Prehab, How Much is Enough

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Getting to Work

Sometimes it can be hard to find the motivation to get into the gym when you are injured, especially for me when I know all the hard work I am putting in now will be essentially erased in the next few weeks. But working out pre surgery is one of the most important tools you have in the lead up to an invasive surgery. So the question is, how do you know how much training you should do? And how can you balance the work load whilst limiting inflammation and pain. Hopefully in this post I will be able to answer some of these questions and give a better idea on what is expected from an athlete before they undergo a surgery.

Training Whilst Injured

Obviously this question depends on several conditions, the first and most obvious is the type of injury. My injury is an ACL Rupture, and luckily enough that is all that was hurt in the crash. I essentially have full mobility with slight pain and inflammation limiting my range of motion. but if you have broken your femur your ability to perform even simple tasks is much more limited.

So as I said, firstly the type of injury you have suffered will have a major effect on your ability to exercise. Secondly, what is your current level of mobility, if you can barely walk you will be struggling to do even the most basic exercises and should be focused on fixing whatever is causing that issue (reducing swelling, gaining confidence, etc). Thirdly and probably the one that matters the most for your personal workload. How were you when you got injured. If you’ve been avoiding the gym for a few months and rupture your ACL you cannot expect to jump back into a high workload training schedule without having issues.

That being said, here is what I have been advised to do each week based on my injury and mobility level and pre injury fitness level.

  • 2 Lower body sessions per week, including squats, hamstring curls, dead lifts and other exercises that do not require any dynamic movement (moving side to side) or any twisting in the knee to protect the joint.
  • 2 Upper body sessions per week, these sessions are essentially normal sessions for upper body, with limited work done standing.
  • 3 Cardio sessions, either on the stationary bike or the rower. Running is possible for some people but I am not a very good runner at the best of times so I have been told to avoid it for now.
  • 1 Core only session per week.

With an injury similar to mine it is very important to do as much isolated weight lifting as possible. Doing things like assisted single leg squats and single leg leg press allows my bad leg to catch up to my good leg and ensures I’m not favouring one side over the other. Which can be a big issue when thinking about returning to snow.

Is This Enough

This amount of exercise is more than enough for most people, but for myself, if it’s not hurting at all I will sometimes do other things like going for long walks or even going bike riding along flat trails in low gears. At the end of the day the amount of exercise you do depends on you as a person, for me I do what I am told and then a little extra on top when I can. Some people may need to do less and spend more time working on pain management and inflammation. I know people who haven’t been able to walk at all let alone do 100kg squats 5 weeks post injury, it is all subjective.

The current workload for me currently is similar to what I was doing in the preseason of last year, if just a little less intense. However when it comes to prehab its about doing as much as possible without doing any damage. The more work you do before surgery the “less” work you have to do post surgery to get back to where you started.

Has anyone who has had similar or different injuries got any feedback on how they dealt with rehab and prehab, as well as staying motivated to get into the gym even when it feels pointless? Let me know in the comments.

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