We spend every day dealing with a wide variety of injuries. It is for this reason that we maintain our philosophy around the importance of joint preservation as part of wider injury prevention. This is done via pre-habilitation or ‘pre-hab’ - acting before an injury occurs.
Below we cover the basic ‘pre-hab’ guidelines commonly used in sports injury and performance medicine, with particular focus on the lower back in this article.
SO WHY PREHAB, I FEEL FINE?
A normal healthy joint will function just fine, but when we place additional resistance stresses on our joints, sometimes they are not strong enough to deal with this and the capabilities are exceeded. Here is where ‘pre-hab’ comes in. Focus areas are:
• Increase joint dynamic control and stability • Increase strength and function of supporting muscles • Promote recovery from exercises • Prevention additional micro-trauma from developing
PRE-HAB FOR THE LOWER BACK
Back pain is the most common injury we suffer and with back pain - everything else is affected. Over the years, research has over-focused on core strengthening, however, we have found that dynamic functional mobility is far more important.
Spinal prehab focuses on:
• Static postural control • Core function (as opposed to ‘bracing’) • Dynamic stability • Functional mobility
Core muscles are the foundation for supporting your spine, but you should get away from the idea of 'core bracing' and 'core strength' and edge more towards mobility and functional stability, alongside endurance and stamina. Our core muscles should be working automatically in high powered functional tasks, without the need to statically ‘activate’.
PREHAB EXERCISES FOR THE SPINE AND LOWER BACK
Exercise (1) - Superman Hold Kneel down on all fours, brace core muscle and slowly extend out one leg. Then with the opposite hand, make a salute, with the elbow facing out at the side. Hold for 15 seconds and repeat x 3
Exercise (2) - Superman Dynamic With the hold position from exercise one, slowly bring your elbow in towards your opposite knee, meeting in the centre. Repeat this dynamic movement for 10 repetitions and then swap. Control your core muscles throughout this exercise
Exercise (3) - Superman Rotation Take the hold position from exercise one, slowly lift your elbow up towards the ceiling. Repeat for 10 repetitions and once again, control core muscles throughout
Exercise (4) - Lunge Position, With High to Low Wood Chop Next to a cable machine, kneel down into the lunge position with the knees at 90°. Then, perform a slow and controlled mid-spine rotation with the arm going over the front knee (note: only rotate to 45°). Perform 10 repetitions x 3 on each side
Exercise (5) - Straight Arm Pull Down (A) On The Ground: Facing a cable machine with both knees 'softened', hold the bar in front and pull down to thighs with straight elbows. Perform for 10 repetitions x 3, bracing core muscles (B) With Bosu Ball: Reduce resistance and perform standing on a bosu ball
Exercise (6) - Single Leg Bridge Lie on your back with your knees bent at 90°. With one leg straight (knees still together), slowly lift your hips off the mat. Perform 10 repetitions x 2
Exercise (7) - Backward Lunge With Overhead Rotation Perform a backwards lunge, then rotate your spine in the opposite direction to your rear leg. Perform 10 repetitions to each side x 2
Exercise (8) - Single Leg Bosu Cable Row On one leg and slightly softened knee, stand in the centre of a bosu ball. With two single handle cable attachments with a little bit of resistance, pull it in towards your chest. Counterbalance your weight during this exercise to remain balanced. 15 repetitions x2
Exercise (9) - Single Leg Deadlift Stand on a single leg with a dumbbell held in the opposite hand. Slowly bend your knee and lower your dumbbell towards the floor in front of your foot. Remember to keep your chin and chest up during this exercise so you don't bend your back (note: push and drive up using your heel and not to bear weight onto your toes). 10 repetitions x 2
Part 2 of 'pre-hab' article which we will focus on injury proofing your Glutes, Hamstrings and Quads.
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