T Nation

Let's Talk about Prehab Movements

I hear a lot about doing prehab movements as prework before a training session.

Can any elaborate? What are some standard prehab movements? Mobility work? Foam rolling? Does that all fit in the “prehab” category?

I understand the purpose of the prehab stuff is to prevent injury by addressing common weakness, but I’m looking for advice on what to put in. I know it’s an individual thing, but throw out some suggestions of thing you think are good to do regardless of experience/etc.

Thanks in advance.

[quote]boyscout wrote:
I hear a lot about doing prehab movements as prework before a training session.

Can any elaborate? What are some standard prehab movements? Mobility work? Foam rolling? Does that all fit in the “prehab” category?[/quote]
The definition depends on who you ask, but I think you basically summed it up: [quote]the prehab stuff is to prevent injury by addressing common weakness[/quote].

I’d consider foam rolling a related part of mobility work, which is separate from what I consider “prehab”, but at some point it’s just getting muddled by semantics… just do the crap that’s gonna keep you healthy.

When I talk about prehab stuff, like you mentioned, it usually depends on the individual’s goals and needs. But you generally can’t go wrong working on the hips/low back and upper back/shoulder girdle since almost everyone has lower back pain and/or upper back weakness. This is especially common in folks doing seated office work 40 hours a week.

For the hips/low back, I really like reverse lunges with an over-the-shoulder reach (reaching to the side opposite that which is stepping back). 5-8 slow, stretching reps per leg, as part of the general warm-up

For the upper back, I go with either a 1-arm cable cuban press or a face pull with static hold. The latter is a “favorite,” as I really like the static hold for enhancing scapular strength/stabilization. 2-3x10-15, holding the “peak contraction” for a 5-count.

Reverse lunge with reach, though I’d recommend reaching more horizontally, rather than vertically, to really open up the hip flexor. In this pic, you’d reach towards the right (because the left leg stepped back), do all the reps on that side, and then switch sides.

Face pull w/ static hold. Hold the midpoint, like a double biceps shot, squeezing the shoulder blades together for a count of 5, then return to the arms extended position. Having a neutral-grip (palms facing your ears at the midpoint) is also essential.

For the 1-arm cable cuban press (no pic of that):

The foot of the working side is in line with the low pulley, standing a step or so away from the stack (facing the stack), using a single handle. The tempo is pretty slow and deliberate.

Basically it’s a wide upright row (stopping when the elbow is parallel to the ground), smooth transition to a 90 degree external rotation (careful not to let the elbow drop), smooth transition to an overhead press. Then reverse the three-step process to lower the weight.

Look up Eric Cressey’s Articles and/or buy his mobility book/DVD (its sold here on T-Nation)

He’s the sh*t with all that stuff; I just finished a 5 week stint training at his facility.

[quote]Chris Colucci wrote:
boyscout wrote:
I hear a lot about doing prehab movements as prework before a training session.

Can any elaborate? What are some standard prehab movements? Mobility work? Foam rolling? Does that all fit in the “prehab” category?

The definition depends on who you ask, but I think you basically summed it up: the prehab stuff is to prevent injury by addressing common weakness.

I’d consider foam rolling a related part of mobility work, which is separate from what I consider “prehab”, but at some point it’s just getting muddled by semantics… just do the crap that’s gonna keep you healthy.

When I talk about prehab stuff, like you mentioned, it usually depends on the individual’s goals and needs. But you generally can’t go wrong working on the hips/low back and upper back/shoulder girdle since almost everyone has lower back pain and/or upper back weakness. This is especially common in folks doing seated office work 40 hours a week.

For the hips/low back, I really like reverse lunges with an over-the-shoulder reach (reaching to the side opposite that which is stepping back). 5-8 slow, stretching reps per leg, as part of the general warm-up

For the upper back, I go with either a 1-arm cable cuban press or a face pull with static hold. The latter is a “favorite,” as I really like the static hold for enhancing scapular strength/stabilization. 2-3x10-15, holding the “peak contraction” for a 5-count.[/quote]

Thanks Chris!

I guess I was just confused where the line gets drawn. I’ve read most of Cressey’s stuff on here. What falls into prehab vs. mobility. In the end it probably doesn’t matter. Just do the stuff that keeps you healthy, like you said.

My main issue seems to be tight hips. But after a few mobility drills it’s fine. I can get low with a nice spine while squatting, so no real issues.

Should foam rolling always be done as a prework to lifting? I don’t do that. I do use foam rolling on off days to help with recovery. Bad call?

I seem to have trouble keeping my back tight during pressing movements, the facepull drill looks like it will help a lot.

There is no bad time to do foam rolling. I do it pre-workout, and I do it on off days for recovery. It won’t hurt you.

I think chris colluci covered most of the basics, but heres a few thoughts.

There aren’t a set of basic prehab movements that EVERYONE should do. “If it ain’t broke, dont fix it” definately applies here.

The best thing to do, is to get someone to test you for potential problems. A skilled trainer or PT will be able to do this, otherwise you can pick up something like Magnificent mobility, inside-out, or athletic body in balance, and have a friend help you with some of the tests.

The point of prehab is to prevent or reduce the risk of injury. It isn’t only about strength imbalances, but also asysmtries, mobility, stability, etc.

