Here at Tier 1, we get asked this question a lot, like a hell of a lot! People are always getting in touch asking if us if it would best to see Stuart or Ollie (our Therapists) or Jon (Our Coach) for exercise prescription, coaching and training. The reason for these questions appears to be that there is seemingly a grey area in people’s minds as to where the point of injury rehabilitation stops and the return to training begins.
The truth however is that there isn’t a physical gap or grey area between the two. Rehabilitation and Training are on a cyclical continuum. In fact one directly influences the other at all times. The simplest way to explain this boils down to two things: Stress and Adaptation.
The human body is an incredible piece of kit. It is constantly adapting and making changes depending on what demands – (aka stress) are placed upon it. For example, if we wish to make our body stronger, we can apply a mechanical load upon it, i.e. weight training. You see, Weight training stresses the muscles and nervous system. The body then detects this particular form of stress and makes a host of adaptations such as producing bigger, stronger muscle fibres and making sure your nervous system is better coordinated. This process allows for greater strength next time around. Put simply, you become stronger!
The reason for this is simple, the human body likes to be efficient and does not like to have its normal levels of energy production disrupted too much. So whenever stress disrupts this, it will make changes to ensure that it is better equipped to reduce the disruption, in case there is a next time (Stress = Adaptation!)
Now, when injury strikes, the ability for the injured area to handle normal levels of stress, and mechanical loading (etc., etc.,) is reduced due to pain and reduced power output from the central nervous system. These necessary processes protect the region due to the potential physical disruption of muscle, ligament or joint fibres etc. All of this doesn’t mean we should rest however as although the ability to handle stress is reduced, it is not completely diminished. What this means is that we have to operate at a reduced level and apply just enough to stress to the area so that it forces a positive adaption without exceeding a threshold into pain and further injury.
The simple purpose of exercise rehabilitation is to restore the ability to perform an action, sport or activity of daily living to the same level or above prior to the injury that occurred. In an ideal sporting context, it should be a smooth transition from pain to performance so to speak. In terms of stress and adaptation, it is a progressive continuum of stress application and adaptability based upon what the body can tolerate. At one end of the continuum is rehab where a lower level of stress being applied is necessary and at the other end is performance where a much higher level can be applied for adaptation and progress.
So now go back to our original question: Rehab vs Training – What’s the difference? The difference is the levels of stress and adaptability between the two. The point is they are part of the same cyclical continuum. (See below). This is why we always coin the term “Rehab is Training and Training is Rehab” because very often, good rehab is just good training! Good training can also provide the perfect stimulus and adaptations in the body to often prevent injuries from occurring in the first place!
To summarize then, knowing where you are on the continuum will often pave the way for a successful outcome whether it returning from injury or simply improving your performance! But then again….deciphering that riddle is where the Tier 1 Team steps in!
“Rehab is Training and Training is Rehab”