Pre-hab

That's not a spelling mistake, a typo, a reference to the famous Steve Prefontaine, or anything similar. Pre-hab is a term I recently heard which describes exactly the direction my thinking - and practice - has been heading recently regarding overall fitness and injury prevention, from both a coaching and my own training perspective.

In essence, pre-hab is/are the training activities you undertake to develop the fitness, capability, durability, injury-resistance and performance of your overall physical fitness and conditioning. In the past I've referred to it as complementary training, in that it complements swimming, biking, running, etc, but more recently actually see it as an essential aspect of a training routine.

Adding pre-hab activities to your training schedule means adding drills and exercises to address both common and individual weaknesses you may have. These are particularly relevant for running where the battle against gravity is constant - any boost you can give your supporting infrastructure via improved strength will have on-going pay-offs in terms of pre-empting weaknesses which may lead to injuries, and maintaining form under fatigue.

Some of the most common problems leading to injuries in runners stem from weaknesses around their hips. Often as a runner increases their mileage, hip and core strengthening is left by the wayside. As the miles increase, so should the minutes devoted to strengthening those stabilising muscles, that is, pre-hab activities.

Relating this to the common ITB injury, a study published in February 2010 in the Journal of Orthopaedic and Sports Physical Therapy recorded several key discrepancies between runners with ITBS and those without. “Most of the differences between them were up at the hip,” says Dr. Reed Ferber. “So the hip rotated too much and the hip collapsed inwards too much, and that drew the knee inwards.” In short, wonky hip mechanics were overworking the IT band, causing pain.

The same study found that only 12 percent of runners have a tight IT band. Interestingly, he also discovered that 80-90 percent had weak hip stabilising muscles. So for these runners pre-hab activities focused on strengthening glutes and related core and hip muscles would help to ward off potential problems before they occur.

Most often pre-hab activities are centred around core strength and control, something that I’m a huge fan of. It’s been rightly said that if your core isn’t strong then nothing else can be. Your core muscles – those around your hips, between your thighs and chest – support and enable every movement of your trunk. Think for a few moments how much you rely on these muscles for everyday movement, let alone the additional strain on them during exercise.

Core strength isn’t just about having a six-pack, it’s also about how well you control and maintain the muscle movement at times of low – and high – stress. The greater the fitness and endurance of these muscles the better you’ll be able to hold your form and efficiency together when it most counts, in the heat of competition. Plus the additional benefit of pre-empting weaknesses and imbalances which may lead to injury.

Pre-hab is not just limited to your core, it also includes things like your calf strength, ankle stability, and so on. Basically, any and every area of your body which is susceptible to injury can benefit from pre-hab. Just a few minutes per day can make a difference.

Don’t wait until things go wrong to do rehabilitation. An gram of prevention is worth a kilogram of cure. Building pre-hab activities into your schedule is a great step in the right direction towards all-round fitness, durability and performance.