Physical rehabilitation is awesome! I love conversing with my friends in the health and fitness industry (coaches and therapists) about their strategies when it comes to client rehab (and prehab = injury prevention). As a health professional, it’s essential to have these open conversations with other professionals in order to maintain an open mind and to ensure the best treatment of care possible for your clients.
There’s no one way to optimally train or rehabilitate the human body and anyone who claims their method is the ‘best’ way is either trying to sell you something or doesn’t know enough about other physical practices. Any black and white statements about the human body or with certain physical practices should always be taken with a pinch of salt.
Despite my love for rehabilitation, there are issues that I have with ‘traditional’ physical rehab that I want to address…
Not addressing the whole story
Let’s look at a very common injury amongst physically active people/athletes and how this injury is treated. YOU might have even suffered with this at some point in your life… Hamstring strains.
- 80-85% of hamstring strains occur during the swing phase of high speed running when eccentrically loaded (as your hamstrings ‘lengthen’).
- 80% of hamstring injuries effect the long head of the biceps femoris (most lateral hamstring).
- Research shows eccentric strength exercises are best to prevent hamstring injuries and recurrences.
- Hamstring exercises such as the Nordic Hamstring Curls are great for hamstring rehabilitation and injury prevention.
The above is a brief example of how a coach or physical therapist might carry out hamstring rehabilitation after the hamstrings have been strained. This is a very ‘traditional’ way to treat hamstring strain. I have no issues with this thought process but there are components missing that I believe are essential to producing a long term change.
The next paradigm
Research has also shown that hamstring issues can originate from pelvic asymmetry. Because the hamstrings attach onto the sit bones of the pelvis, problems with alignment of the pelvis can effect the hamstring’s ability to eccentrically load (‘lengthen’) during the swing phase of running.
If there is an asymmetry at the pelvis and an individual is then performing hamstring strengthening exercises, the potential cause leading to the hamstring injury in the first place has not been addressed. This can leave the person open to recurring injuries in the future. The irony is any ‘weaknesses’ in the hamstrings might also be an end result of the pelvis being misaligned, and bringing the pelvis back into a functional alignment can result in the hamstrings testing as ‘strong’. Making it unnecessary to do strength exercises for the hamstrings in the first place!
The next next paradigm
What I’ve addressed here is just one potential outcome. The mobility of the sciatic nerve, the feet’s ability to deal with ground reaction force and even your shoulder movements can all be the reason why the hamstring’s ended up injured.
Doing strength exercises because a muscle appears to be ‘weak’ may be the right course of action… And it may not. If the goal is to produce a long term change, then we need to view the body as an integrated system. One part of the body effects another part of the body and so on… A muscle might test ‘weak’ because of a functional issue somewhere else. On the other hand, a muscle might still need strength training even after other areas have been addressed and worked on… It’s all case by case and dependant on the individual.
What’s the point?
I’m not knocking strength training or rehabilitation. My point with this blog is to get you ask yourself the question, ‘WHY?’
Why am I doing what I’m doing? Am I taking into consideration the whole system when I’m training a specific muscle group? What are my goals with exercise?
If you would like to continue this discussion please comment down below or private message me on my facebook page, Movement Biomechanics (click on the icon below).
Thank you and I look forward to connecting with you 🙂
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