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Prehabilitation & Preseason Conditioning. Chapter 7. Prehabilitation versus Rehabilitation. Rehabilitation: process of restoring function through programmed exercise to enable return to competition

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prehabilitation versus rehabilitation
Prehabilitation versus Rehabilitation
  • Rehabilitation: process of restoring function through programmed exercise to enable return to competition
  • Prehabilitation: trying to prevent injuries before thy occur through a preventative management program
preseason conditioning
Preseason Conditioning
  • Program that allows the body to gradually adapt to the demands to be placed on it
  • Beginning 6-8 weeks prior to sports participation
  • Overall conditioning plus concentrate on sport-specific weaknesses
  • Doing too much, too soon, at high intensity not allow body to adapt effectivelyincreases risk of injury
strength training
Strength Training
  • Highly adaptive process whereby the body changes in response to increased training loads
  • Adaptation: systematic application of exercise stress sufficient to stimulate muscle fatigues, but not so severe that breakdown and injury occur
strength training1
Strength Training
  • Skeletal muscle highly adaptable
  • Hypertrophy: increase in size of muscle tissue
  • Atrophy: weakness and wasting away of muscle tissue
  • Progressive Resistance Exercise: type of training in which muscles are worked until they reach their capacity
    • Once athlete is able to maintain that capacity, the workload on the muscle is increased to further build strength and endurance
    • Factors that determine rate and type of strength gains include:
      • Overload
      • Specificity
      • Reversibility
      • Individual differences
  • Progressive overwork of muscles at a controlled, increased rate, to achieve consistent gains in strength
  • Muscles increase in strength and size when forced to contract at tensions close to max
  • Muscular tension must be attained at an adequate intensity and duration for optimal development of strength
    • 4-8 repetitions in multiple sets (3+)
    • Proper rest intervals between sets
  • Ability of particular muscle groups to respond to targeted training to those muscle
  • Increased strength gained in that muscle group only
  • When muscles contract, they recruit different types of motor units to carry out contraction
    • Slow-twitch fibers
    • Fast-twitch fibers
motor unit
Motor Unit

Slow-twitch Fibers

Fast-twitch Fibers

Type 2

Easily fatigued

Generate short bursts of strength or speed

Fire rapidly

Use anaerobic metabolism to create fuel

Sprinting or weight lifting

  • Type 1
  • Resistant to fatigue
  • Fire more slowly
  • More efficient at using O2 to generate more fuel (ATP)
  • Used for continuous, extended muscle contractions over a long time
  • Marathons or bicycle for hours

Amount of training that occurs in muscle fiber determined by extent to which it is recruited

    • High-repetition, low-intensity exercise slow-twitch fibers
      • Distance running
    • Low-repetition, high-intensity exercise fast-twitch fibers
      • Weight training
  • Training program should be structured to produce desired training effects
  • Process of muscle atrophy due to disuse, immobilization, or starvation
  • Leads to decrease strength and muscle mass
  • Slow-twitch fibers atrophy faster
  • Important to rehab with strength and endurance after period of immobilization
individual differences
Individual Differences
  • People vary at rate at which they gain strength
  • Endurance athletes = more slow-twitch fibers
  • Strength athletes = more fast-twitch fibers
  • Fast twitch fibers tend to gain strength faster
  • Intense, progressive resistance training mainly enlarges fast-twitch fibers

people with more fast-twitch fibers will tend to gain strength faster, be stronger, and have greater potential for strength gains

