Rehab Plans

I think that we have to start by saying that rehab is hard!

You obviously need a carefully designed training plan that is completely tailored to your start point and your goals. But there are some principles:

  • Start by doing the sessions alone (meet friends for coffee afterwards). This is so hard, as you so want to go back to social sessions in training groups, clubs or classes. But you need to be able to do exactly what your body needs, and not one step or one rep more. It is hard not to be sucked along in a group, and the ‘walk of shame’ if you need to stop early goes against every part of our training and mindset.
  • Be super-strict on form and stop the minute that it slips. Your progress relies on building back the perfect patterns – initially without loading and then gently, incrementally building the load and volume. You may have got away with poor form before your injury, but you are less likely to after an injury. So you need to know your ‘tells’ – the little cheats that your body finds as workarounds without you being consciously aware. Building the right muscle memory and grooving the right movements is the opportunity to make yourself better and stronger than ever before!
  • Be ready for the length & shape of sessions to be completely different. In order to pace your body’s recovery and pain management, sessions are likely to need to be shorter and possibly to do multiple repeats spread out across the day. You need to be excited about getting your trainers on, but totally committed to not exceeding the plan, even if you feel fantastic! Your body will only recover if you do not put the nervous system into stress, which can lead to cramping, spasms, and tightness when you need fluid and unencumbered movement.
  • Warm-ups and cool-downs are critical, plus releases and stretching. You may have skimped on these before, but now you need to adopt these approaches. Self-myofascial release and stretching have been proven to improve performance and range of movement when inserted in both warm-ups and cool-down.
  • Have a written list of red, amber and green sensations/pain levels. Keep going when it is green, move to being wary and extra-focused on your form when on the amber list and stop as soon as you hit one red. No ifs and no buts! These decisions are very difficult to make on the fly – hence the value of writing a list in advance.
  • You need to invest the early months into base training. This is true across all parts of cardiovascular, strength, power and flexibility. Without rebuilding the foundation in all of these areas, there is a massive chance of re-injury or new injury from compensation as well as it being a lot harder to build up to your previous levels. Remember that in just 6 weeks you will be completely detrained, so need to start from a completely different baseline from your history.
  • Your body will need more recovery – so give it what it needs. The right rehab training level can seem so low that there is a tendency to squeeze in extra sessions. But the progressive overload approach only works if the body gets the recovery that it needs to make progress.
  • There are no short-cuts. Keep doing the exercises and following the guidelines from the surgeons. physios etc. These need to be a part of your foundation.
  • Keep a rehab diary of what you do and how you feel. Often pain and problems develop a little while after, and often a day after, and the cummulative effect can be a factor too. So keeping a diary is the way to spot what is working, and spotting the triggers for pain or problems. Most people start with a rhythm of trying something, then having a rest day – in order to monitor the impact.