PreHab Exercises. Improve Movement Quality, enhance performance and prevent injuries.
PreHab Exercises are training tools individuals can use in existing training programs to develop both Mastery and Longevity within a specific skill (including running, weightlifting, and swimming) or for a particular sport (such as football, basketball, or CrossFit).
Additionally, PreHab Exercises can simply be incorporated into an exercise program or fitness routine to improve the overall quality of Human Movement, which in turn leads to increased efficiency within Daily Life Activities and Movement Patterns.
Essentially, PreHab Exercises are a form of ‘physical therapy’ in which individuals can rehabilitate from the effects of repetitive movements, such as running or swimming, as well as lifestyle factors, including driving and prolonged bouts of sitting, to restore biomechanical alignment and arthrokinematics (joint function) that ultimately improve how an individual moves.
The PreHab Exercise Website
In 2014, Michael Rosengart, CPT, CES, CSCS, created the PreHab Exercise website as a resource for those who wanted to maximize their training results by improving the way they move.
One of the most common issues noticed by Michael, a Corrective Exercise Specialist with the National Academy of Sports Medicine, was the growing disparity in how individuals move (effected by modern living) compared to the fundamental blueprint of Human Movement, hence his decision to design the PreHab Exercise website and author/illustrate the PreHab Exercise Book series.
In addition to video and text on the PreHab Exercise website, Michael uses his artistic ability to create illustrations that help an individual understand the alignment and action of various exercises.
Michael is a long-term personal trainer and strength coach, training athletes and clients since 2000. He has seen many different types of training disciplines, from the emergence of ‘functional training’ to the development of ‘CrossFit’ and the beginnings of ‘mobility training’. Additionally, Michael has learned from some of the brightest minds in the field of training, health, and fitness, including Tom Myers, Katy Bowman, and Gray Cook, to name a few.
Click Here to read more about Michael Rosengart, CPT, CES, CSCS
Mission Statement of the PreHab Exercise Website:
The objective of the PreHab Exercise website is to help people improve the way they move by educating them through text and illustrations.
Furthermore, the PreHab Exercise website stands to educate individuals on effective training techniques and exercises that help individuals restore biomechanical alignment and function to improve Movement Quality, enhance performance, and prevent injuries and/or compensation patterns and movement inefficiencies.
Why use PreHab Exercises?
PreHab Exercises enhance performance, promote longevity, and prevent injuries by limiting patterns of compensation and malalignments in an individual’s movement.
In other words, PreHab Exercises help an individual move better. Once an individual improves movement, he or she has the potential to perform better for longer, without an increased risk of injury.
PreHab is Rehab?
From a certain perspective, PreHab could be considered rehab because both PreHab and rehab actively pursue restoring as much biomechanical alignment and function as possible. It must be stressed that PreHab does not take the place of rehab. When injured, individuals should not skip prescribed Rehab with Physical Therapists to perform PreHab by themselves (or with a coach/trainer). This is not appropriate in any sense. Instead, it would be most appropriate to complete the rehabilitation process with a Physical Therapist and then incorporate PreHab Exercises into their training programs to maintain optimal biomechanical alignment and functionality.
PreHab is not a substitute for Rehab when an individual is diagnosed with an injury.
PreHab to Avoid Rehab
The above header is a catchy phrase that danced around the internet for a couple of years after Tim Ferriss popularized the concept of ‘PreHab’ in his book, The Four Hour Body. The sentiment behind the aforementioned phrase is a noble one and true in many ways. It is a short way of saying: physically prepare your body and practice Movement Patterns (exercises, sports’ drills, etc.) with proper form to avoid unnecessary injury in the future.
PreHab Exercises are training tools to help an individual prepare the body to practice/compete in sports/training with proper alignment/technique and prevent unnecessary injuries.
Opposition to PreHab
There have been coaches and trainers who voice opposition to the concept of PreHab. For example, renowned trainer Joe De Franco expressed his disagreement with the concept of PreHab by stating his belief that if an athlete trains correctly, meaning if they lift weights and perform exercises with proper form, then there is no need for PreHab. In many ways, De Franco and the others who oppose PreHab are correct. If an individual actively practices movement with proper biomechanical alignment and neuromuscular facilitation (activation sequence of muscles), there is no need to correct the movement. In short, if it’s not broke, don’t try to fix it!
Unfortunately, the lifestyle associated with the modern world does more to hinder an individual’s Movement Quality and disrupt biomechanical integrity, ultimately leading to malalignments and patterns of compensation.
