning your gym training session

- We want to "turn the dimmer switch up", to optimise the mind-muscle connection, as well as possible

- We should optimise the body's movement quality, biomechanics, and balance by preparing the joints, muscles and tendons for what they are about to go through either in a surgical setting or in a training environment

- Ultimately, the aim is to PREvent injury from occurring, where possible.


Taking a step back and looking at this idea holistically, other factors contribute to the optimisation of athletic performance. These factors include nutrition and hydration, sleep/recovery, and mindset, and they must have equal attention. A prolonged imbalance of these factors could potentially lead to reduced performance, thereby increasing the risk of injury. Healthcare professionals with expertise in these fields, such as Dietitians and Sports Psychologists, are useful here.


There are numerous exercises out there in the Prehab world. As long as they are meaningful to you, and the activity you do, be it on the training field or in the gym, that's the most important factor.


To optimally perform at your best consistently, it's important to consider undergoing Prehab treatment and an appropriate program on a consistent basis. If you work on any impairments they will have a reduced impact on your performance and may, in fact, become your strengths!


At Modern Chiro, we understand that Prehab treatment and programs are important to improved performance at all levels of sport. We do musculoskeletal screenings, for pre-surgical and/or as part of your sporting fitness. We then prescribe a program tailored to you to improve the issues at hand.


As our goal is to help people achieve their best level of performance in their sport, or otherwise, we would love to help you perform at your best and avoid getting injured.



David Jeremic,

Chiropractor


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1. Siddique, U., Rahman, S., Frazer, A.K. et al. Determining the Sites of Neural Adaptations to Resistance Training: A Systematic Review and Meta-analysis. Sports Med (2020). https://doi.org/10.1007/s40279-020-01258-z

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