isometric exercises
Isometric Exercises
  • Muscles contract but there is no motion in the affected joints
  • Muscle fibers maintain a constant length throughout the entire contraction
  • Performed against an immovable surface or object
benefits of using isometric exercises
Benefits of Using Isometric Exercises
  • Exact area of muscle weakness can be isolated
  • Strengthening can be administered at proper joint angle
  • Provide relatively quick and convenient method for overloading and strengthening muscles
  • No special equipment needed & little chance of injury
  • Contraindication: those with circulation problems and high blood pressure
isotonic dynamic exercise
Isotonic (Dynamic) Exercise
  • Activity that causes the muscle to contract and shorten (movement of joint during ctx)
  • Weight training with dumbbells/barbells
    • As weight lifted through ROM, muscle shortens and lengthens
  • Calisthenics (chin-ups, push-ups, sit-ups)
    • Use body weight as resistance force
  • Improves blood circulation, strength, and endurance
manual resistance training
Manual Resistance Training
  • Form of dynamic exercise that is accomplished with training partner
  • Partner assists by adding resistance to lift as lifter works the muscles through FROM
  • Partner adds enough resistance to allow lifter to fatigue muscles, but that lift can be completed
  • Advantages
    • Requires minimal equipment
    • Spotter can help control technique
    • Workouts can be completed in less than 30min
    • Training can be done anywhere
  • Disadvantages
    • Requires extra person
    • Both must be trained to do exercises properly
isokinetic exercise
Isokinetic Exercise
  • Uses machines to control speed of contraction within ROM
  • Attempts to combine best features of both isometric and weight training
  • Provides muscular overload at constant, preset speed while muscle mobilizes its force through FROM
  • Cybex, Biodex
circuit training
Circuit Training
  • Uses 6-10 strength exercise that are completed as a circuit, one exercise after another
  • Each exercise performed for specified number of reps or time period before moving to next
  • Each station separated by brief, timed rest
  • Total number of circuits performed my vary depending on athlete’s training level
stretching flexibility
Stretching & Flexibility
  • Stretching: moving the joints beyond the normal ROM
    • Useful for injury prevention & treatment
    • Athlete increases the length of the muscle

leads to increase ROM  limbs/joints can move further before injury occurs

  • Flexibility: ability of a joint to move freely through it’s FROM
warm up
  • Essential component of stretching
  • Increases heart rate, blood pressure, respiratory rate

Increase delivery of oxygen and nutrients to muscles

 Allows muscles to prepare for strenuous activity

  • Warm-up should be non-strenuous but allow athlete to perspire
warm up facts
Warm-up FACTS
  • Active person tends to e more flexible than inactive
  • Females tend to be more flexible than males
  • Older people tend to be less flexible than younger
  • Flexibility is as important as muscular strength and endurance
  • To achieve flexibility in a joint, surrounding muscles must be stretched
static stretching
Static Stretching
  • Gradual stretching of a muscle through entire ROM
  • Slowly until a pulling sensation occurs
  • Hold position for 20-30 seconds
  • Should not be painful
ballistic stretching
Ballistic Stretching
  • Rhythmical, bouncing action
  • Stretches muscle a little further each time
  • Performed 10-15 times
  • Research shows increase incidence of injury; bouncing action activates stretch reflex resulting in small muscle tears and soreness
proprioceptive neuromuscular facilitation
Proprioceptive Neuromuscular Facilitation
  • Involves combination of contraction and relaxation of muscles
  • Proprioceptive: stimuli originating in muscles, tendons, and other internal tissue
  • Neuromuscular: muscles and nerves
  • Facilitation: hastening or enhancement of any natural process
  • Requires initial isometric ctxvs maximum resistance at end of ROM
proprioceptive neuromuscular facilitation1
Proprioceptive Neuromuscular Facilitation
  • Requires initial isometric ctx versus maximum resistance at end of ROM
  • Position typically held for 6 seconds followed by relaxation and a passive stretch
  • Repeated several times
  • Designed to be completed by qualified assistant
cardio respiratory conditioning
Cardio-Respiratory Conditioning
  • aerobic or endurance training
  • Activities that put an increased demand on the lungs, heart, and other body systems
  • Can improve performance in all types of sports and activities
  • Uses large muscle groups for activities
  • Goal is to train heart and other muscles to use oxygen more efficiently perform exercise for longer periods of timeimprove overall fitness level

Muscular Endurance

  • Ability of muscles to sustain high-intensity, aerobic exercise
  • i.e. weight lifter who has trained to complete 20 bench presses at 150lb in 60 seconds

Cardiorespiratory Endurance

  • Relates to whole body’s ability to sustain prolonged, rhythmical exercise
  • i.e. cross-country runner completing a five-mile run
physiological effects
Physiological Effects
  • Heart increases in size increasing pumping volume
  • Resting heart rate decreases
  • Contributes to decrease in blood pressure
  • Increase in amount of air exchange in lungs provide more efficient oxygen transfer to blood
  • Increase resting metabolism
  • Athlete works, conditions, and competes at higher level
benefits of cardiovascular conditioning
Benefits of Cardiovascular Conditioning
  • Reduced fatigue
  • Improved self-confidence
  • Improved muscle strength and tone
  • Increased endurance
  • Reduced stress levels
  • Reduced body fat
  • Improved overall physical and mental health