PreHab Exercises are a training tool to help individuals living in the modern world restore biomechanical integrity and improve their Movement Quality.
Biomechanist Katy Bowman did the fitness world a huge favor when she shed light on the biological phenomena of ‘mechanotransduction,’ which refers to the process by which force and positions (including alignment and posture) shape, reshape, and deform the physiological structures of the body, leading to vast changes in how a person actually moves. In other words, Bowman explains the massive effect Daily Life Activities have over the human body; simple movements repeated continuously over time can literally mold the body into a new posture and alignment. One common example is ‘Text Neck,’ a Forward Head Posture created by the habitual act of dropping one’s head to read messages on a Smart Phone.
PreHab Exercises help correct and/or eliminate the negative effects that Daily Life Activities (Lifestyle), Repetitive Movements (Lifestyle and Training), and Overreaching (Training) has on the human body.
Daily Life Activities
There are numerous ‘little’ acts individuals perform every day that reshape their bodies, in many cases for the worse. Texting is one of them. Driving, sitting at a desk, holding a bag over one shoulder, standing on one leg, wearing high heels, lounging on the couch and many, many other Daily Life Activities constantly reshape the body and impede an individual’s biomechanical alignment and arthrokinematics, which ultimately decreases Movement Quality and increases the risk of injury at the same time limiting the individual’s potential for optimal performance.
Elevated Shoulders is another common compensation pattern caused by repetitive movements including working on a computer, wearing a backpack or shoulder bag, and even driving.
PreHab Exercises can serve as ‘correctives’ to restore biomechanical integrity to an individual’s Movement Patterns that have been altered by Daily Life Activities in a modern world, i.e. texting, sitting, etc.
Daily Life Activities also include ‘repetitive movements,’ which are simply movements performed numerous times within a certain period of time. Repetitive movements threaten the quality of Human Movement in two distinct ways:
• Repetitive Movements overstress certain physiological structures (soft tissue and joint arthrokinematics) and create both acute and long-term damage.
• Repetitive Movements create a neuromuscular tendency to use certain muscles, even when not appropriate, which alters an individual’s biomechanics and decreases Movement Efficiency.
Many runners experience knee pain or other aliments as a result of the repetitive nature of their sport, an example of how repetitive movements wear down the physiological (soft tissue and joint) structures and can cause pain or injury.
Another common example is swimming, an activity where an individual continuously works the Latissimus Dorsi (Back Muscle) and the Pectoralis Major/Minor (Chest Muscles). Individuals who swim frequently often develop the tendency to Internally Rotate the Shoulders when attempting to use the arms, which can manifest as Rounded Shoulders, a common compensation pattern.
PreHab Exercises can help counterbalance the accumulative effect Repetitive Movements have on an individual’s posture/alignment and Movement Patterns.
In virtually every training program in the world, there is one common principle used to produce results and progress an individual through the program. This is the principle of ‘Overload.’
The Principle of Overload is the practice of exposing or introducing the body to a greater magnitude of stress/stimulus (i.e. more weight, a longer time under tension or at work, a faster speed, more complexity, etc.) than the body has been exposed to on a regular basis. Once the body has been exposed to a greater magnitude stress/stimulus, it can adapt and grow to be able to handle that magnitude of stress/stimulus.
The Principle of Overload echoes the simple philosophical premise: to get/be something one has never had/been, a person needs to do something that he or she has never done.
When an individual is introduced or exposed to ‘Overload,’ the body begins to ‘Overreach,’ which is the act of attempting to extend beyond one’s current capabilities. In short, Overload leads to Overreaching, which then forces the body to adapt and expand its current level of capabilities.
Compensation in Overreaching
In the moments when an individual is overreaching, the body instinctually employs patterns of compensation that compromise biomechanical integrity and alter the individual’s Movement Patterns, sometimes to a small degree and other times to a large degree.
Video: Kendrick Farris Sets Personal Record
In the following Team USA video, Kendrick Farris exhibits how a small degree of compensation can occur while Overreaching. On his lift, Farris experiences a slight wobble as his body attempts to stabilize in the bottom of the lift and a slight wobble as he ascends to the top of the lift. With a lesser load, Farris most likely would have been steady throughout the entire lift. However, this Overload set provides his body with a stress/stimulus that causes his body to continue to adapt and grow stronger.
PreHab Exercises can help the body restore biomechanical integrity during periods of Overreaching while still positively adapting to the Overload stress/stimulus.
