Myself and Andrea had the pleasure of attending Dr. Jacob Harden’s Prehab 101 and Movement Optimization course over the past weekend.
This course educates fitness professionals and healthcare practitioners on how to raise the ceiling of our body’s structural capacity to avoid injuries. It also looked at overcoming injury and how it affects our tolerance for movement. Dr. Harden spoke about physical stresses applied to the body and how incremental movement and loading is necessary for adaptation to take place. We had an amazing time learning new exercises for the core, shoulders, hips and everywhere else in between. We are excited to share this with the it’s time clients!
What is Prehab?
Prehab is not injury prevention. It’s impossible to eradicate injuries completely because life it not predictable and some injuries are inevitable (e.g. running into a pothole and rolling an ankle). Instead, Prehab is building up our tissues capacity so that they’re more structurally durable. Over time, you will start to raise the ceiling of your body’s capacity, and as you do your body will be able to handle more and more stresses. The more you build your tissue’s capacity the more activities or weight you will be able to handle without injury. The big takeaway from this course was you must be functional and strong enough for YOUR life. If you want to hike the grouse grind, your knees and ankles must be strong enough to support your body up the 2,830 stairs.
The only way to raise your ceiling is to train! To build resilience in your muscles, ligaments, tendons and bones you need to apply an appropriate amount of physical stress that will trigger adaptation. This stress needs to be enough to stimulate adaptation but not too much that it surpasses your tissues stress capacity, causing injury. But how will you know if it’s enough stress? A good way to know you are triggering adaptation is to train near your stress tolerance level. This is your body’s alarm system, for example that feeling of soreness the next day is your body telling you that you are close to your stress tolerance. If the physical stress is not progressively increased, then you will only maintain your tissues current capacity. Additionally, if the stress applied is less than what you are used to, your tissues will become detrained, meaning they will start to lose strength and function. Your body isn’t going to keep strength and mobility in your joints and tissues if it’s not being used.
The take home message here is that you need to train near your stress tolerance level to trigger adaptation, but not past your stress capacity level where you will get injured. The training must also be consistent to see any adaptation. Ultimately, clients who train three or more times per week will have better results. Those who training more than three times, vary the intensity of each day to stay within their limits, e.g two hard days, two medium days and one easy maintenance day.
Stress is Stress
Everything puts stress on the body. For example, as I sit here and write this I am putting compressive stress on my low back and hips. Most of the time physical stress is unavoidable, from the time you get out of bed in the morning you are placing some amount of stress on the body. However, just because you cannot avoid these stresses it doesn’t mean you can’t manage them. I can manage the time that I spend sitting here or the posture that I am sitting in to minimize the stress on my back.
Stress is stress, the body cannot tell the difference between life stresses (work, family, nutrition, sleep) and exercise/physical stress. You must listen to your body and account for these additional stressors when determining adequate recovery periods. Reduced sleep, work stress, and poor nutrition might leave your workouts feeling harder than normal but this is not a time to push your limits, it’s a time to regenerate! Use this opportunity to work on your technique, patterning, mobility, core, or motor control. On the other hand, if you feel great and have a hard workout where you are pushing your limits your body will need more time to recover. This is the most important time to have good nutrition and sleep habits. If you want to apply stress you must recover from that stress.
Physical stress is a combination of a movement pattern and the amount of load placed on that pattern. For example, the movement pattern could be a squat, and the load would be your bodyweight or however much weight you are carrying. A squat with an inefficient pattern or heavier load both place more stress on the body, versus an efficient pattern and a lighter load.
The energy we use must be appropriate for the task at hand, and use no more energy than necessary. This is called movement efficiency. As effort and load increase, your movement efficiency must increase as well to minimize the risk of injury. An example of this is picking something up from the floor. If I were simply picking up a pen off the ground, I have a wide variety of techniques (movement patterns) that I can use without being too cautious of how I do it (e.g. bending my spine). However, if it was a 300lb deadlift my options to lift without injury are much more limited to a very technical pattern (utilizing breathe and bracing of the spine with a hinge). Furthermore, if you have an injured back, your options for how you lift the pen are limited, you may have to treat it like a heavy deadlift, in order to protect from further injury. An important key here is to not villainize the pattern, it is also the load placed on that pattern that increases the stress placed on the body which can cause injury.
What happens when I get hurt or am recovering from an injury?
After an injury the body’s capacity for physical stress will decrease dramatically. This is when you need to take precautions and slowly build back up to your full strength with progressive loading. Once the pain is gone away we can’t expect our body to be able to handle the same stress that it could right before the injury. Therefore, training within your body’s current capacity is essential for not getting re-injured.
How can I put this into my current exercise routine?
- Use an RPE scale
An RPE scale is defined as your rating of perceived exertion. It’s a way to determine how hard you feel like you are working. For example, on a scale of 1-10, 1 is lying in bed and 10 is running away from a bear. You can use this scale to manage the stress placed on your body. One day you could rate your 10kg TGU as being a 5/10 and another it could feel like 8/10. Listening to your body is key when training near your stress tolerance level to keep your body below its stress capacity to avoid injury or over training.
- Plan your recovery time
Plan recovery time into your schedule based on other stressors that might happen that week. If you have a big project due at work this week, you know you won’t be getting as much sleep and you won’t have time to cook yourself a nutritious lunch for the next day, therefore you should take that into account with your training and recovery time. Recovery is vital for your fitness progress as the body can only make adaptations at rest. Strategies include staggering your workouts in terms of difficulty. Add in a mobility and core day in between your strength workouts for relaxation and stress reduction.
- Heal from injuries then progressively reload
While you are recovering from an injury the first step is to remove aggravating factors. Then you need to modify your activity so it doesn’t include those aggravating factors. Additionally, maintain your fitness levels throughout the rest of your body. Gradually reload the injured tissue so as it heals it becomes stronger, until you get to the point that it is stronger than before you hurt it.
Written by Jessica Pastro and Andrea Brennan, Kinesiologists and Strength Coaches at it’s time! Fitness Results
Content based off of course Prehab 101, by Dr. Jacob Harden