How to Plan an Exercise Rehabilitation Session

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One of my pet peeves in the rehabilitation profession is that patients who are prescribed a rehab programme are typically given a shopping list of exercises with little care put into their execution. how are you supposed to design an effective programme in that time as a practitioner? or, the software platforms that practise gravitating toward exercise programmes are often incredibly poorly designed.

It’s critical to have a structure in place for how you design your sessions, not only for patient results but also for the systemization of development.

Consider the eight acute resistance training factors that you may alter in your programmes to better understand how you might arrange your session.

  • Exercise
  • Sets & Reps
  • The prescribed resistance
  • Order of exercises
  • Speed of the exercise
  • Relaxation periods between reps and sets
  • The periodisation across different weeks

Exercise is the most controlled variable by practitioners when constructing an exercise rehabilitation programme, and offering new rehab exercises at each meeting has practically become a rite of passage in order to keep athletes interested in the process.

Being able to categorise our workouts into discrete ‘blocks’ with a specific focus/goal will ensure that you, as the rehab expert, are able to check off all of your athlete’s goals in each session.

Once you’ve specified your workouts and their sequence of execution, you’ll be able to focus on the other factors, which is where being particular in your training prescription can help you overcome specific injury limitations.

The following is the structure/order that uses with athletes:

Preparation:


Prep work has a negative reputation since it has traditionally consisted exclusively of passive treatments like stretching and foam rolling before a strength exercise. However, there are numerous effective avenues you can utilise to set your athletes up for success right at the start of a session.

This block should include any immediate preconditioning that may help with loading throughout the rest of the session, such as isometric modalities for a neural drive or pain relief (see image below); ROM work; BFR training for pre-fatigue, and/or any soft tissue therapy or mobility drills that you may want to prescribe the athlete.

The crucial thing to remember is that this practice should have a clear goal in mind so that the athlete may get the most out of his or her subsequent blocks. This is especially beneficial for athletes who are still in the early phases of their recovery and are experiencing neuromuscular inhibition as a result of pain and/or oedema.

Gait Mechanics:


The fundamentals of running mechanics should begin the day the athlete can completely weight bear, whether on or off crutches, for lower limb injuries. Setting the groundwork for excellent running postures will make returning the athlete to the field simpler since they will have progressively built up to the demands of linear running in lower-load, safe conditions.

This part of the session comes first to maximise the athlete’s freshness and to function as a central nervous system stimulation, which would normally come at the conclusion of a performance-based warm up.

Velocity:

The focus should be on blocking velocity prescriptions based on the athlete’s position on the plyometric continuum. The goal is to encourage the basic learning of positions that will be subjected to more complicated and turbulent settings in the future. The point is to promote the foundational learning of positions that will later be exposed to more complex and chaotic environments. There may be no velocity block at all for athletes in the early stages of rehab, or the prescribed exercise(s) may be mundane and repetitive, but the point is to promote the foundational learning of positions that will later be exposed to more complex and chaotic environments. Building the athlete’s capacity to resist ground impact will aid in a seamless return to running and enhance their confidence.(see the image)

Block of Resilience


This is when any extra stimulation that the damaged limb/part of the body needs should be prescribed at the end of the session (if needed). Once the athlete has completed their recovery, the resilience block is an ideal location to put ongoing rehab ‘top up’ training or injury prevention-based exercises that are particular to the athlete’s sport, such as hamstring or adductor focused top-ups for field sport athletes.

I hope you found this informative, and remember that systemising programme creation is a critical step in not only saving you time but also ensuring you achieve the best results for your athletes. (Image coursey: Google.com/ Justin richardson)