Progressions of Overload
A training program is essentially a scheduled progression of Overload and Overreaching in various forms. During training, the body is continuously introduced to larger stresses/stimuli from which the body will recover. This forces the body to adapt to effectively manage this new level of stress/stimulus, whether it is an amount of weight (load), length of duration (time or distance), added movements (complexity), or higher rate of performance (speed).
Within the paradigm of training, Supercompensation represents the period of time in which the body has fully recovered from an applied stress/stimulus and has successfully adapted to meet its level of physical demands, whether in terms of strength, power, speed, or endurance. It is ideal to resume training and apply another new (greater) stress/stimulus at the height of the Supercompensation curve to keep the training adaptions progressing in the predetermined direction of the training program.
PreHab Exercises are tools for an individual to use as part of the preparation phase for the introduction of a greater stress/stimulus as well as for assistance in facilitating fully recovery and restoring biomechanical integrity as the body progresses through Supercompensation.
Watch Out for China: The Rising Dragon in the Future of the Olympics
China understands that training to be an Olympic athlete takes years of progressive training and overreaching, which is why the Chinese Olympic Team starts recruiting and training their athletes at the age of six.
Watch the video: https://youtu.be/8-OGKGmxSbw
What exactly are PreHab Exercises?
The PreHab website is dedicated to the teaching and instructing of PreHab Exercises. This includes four different training objectives as well as a host of Assessments and Movement Evaluations.
A.M.A.S.S. Method of PreHab
Michael Rosengart, CPT, CES, CSCS created the A.M.A.S.S. Method of PreHab as a systematic way to approach PreHab and Training. The method is relatively simple and pragmatic as well as adaptable and flexible.
The A.M.A.S.S. acronym embodies the five key objectives of the method, which are:
A = Assess
M = Mobilize
A = Activate
S = Stabilize
S = Strengthen
More specifically, the A.M.A.S.S. Method will:
A = Assess Alignment and Movement
There is a proverbial saying in the field of training: ‘if you’re not assessing, you’re only guessing.’ This sentiment is exactly why the A.M.A.S.S. Method starts with assessing. Every training program is ultimately measured by its effectiveness; has the training program produced the results that it said it would? The only way to measure this is to also know the starting point.
While the individual’s personal goals determine the end point of a training program, Assessments and Movement Evaluations determine the starting point. Once the starting point and final goal have been established, the middle of a training program can be created. This will consist of a series of sessions that introduce a hierarchy of training stresses/stimuli in a realistic progression.
The assessment and movement evaluations are crucial to strategic planning in regards to training. Numerous kinds of assessments can be used to determine an individual’s beginning ability level: Gait Analysis, Static Posture Analysis, Functional Movement Screens, etc. The PreHab website covers several types of assessments and evaluations. However, one assessment should be made at the start of every single training period, simply, ‘how are you feeling today?’
Assessments and Movement Evaluations reveal what PreHab Exercises are necessary for the individual to meet his/her specific training goals.
M = Mobilize the Soft Tissue and Joint Structures
Once the assessments and movement evaluations have been completed, the next stage of the A.M.A.S.S. Method is Mobility Training. The PreHab Exercise website mainly covers three different types of Mobility Exercises: Soft Tissue Therapy, Joint Distractions, and Effective Stretching Techniques.
Soft Tissue Therapy
Soft Tissue Therapy is the deliberate practice of restoring length and responsiveness to the muscles, tendons, and fascia through a combination of acupressure or Myofascial Release. Soft tissue therapy practices include foam rolling, massage, and Instrument Assisted techniques.
Click Here to read more about Soft Tissue Therapy
Joint Distraction exercises use ‘pulling’ or distraction forces to create more space between joint surfaces. This decreases friction and allows more fluid motions to occur within the joint capsule, which ultimately increases the joint’s Range of Motion while aligning the joint’s arthrokinematics.
Click Here to read more about Joint Distractions
Effective Stretching Techniques
Believe it or not, many people do not stretch in a way that actually improves flexibility or Range of Motion. For many reasons, stretching has either been overlooked or thought of as a waste of time, which may explain why so many people do not know how to stretch effectively.
The PreHab Exercise website illustrates and teaches the following effective stretching techniques: Restorative Stretching (Static Stretching), Active Stretching (including PNF and Active-Isolated Stretching), Eccentric Stretching, and Dynamic Stretching.
