Prehabilitation and
Preseason Conditioning
Chapter 7
Sports Medicine 1
Rehabilitation and Prehabilitation
 KEY

CONCEPT
Prehabilitation decreases the chance of injury
by addressing areas of concern or deficit
identified before participation in a sporting
event. A program can be implemented to
strengthen and develop these areas, thus
reducing the chance of injury during
participation.
Rehabilitation and Prehabilitation
 A preventative
management program
with the goal of
preventing injury
 This program addresses
concerns or deficits
recognized by the
athlete’s family physician
or other sports medicine
specialist prior to sports
participation.
Preseason Conditioning
 KEY

CONCEPT
Preseason conditioning allows athletes to
gradually build up to a level of activity that will
be expected of them on the playing field. By
starting slowly, the body is allowed to adjust to
the new demands; once the body has
accommodated, the athlete can once again
increase the demand on the body. By working
incrementally to get the body adjusted, the
athlete can prepare for the demands of the
season.
Preseason Conditioning
 Whenever
athletes start a fitness program,
or after they take an extended period of
time off, their bodies need to time to adjust
to the new stresses and demands.
Preseason Conditioning

Preseason conditioning focuses on developing
the athlete in the off-season.


The conditioning program should begin six to eight
weeks prior to sports participation to allow the body to
gradually adapt to the demands to be placed on it.
Sports medicine physicians, certified athletic trainers,
and qualified youth coaches should prescribe a
preseason conditioning program and provide athletes
with information on the type, frequency, intensity, and
duration of training.
Strength Training

Strength training is a highly adaptive process
whereby the body changes in response to
increased training loads.




Adaptation requires a systematic application of
exercise stress sufficient to stimulate muscle fatigue
without injury.
If muscle is working beyond its normal limits, it adapts
by becoming larger (hypertrophy).
If a muscle is worked less than normal, it becomes
smaller (atrophy).
The purpose of progressive resistance exercise is
to allow the body to adapt to the increased demand
placed upon it.
Strength Training

KEY CONCEPT

Progressive resistance training allows the body to
adapt to the increased demand placed upon it
through training. The rate and type of strength gain is
determined by four factors: 1. overload is the
overwork of muscles at tensions close to their
maximum; 2. specificity is the targeting of a particular
muscle group alone; 3. reversibility is the
characteristic of muscles that cause decreases in
strength and mass with disuse;4. individual
differences also account for an individual’s ability to
strengthen certain muscles at a particular rate.
Genetics have a strong influence on strength gain.
Strength Training

Overload




Muscles increase in size and strength when they are
forced to contract at tensions close to maximum.
Muscles must be overloaded at a progressively
increased rate.
The ideal number of repetitions is between four and
eight, done in multiple sets of three or four.
Proper rest intervals between sets allows muscles to
recover from exertion and prepare for the next work
interval.
Strength Training

Specificity


Muscles adapt specifically to the nature of the work
performed, an attribute known as specificity.
When muscles contract, they recruit different types of
motor units to carry out the contraction.
• Slow-twitch fibers are recruited for low-intensity activities
such as jogging, and are relatively fatigue-resistant.
• Fast-twitch fibers are used for high-speed or high-intensity
activities, such as weightlifting, and fatigue more rapidly.
Strength Training
 Specificity


cont-
Increases in strength, including rehabilitation
after injury or surgery, are very specific to the
type of exercise, which should be as close as
possible to the desired movements of the
activity.
Muscle fiber type appears to play an
important role in determining success in some
sports, such as distance running and sprints,
but not in others, such as shot-putting.
Strength Training
 Reversibility


Muscles atrophy with disuse, immobilization,
and starvation.
Slow-twitch fivers will typically atrophy faster
than twitch fibers, an important factor to
consider when designing a rehabilitation
program after immobilization.
Strength Training
 Individual


differences
Some differences in the strength gain rate are
due to the relative predominance of fast- and
slow-twitch motor units in muscles.
Fiber composition is genetically determined,
although a good training program can make
up for genetic deficiencies.
Strength Training

Stretching and flexibility



Stretching, moving joints beyond their normal range,
is useful for injury prevention as well as injury
treatment.
Range of movement is increased due to increasing
the length of the muscles, which means that limbs
and joints must move further before an injury occurs.
Warming up is an essential component of stretching
by increasing heart rate, blood pressure, and
respiratory rate, consequently increasing oxygen and
nutrient delivery to the muscles.
Strength Training

