T Nation

Help Me Create a Comprehensive Prehab Program


#1

Right now I'm just basically throwing some info together but really don't know much about proper layout for a prehab program. For all I know, this protocol could make me even more horrifically imbalanced and injury prone than I am now. So if anyone could chime in with what's worked well for them, what they've heard from PTs, or anything they think might be helpful, that would be great.

Something basic that one can easily incorporate into their warm-up and workout is all I'm really after here.

These are the major things I can think of:

After breaking a light sweat, choose from the following:

Shoulders:

Mobility-------wall slides, shoulder dislocates, thoracic extensions on foam roller or tennis balls

Scapular stability---------YTWs, scap pushups, medicine ball pushups (go all the way up on each rep), scapular retraction row

Rotator cuff strengthening--------int/ext rotations, anterior capsule stretches

Others I'm not sure where they fall--------facepulls, lateral raises with a shrug, band pull aparts,

Choose at least one from each category.

Lower body:

Hip flexors and adductors--------lunge with twist, lateral squats, leg swings, Scorpions
Lateral leg lifts (lying down move leg up 90 degrees and drop to opposite side, controlled, lift back to starting position following initial path)

Glute activation drills--------glute bridge, cork hip lift, fire hydrants, clamshells, and mini-band walks (band around ankles, walk laterally on heels)

Ankle mobility--------Whatever this one is called: http://www.youtube.com/...h?v=RPa9-fpqnUE , Band ankle inversion (foot turned in) and eversion (foot turned out)

Choose two from each category.

Couple of things to focus on more in workouts:

1) A lot of coaches say that more pulling is the best shoulder injury prevention. The inverted row and sled pull seem to be very popular forms of horizontal pulling for combat athletes. Mike Boyle says you should be able to do a chin-up with as much weight (including your bodyweight) as you bench, so I'll be adding more weighted pullups to my workouts (I have no idea what I bench though).

2) Incorporating lots of single-leg work into leg workouts is also good injury prevention. I've seen a lot of MMA fighters incorporating one legged RDLs and pistol squats in particular. Various lunges, step ups, Bulgarian squats are also good.

3) Core stability. Lots of standing wheel rollouts, planks, various pushups (elevated, arms extended, medicine ball, one-arm, etc).

Follow up the workout with some static stretches for the major muscles.

So these are some things I'm going to be adding to my warm-ups and workouts to help minimize my risk of injury and keep my unhappy shoulder from flaring up. Please chime in if you think you can help me. Thanks.


#2

I would eliminate the shoulder dislocates and the scorpions. Bill Hartman says the dislocates can be damaging and Mike Boyle says scorpions can do a number on the back.


#3

Cressey and Robertson wrote a program, a while back, aimed at correcting/preventing imbalances and reduce injure likelihood. Search for "Neanderthal No More" (part IV is more on the prehab side, part V is a more overall weight training program).


#4

This is what I do:

Upper body days - takes about 10 min
T-spine foam rolling 10 reps
Arm circles 10 reps each way
Dislocates w/purple band 10 reps
YTWL 5 lb DBs for 12 reps

Lower body days - takes about 15 min
Glute, T-spine, IT band, adductor foam rolling 10 reps
Fire Hydrant Circles 10 reps each way
Prone Scorpion 10 reps
Rollover into V-sit 10 reps
Mountain Climber stretch 20 sec/side
Hip flexor stretch 20 sec/side


#5

This looks pretty good. Another think to think about, is the 23/1 principle. Theres an article on here about it somewhere. But basically you are in the gym only for an hour, but have 23 hours a day where you might be sitting, standing, lying in bed, etc. So one key thing with a prehab program might be to determine whether your biggest risks come from the 23 hours outside of the gym, or the 1 hour inside the gym.

In the gym, there is only so much you can do.

-Proper form
-proper loading
-proper exercise selection
etc.

I myself in the past have had some shoulder issues (I was a pitcher), but have pretty much illiminated it all together. Some of the things I did were: On bench, keep the elbows tucked, go with DB bench or floor press over flat barbell bench. Be less agressive with loading on pushes than I am on pulls, or just do less total volume on pushes. On pullups, I have found that shoulder width grip gives me the least issues. etc.

As for the 23 hours outside of the gym. Try to identify the problems and neutralize them, and your warm-ups and stretching/mobility will help with this as well.

Other sources:

"The prehab Deload"
Cressey
Hartman
Robertson