Click Here to read more about Effective Stretching Techniques
A = Activate the Essential Neuromuscular Connections
Once an individual has effectively mobilized the body, the next stage of the A.M.A.S.S. Method is Activation. This stage seeks to activate muscles and Motor Units that are habitually inhibited (turned off) yet are required to restore the biomechanical integrity (alignment and function) of the associated joint structures.
For example, an individual who sits for 8-10 hours a day may develop a tendency for the inhibition of Gluteus Maximus and Gluteus Medius (Hip) muscles (a tendency for the muscles to be ‘turned-off’). Therefore, a series of Hip Activation exercises can be inserted in the training program to facilitate (activate) or ‘awaken’ the neuromuscular connections of the Glutes, which ultimately leads to improved Hip Stability and function throughout the rest of the training session or during practice/competition.
PreHab Exercises can be used to activate essential neuromuscular connections that create biomechanical integrity and improve Movement Quality.
S = Stabilize the Joints and Slings
Once Activation Exercises are complete, the next stage of the A.M.A.S.S. Method is Stability. The training objective in this stage is to maximize Whole-Body Control by improving the control, balance, and coordination at specific joints as well as throughout the ‘Slings’ or Stability Subsystems in the body.
Before speaking specifically, it is necessary to clarify the concept of ‘Body Control.’ Within the spectrum of Human Movement, the body can be moved by an external force, an internal force, or momentum.
Internal Force refers to the actions of the body used to orchestrate a host of muscle contracts that propel limbs or body segments in specific directions at a specific speed. For example, the act of raising a hand in class is created solely by the contraction of specific muscles in the shoulder and arm.
An external force might be another person, such as a defendant tackling the ball carrier in a game of American Football. Or an external force may be gravity, as when a person lets go of a pull-up bar or a set of rings and drops to the ground. Conversely, the body may also move due to momentum. A baseball player uses momentum built up from running to slide into third base, or a parkour athlete uses momentum to swing around a pole and leap to another obstacle.
In regard to Stability and Body Control, both External Forces and Momentum are obstacles an individual must overcome to maximize efficiency in movement AND protect the body. However, this does not mean an athlete or individual should not use momentum.
The gymnast effectively demonstrates a great deal of stability and efficiency in Body Control when she sprints down the runway, leaps head over heels over the vault, and ‘sticks the landing’ (lands in one spot without teetering or falling). In this instance, the gymnast literally absorbs and overcomes all the momentum created in the sprint and jump to “stick it” and land in one spot without any teetering or falling.
There are many possible levels of momentum and external forces an individual may need to overcome to establish Body Control and create Stability in movement. The PreHab website explores various exercises that help individuals prepare their bodies to meet the various levels of imposed demands and while improving Stability and Body Control.
The PreHab Exercise website explores several different kinds of Stability Exercises including:
• Integration Exercises that facilitate the efficient transfer of Kinetic Energy from one region of the body to another, such as the Shoulders to the Spine to the Pelvis.
• Neuromuscular Reactive Training (NRT) that develops reactive coordination, balance, and control while also ‘re-educating’ or re-patterning specific muscles or neuromuscular firing sequences.
• Primal Movement Patterns that tap into an individual’s movement DNA to enable ‘lost’ or inhibited neuromuscular firing sequences.
• Isolated Strength and Conditioning exercises that correct movement dysfunctions and muscle imbalances throughout the body.
PreHab Exercises can help to correct dysfunctional Movement Patterns and enhance both Stability and Body Control, which leads to improved Movement Quality and Efficiency.
S = Strength: The Accumulative Ability of the Neuromuscular System
The last and final stage of the A.M.A.S.S. Method is Strength, which, in its most simplistic form, refers to ‘ability.’ This ability can go in a variety of directions. Someone may be strong because he has the ability to lift a lot of weight. Or someone may be ‘strong willed’ because he or she has the ability to get his or her way. Or someone may be ‘mentally strong,’ meaning that she has the ability to guard her mind from negative or disempowering thoughts.
In regards to a training program, this simplistic view of Strength helps an individual plan and develop the ability of the neuromuscular system in specific directions, including the following types of strength:
Sports Specific Skills
This website shows how the A.M.A.S.S. Method prepares an individual to further develop his or her preferred type of Strength.
How to PreHab?
The question of ‘how to PreHab’ or how to do any of the assessments and exercises within the PreHab model are answered in the articles on this website as well as within the pages of the PreHab Exercise Book series.
In the meantime, if you have any specific requests, comments or questions, feel free to contact Michael Rosengart at Michael @ prehabexercises.com.
Thank you for visiting the PreHab Exercise website and keep on getting better!