Prehab, Warm-up, Recovery and You

Injury or decreased performance seems to be something we all face.  Both of these seem to come unexpectedly and we think that our body is failing us or "I am just getting old!"   The truth of the matter is we are our own worst enemies.  We tend to be locked into positions of immobility (sitting at a desk, sitting in a car, waiting in line, etc.).   Our bodies will also adapt to the movement of least resistance.  For example, if our hips are tight, will squat with our heels up or lean forward. These are compensations to get around the stiffness or movement loss.  However, if the true issue is not addressed then these compensations will hurt us.  Our body lets us know this first with stiffness, then loss of performance, and finally pain!  This is where we come into three ideas of warm-up, prehab, and recovery.  To many people warm-up is something to get you moving and maybe not that important.   Prehab is a term many are not familiar with unless they have had an injury and are trying to avoid another one.  Recovery is typically considering just "resting." However, warm-up, prehab, and recover are more important than your workout or activity itself when it comes to performance and avoiding the "injury bug" or "old age syndrome."

Compensation: Getting it done no matter what or crawl across the finish line

Warm-up seems like a simple concept and that may be why many fail to do it correctly.  In physical education classes (if you had some) we were taught that the warm-up gets the blood flowing and the muscles ready to work.  That is correct but the real purpose of the warm-up is being able to move within your full range of motion with little effort.  This should translate into lower risk of injury and allow for optimal performance.  When you warm-up, you should not attempt to increase your natural motion or push far beyond your limits.  Warm-ups should not be too difficult but they should also not be so easy that you can "tune" yourself out from your body or go into automatic pilot.  Feeling the movement and working those areas that feel tight is the real key to an effective warm-up.  Foam rolling or using a lacrosse ball is popular because you get feedback and easily adjust as an area becomes less sore and taut. It is hard to "tune" this out.  The same should be true of movements.

Example of Warm-Up for Overhead Squat

Prehab may not seem as simple and more for the rehabilitation setting.  However, prehab is very important activity to help avoid the injury 'bug.'   Prehab is where we work on areas that tend to be sticking points or weakness.  This is also the time to work on getting those stabilizing muscles to activate specifically with or without a heavy load.  Again, this should be performed mindfully adjusting movements as needed.  The movements should feel natural and add to natural movement.  "Knocking" these out or just going through the motions is not enough when it comes to prehab.  This should take mental effort to accomplish correctly and leave you feeling better when you are finished.  Soreness from doing something new is good but pain or decreased motion is not the intent. Make sure alignment is good and that compensations do not occur when doing prehab (this is the time to get rid of those compensations).

Lower Extremity Control and Balance Exercise for Prehab

Recovery seems to be the new hot topic with sports and performance.  There are machines that will pump your legs, you can float in a salt-water tank, get in a massage chair, or get a massage.  What these all have in common is they are effective but only passive means to recovery.  Meaning, they do something to you versus you doing something.  Recovery should include you actually doing something or what we in the business call "active" recovery.  The goal of active recovery is to restore natural motion after a workout and to address any areas that or more sore.  Foam rolling and lacrosse ball rolling are often used here but they really only address sore tissue. Your warm-up exercises and even prehab exercise should be used here. It really does not have to be complicated or "intense" just as simple as restoring good and pain free motion (or maybe much less pain free).  We usually tend to complicate recovery or think it has to involve to machine or a reclining position.  We also tend to just skip this altogether and get in the care and go. 

Passive Recovery

The human body was meant to move but it requires maintenance just like a car.  How many of you do regular preventative maintenance on your car (unless you are hoping it falls apart so you can get a new one)?  So why are you not perform preventative maintenance on yourself?  Just as it is very important to do preventative maintenance when a car gets older, it is important for us to perform preventative maintenance consistently to keep running properly.  We so often concentrate all our efforts on the workout or skill and neglect the most important parts warm-up, prehab, and recovery.  It is like not changing your oil and letting the radiator dry out.  Your car will break down and not be able to drive.  Well, your body will break down and not be able to perform if you neglect the warm-ups, prehab, and recovery.  There are some of you that probably are saying, "...man I've been doing this for a long time or back in my day we didn't do that crap!"  How many of you are not in your heyday now and are actually battle injury after injury or maybe the same one?  Is your performance the same as back then?  It is because your body has a threshold of "getting by" but eventually your body will tell you enough is enough.  You can survive so long without doing warm-up, prehab, and recovery but eventually you will see a Doctor, Physical Therapist, Chiropractor, Massage Therapist, Acupuncturist, or whomever. Maybe you will see them all for one injury or another.  If you have unlimited money to spend, then this is not an issue.  If you do not have, unlimited money to spend then maybe you should do the warm-up, prehab, and recovery more. 

