Prehabilitation is a newly popular term in fitness. In theory, it is an important consideration. It is, however, overdone.
Prehabilitation is the application of exercises intended to prevent injury. This is, of course, wise at the start of any exercise program. It should not, however, be the dominant element of a training program. Remember: “opportunity costs”.
Prehabilitation should focus on areas of weakness and potential areas of weakness (that is, areas likely to be injured. Years ago, one of my mentors was a teacher/coach named Dave Goethals. His Badminton class was affectionately known as “Conditioning with a Racquet” by the students. He included hip and rotator cuff conditioning in all of his teaching and coaching. It showed in the performances of his athletes—injury was a rarity. These areas—the hips and shoulders—are the key links in sports and human performance. It is the hips, for example, that are the key to preventing ACL tears (the often career-ending knee injury). Another key area for prehabilitation is the “core”—the abdominals (all of the abdominals, not just the showy rectus abdominus) and the critical support muscles of the spine.
Once these muscles are sufficiently strong, the focus should shift to strengthening the larger muscles and performing the stronger lifts (e.g., squats, deadlifts, bench, rows, presses, and their variations). Progress is otherwise hindered by spending a disproportionate amount of time of the nonessentials.
If just beginning an exercise program, one is wise to spend some time on mobility and stabilizer exercises—e.g., stretching, rotator cuff, 4-way hip, core, and balance exercises. Along with these a greater emphasis will be on mastering the technique of the core exercises. After an appropriate amount of time (perhaps not more than 4-6 weeks), the primary emphasis should shift to strength building. Over time, the “prehabilitation” can be revisited during periods of deloading or be cycled in as a part of a periodization plan (the cycling of the exercise plan over time to capitalize of elements of specificity).
A better overall term for prehabilitation, used in strength and conditioning, is “general physical preparedness” (GPP). GPP emphasizes the overall benefits for pre-conditioning the physiological systems (i.e., health-related and motor skill-related components of physical fitness and performance) for later “specific physical preparedness” (SPP). GPP is the foundation, not the building blocks. Likewise, prehabilitation is a foundation. As a foundation, it requires maintenance, but it should not take away from the building of the structure (SPP).
Our goal in exercise should be to improve performance. (“Exercise” is, afterall, defined as physical activity that is performed for the purposes of improving one’s health, physical performance, and/or appearance.) One cannot begin to improve until one begins to emphasize progression.
Be your best today; be better tomorrow.
Carpe momento!