How to make rehab NOT suck…
When most people think of the word “rehab”, they might picture a treatment table in a physio’s office, or those dinky multicolored resistance bands you can pick up at the pharmacy, or maybe a dull PDF with sketches of a man doing stretches from a chair.
Cringe.
I’ve been on the receiving end of my fair share of that type of ‘rehab’, and I always found myself staying stagnant. I’d get treated in the clinic, and feel great for a couple of days. Then my low back would start hurting again and I’d wonder what I’d spent my money on.
I found it deeply frustrating. And it wasn’t until I started doing my own research that I realised this isn’t how rehabilitation should be.
So, on the off-chance you’ve experienced something similar, I wanted to save you the time and aggravation I went through, and tell you exactly how your rehab should look, most of the time.
What to look for in a rehab plan that’s not a money- & time-waster:
It should start easy, and get progressively more difficult from week to week. The plan should clearly show you when to add weight. When to add reps. When to hold for longer. When to increase range of motion. When to remove external assistance. It might start light, but after a few weeks, you’ll likely shake, wince and definitely break a sweat. If not, you’re either really really early in the process, or the plan sucks.
It should look, and feel, like strength training. Rehab and training are the same thing. They’re just at different rungs of the Pain to Performance ladder (click to see my really dodgy drawing). So if you can do all of your rehab from your desk chair, you’re either really really early in the process, or the plan sucks.
It should include cardio, step targets, recovery & nutrition advice. Wild to me how someone can walk into a clinic 20lb+ overweight, in pain, and they’ll walk away with a PDF outlining Cat Cows and breathwork. Now I love Cat Cows and breathwork. But if you’re overweight, Box Breathing isn’t where you should be spending your time. You should be spending your time on making better food choices, moving more often, sleeping more and improving your metabolic health by doing conditioning multiple times per week. So if your plan doesn’t mention that, it sucks. (BTW, check out the links underlined above for more on that…)
It should encourage you to rate your pain levels during the exercise, and 24h after. It’s a myth that the training & rehab process will be a pain free one. Generally, up to a 3/10 discomfort during an exercise is acceptable. But a good program taps in to those pain ratings, so that you don’t stagnate or make things worse. If your program never asks you to note down your pain scores, it sucks.
It shouldn’t require you to have to get regularly manipulated. I’m a Sports Massage Therapist so this could get me cancelled haha. Tabletop treatments are a nice way to get some short-term, feel-good endorphine release. And in some cases they can be helpful when included as part of a comprehensive treatment plan. But most people don’t need it. And it doesn’t create any lasting structural adaptation. Exercise on the other hand, does. So your plan should be 99% movement based. If it’s not, you’re either really really early in the process, or the plan sucks.
These are the guiding principles for my online and in-person coaching. It looks and feels like training, you work hard, you work smart, and it’s part of a bigger plan.
If you wanna chat about a plan for yourself, just reach out.
Hope this helps!
Michael