Quick Thought on Health

The other day, I hiked up Barr Trail to Barr Camp to help haul some trash down (and get a free goody as well).  It was beautiful day for and enjoyable hike.  I started out in downtown Manitou Springs and a large of people were out as well enjoying the weather. When it is nice outside, everyone tries to get outside around here.  However, I noticed some conflicting behaviors that just reflect our view on health.

The first behavior was of man who just finished coming down after ascending the famous incline.  He was breathing heavy and looked happy to be done.  He walked over to the side of the building by the trees and looked poised to celebrate his accomplishment.  He did just that by lighting up a cigarette! 

The next behavior was from a group of women at an organic food restaurant.   I observed this group of six or so not so fit women buy salads for lunch.  The salads are actually very good and do not have any added junk.   Just when I thought things were looking up, they all clamored over to the bakery section (I thought they were going to knock me over) and excitedly ordered the sugary deserts for later.  This reminds me of when I used to work with clients who told me, "All I had was a "salad."  “What else did you have and what did you put on the salad” was my next questions.  

Both of these situations are a reflection of our countries' view on health that; "I earned this by exercising hard" and "eating well."  The first man finished the incline and celebrated with one of the unhealthiest things.  However, it is okay because he worked hard (and just wiped that out with one cigarette).  The women ordered salads, so I guess the sugary deserts are okay.  If I am good, then I am allowed to "cheat".  This is why health is a difficult thing for many in this country.  You do not earn health you work on healthy habits.


What do you think?

The Co-Dependency Conundrum

My previous post on self-efficacy was a bit of story-telling, perhaps enjoyable for some, but without the direct parallels with which some may prefer.  So let's mix it up a bit and start with a question.

What's the difference between buying a frozen "nutrisystem program" delivered to your door for weight loss and learning to eat real, whole foods yourself?

Option #1 - Nutrisystem.  I think it would be way more fun for you to spend a minute pondering why this is a bad idea than for me to lecture you.

How much processed garbage can we sell to people?

Option #2 - Real Food.  In this case, you would be learning a sustainable way to live healthfully.  This is the journey my friend and while it's certainly more effort than having perfectly portioned frozen food arrive at your door for consumption, it's also a healthier way to live.

This may take a little more preparation, but dang, look at that yummy fish!

It's been said there are two kinds of people.  There are the people who delineate everyone into two groups and those that don't.  But really, there are people who live their lives becoming increasingly dependent (perhaps closed-minded and entitled as well) and those who live their lives always working towards growth and learning (perhaps well-versed in learning from failures).  We all know there is such a thing as a healthy dependency and a very unhealthy dependency.  We all depend on food, it's just part of being a biological organism.  But Nutrisystem is actually answering a different problem, it's not really a food problem.

Underlying the so-called food problem is a misconstrued perception about health.  Nutrisystem is really treating your lack of self-action.  That's a fact.

Getting off the food discussion, we have the same problem in healthcare.  Big Medicine isn't that all different than Big Food.  Big Medicine has done an excellent job of creating unnecessary and unhealthy dependency in our culture and it's not just with pharmaceuticals or surgery.  Being that I am a physical therapist, I want to relate this to the world of injury, chronic pain, and even athletic performance.

How many athletes rely on treatments to get through their training?  How many non-athletes rely on treatments to get through their life?  Some athletes use their treatment sessions with their massage therapist, physical therapist, chiropractor, etc as recovery...to help them keep going.  So they go often, pay often, and they receive some sort of temporary relief.  Anyone see a huge-ass hole in this theory of healthcare utilization?  Where in this madness is the personal growth and learning supposed to occur?  At some point you should be learning enough that you no longer require treatments for preventable issues.  In other words, over time you make mistakes and you learn to do better.  You understand how to train smarter, how to warm up and recovery properly, how to listen to your body and adjust, and how to improve or maintain your own body.  Maybe you even learn a thing or two you can do in your lifestyle to make your training or other goals easier to attain.

Underlying the so-called treatment problem is a misconstrued perception about health.  The treatments you rely on are really treating your lack of self-action.  That's a fact.  Aside from major trauma or a genetic disorder, there are few reasons why you would need to keep seeing someone for the same issue indefinitely.  The problem is that Big Medicine thrives on this dependency.  It happens with medications, it happens in relationships, it happens in your therapist or chiropractor's office, and it happens with every bit of advertising to which we are exposed.

My job is to teach you, not treat you.  If we have come to treatment and we do not progress to teaching as soon as possible, we are wrong.  If you don't leave your healthcare provider with more knowledge, understanding, empowerment, and a plan of action for becoming healthier and more independent in the long run, folks we are doing it all wrong.

Said another way, in most cases you don't need us, you need to learn the lessons, learn from your mistakes, learn how to make it better, and move on already.

Yeah Big Medicine is kind of like that...