Stretching and flexibility cont
Flexibility is the ability of a joint to move freely through
its full range of motion.
• An active person tends to be more flexible than an inactive
person.
• Females tend to be more flexible than males.
• Older people tend to be less flexible than younger people.
• Flexibility is an important as muscular strength and
endurance.
• To achieve flexibility in a joint, the surrounding muscles must
be stretched.
Strength Training

Stretching and flexibility cont
Types of Stretching
• Static stretching is a gradual stretching of a muscle through
the muscle’s entire range of motion, done slowly until a
pulling sensation occurs.
• Ballistic stretching involves a rhythmic, bouncing action,
largely discounted today due to its tendency to increase the
incident of injury.
• Proprioceptive neuromuscular facilitation (PNF) involves
a combination of contraction and relaxation of the muscles,
requiring an initial isometric contraction against maximum
resistance at the end of the range of motion, and is designed
to be done with a qualified assistant.
Strength Training
 KEY

CONCEPT
Stretching and flexibility decrease the
chances of injury. Stretching allows the
athlete to actually lengthen the muscle,
resulting in an increased range of motion.
Therefore, joints and limbs can move further
before an injury occurs.
Strength Training
 Isometric



exercise
Muscle contract, but there is no movement in
the affected joints.
Muscle fibers maintain a constant length
throughout the entire contraction.
Isometrics are often used for rehabilitation
because the exact area of muscle weakness
can be isolated, and strengthening can be
administered at the proper joint angle.
Strength Training
 Isometric

exercise cont-
Blood pressure also increases rapidly, so
individuals with circulatory problems and high
blood pressure should avoid strenuous
isometric exercise.
Strength Training
 Dynamic


(isotonic) exercise
Movement of the joint does occur during the
muscle contraction.
Manual resistance training is accomplished
using a training partner, somethimes called a
spotter.
Strength Training
 Dynamic
(isotonic) exercise cont-
• The spotter adds enough resistance to allow the
lifter to fatigue the muscles, and then releases
enough resistance so that the lift can be
completed.
• Advantages include the use of minimal equipment,
the spotter can help control technique, workouts
can be completed in less than 30 minutes, and
training can be done anywhere.
• A disadvantage is getting an inadequately trained
spotter. Both the lifter and spotter should be
trained so that the exercise is safe and effective.
Strength Training
 Isokinetic


exercise
Machines are used to control the speed of
contraction within the range of motion.
Machines such as the Cybes and Biodex
provide isokinetic results; they are generally
used by physical therapists and are not
readily available to the general population.
Strength Training
 Circuit



training
Six to ten strength exercises are completed,
one after another until all are done.
Each exercise is performed for a specific
period of time before moving on to the next
exercise, with a brief rest time in between.
If more than one circuit is to be completed ,
the circuits will be separated by a longer rest
period.
Strength Training

KEY CONCEPT

In isometric exercise, the muscles maintain a
constant length throughout the contraction. This is a
good type of exercise to target an exact area of
weakness due to an injury. In isotonic or dynamic
exercise, there is movement of the joint during muscle
contraction. This type of exercise helps improve
blood circulation, strength, and endurance. Isokinetic
exercises use machines to control the speed of the
contraction within a range of motion. These exercises
provide muscle overload at a constant, preset speed
and full range of motion.
Cardiorespiratory Conditioning
 KEY

CONCEPT
Cardiorespiratory conditioning trains the heart
and other muscles to use oxygen more
efficiently. This allows the athlete to perform
for longer periods of time.
Cardiorespiratory Conditioning
 Also
known as aerobic or endurance
training, cardiorespiratory conditioning
refers to activities that put an increased
demand on the lungs, heart, and other
body systems.
 Large muscle groups are used for
activities such as walking, jogging,
swimming, cross-country skiing, or cycling.
Cardiorespiratory Conditioning

The goal of cardiorespiratory conditioning is to
train the heart and other muscles to use oxygen
more efficiently, allowing the athlete to perform
exercise for longer periods of time.
 Results include an increase in heart size, thus
lowering the resting heart rate and blood
pressure. Also, oxygen transfer rates are more
efficient and resting metabolism increases.
Cardiorespiratory Conditioning
 Other
benefits include reduced fatigue,
improved self-confidence, improved
muscle strength and tone, increased
endurance, reduced stress levels, reduced
body fat, and improved overall physical
and mental health.
Special Individualized Programs

Personal trainers can assist in strength training,
cardiovascular fitness, speed and endurance
work, and body composition. Personal trainers
should be certified and have proven knowledge
and expertise.
 Certified athletic trainers are allied health
professionals who have a considerable
knowledge of anatomy and physiology. They
can be found at many high schools and most
colleges and universities.