The Stepping Stones of Rehab

You will have heard athletes talk about focussing on the process rather than the outcome, and the same applies to rehabbing an injury and returning to sport – it’s a gradual, progressive, PROCESS. Let’s use the simple metaphor of running a marathon. If you’re a regular 10K runner (around 6 miles), you want to get comfortable running 8-10 miles before you run a half marathon (13 miles), and this gradual progression should continue all the way up to running 26 miles of the marathon. If you want to run a fast time you’ll throw some speed work in there (again, introducing it gradually); we don’t need the detail here – basically, we all understand that if a regular 10K runner goes right up to marathon distance without building up gradually, they get injured.

Working backwards to move forwards
Training and rehab programmes shouldn’t work blindly – there should be a goal in mind, the same as in our marathon example above. Let’s say you want to run a 10K, and you’ve sprained an ankle. You need stability in the ankle, so can you weight-bear? Yes? Ok, can you walk? All good? Right then, let’s try a calf raise. If you can do a bunch of calf raises, maybe try some very gentle running on the spot.

For a rock climber with a sprained ankle, the end goal is different; it’s less about being able to climb up, and much more about the ankle being able to protect itself in a fall. So rehab is much more about ankle stability and gradually introducing plyometric landing and bounding exercises to develop ankle strength, proprioception and confidence. The demands on the ankle of running, and of falling 4-5 metres off a climbing wall, are completely different, but the stepping stones approach of gradual exposure to more demanding exercises still applies.

You are not indestructible!
The same holds true for an uninjured, healthy athlete who wants to introduce a new element into the training. Let’s say we have a healthy runner who decides to introduce speed work. If the end goal is two additional sessions a week, one track and one hill session, then gradually exposing the athlete to this type of training might look something like this:

Currently: zero track or hill work
Weeks 1-2: Add 1x track+1x hill session/week @25% of desired volume – (this may literally be just one or two efforts per session – keep reading!)
Weeks 3-4: 1x track+1x hill session/week @50% of desired volume
Weeks 5-6: 1x track+1x hill session/week @75% of desired volume
Weeks 7-8: 1x track+1x hill session/week @100% of desired volume

What, 6 to 8 weeks to introduce this type of training, I hear you cry? The counter argument is that your typical calf strain may put you out of full training for at least 3 weeks. The gradual approach doesn’t look too bad now, does it? And by working backwards with your planning, with the end goal in mind, you can ensure that you make the improvements you want in time for your target event.

I’ve used running as my example – and please note this is just an example, not a recommendation – but the same applies to any sport. Rock climbers new to a campus or fingerboard, occasional cyclists aiming at a 100m sportive, triathletes embarking on a gym-based strength and conditioning programme – please, just THINK!

Hope that helps you prevent some unnecessary injuries!

Phil