Im not an expert in Prehab, but it interests me a lot, so im trying to learn as well. Like I said you dont have have to prehab a muscle or joint that isn’t at risk, but you need to learn how to tell if its “at risk”.

Also, but understanding what can put you at risk, you can gear your training to to avoid the need for even prehab. So in essence theres smart choices you can make that are really pre-prehab work.

For example, a lot of people do too much bench press. But with a better understanding of the body, you might be doing more pushups and pulling and less benching.

Some might see this as “prehab”, but really its just probper strength training. Which IMO means that theres not really any difference between safe, proper training and prehab.

One last point. Although you may need an expert to tell you what needs attention, becoming more aware with your body, and learning some of the tests can be extremely beneficial.

[quote]dankid wrote:

One last point. Although you may need an expert to tell you what needs attention, becoming more aware with your body, and learning some of the tests can be extremely beneficial.[/quote]

Good point.

Anyone have resources about some of the tests?

I was listening to an old Fitcast interview Alwyn Cosgrove, he mentioned something about testing. I’ll have to go back and listen to it again.

Im not sure about resources. Im looking for more as well.

I recently bought “athletic body in balance” by gray cook, which seems to be very good and pretty basic. It was only $20 as well.

I think that book, a friend, and a digital camera will do you wonders.

[quote]dankid wrote:
Im not sure about resources. Im looking for more as well.

I recently bought “athletic body in balance” by gray cook, which seems to be very good and pretty basic. It was only $20 as well.

I think that book, a friend, and a digital camera will do you wonders.[/quote]

Thanks. I did a quick google search on gray cook. “Athletic Body in Balance” is actually on google books with a preview.

http://books.google.com/books?id=3h76LJ6ZAScC&dq=Gray+Cook&pg=PP1&ots=hMIKOpG9do&sig=8ArKPizal1Roc-DMMcALSiurRi8&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPA41,M1

[quote]dankid wrote:
There aren’t a set of basic prehab movements that EVERYONE should do. “If it ain’t broke, dont fix it” definately applies here.[/quote]
I agree with your first sentence, but not exactly with the second. Plenty of people are slightly “broken” to the point where it may not be blatant, but it’s still negatively effecting their training and/or their lives.

Very true. Self-diagnosis, especially if you’re inexperienced, can be inaccurate and/or misleading.

In a perfect world, my friend. In a perfect world.

[quote]For example, a lot of people do too much bench press. But with a better understanding of the body, you might be doing more pushups and pulling and less benching.

Some might see this as “prehab”, but really its just probper strength training. Which IMO means that theres not really any difference between safe, proper training and prehab.[/quote]
To paraphrase a point that Cosgrove once made (I don’t recall in which article; may have been in his blog): At what point does a lunge stop being a strength exercise and start being a mobility drill? Is a 3-rep clean for strength? What about if it’s the second exercise in an eight exercise complex?

While we can sometimes get caught up in categorizing “what does what”, I do think there are some things that are specifically “prehab.” I agree that, ideally, a smart training program would automatically address most of the issues regardless of how you label them.

Cosgrove’s recent article with Chris Bartl gave a nice look at this, when he talked about the seven factors that get addressed during workouts.

But something like a YTWL raise, which by it’s very nature, can’t be done for any reason other than prehab/rehab because it doesn’t lend itself to progressively heavier weight, so it doesn’t qualify as “strength training” and there’s no cardio or particular flexibility benefit.

(You know, at this point, I kinda think I’m rambling. Sorry 'bout that.)

[quote]ninjaboy wrote:
There is no bad time to do foam rolling…It won’t hurt you.[/quote]
This is worth repeating. QFT, as they say.

[quote]dankid wrote:
I recently bought “athletic body in balance” by gray cook, which seems to be very good and pretty basic. It was only $20 as well.[/quote]

Gray Cook also designed the Functional Movement Screen which I believe Cosgrove and Mike Boyle have relied on.

Paul Chek gets into a similar topic with his Primal Pattern movements.

[quote]Chris Colucci wrote:
ninjaboy wrote:
There is no bad time to do foam rolling…It won’t hurt you.
This is worth repeating. QFT, as they say.

dankid wrote:
I recently bought “athletic body in balance” by gray cook, which seems to be very good and pretty basic. It was only $20 as well.

Gray Cook also designed the Functional Movement Screen which I believe Cosgrove and Mike Boyle have relied on.

Paul Chek gets into a similar topic with his Primal Pattern movements.[/quote]

I have Gray Cooks book too and it’s certainly interesting to go through the Functional Movement Screen and see which areas you have problems with. Even if these areas don’t cause you issues in training now, they may do in the future if you keep going.

For example if you have an area which is already tight and you ignore it and keep making it tighter, then eventually something will give. I am working hard now to try and correct stuff which I neglected when I was younger, it would have been much easier if I hadn’t let things get so bad in the first place!

In a perfect world we’d all do perfectly balanced training progs from day one and also would sit and stand etc with perfect posture, but we don’t! Most people have some areas which are too tight or not mobile enough or whatever (whether that is due to their training or their daily lives).

I think by doing something like the Functional Movement Screen or working through the exercises in Magnificent Mobility, you will be able to discover which specific areas you have issues with.

If you find that there are certain movements that you should be able to do, but can’t or you have trouble with doing a correct ROM for say a squat or deadlift, then prehab work for you should address those areas.

If, like me, you are much more dominant at pushing than pulling, then prehab should include some stuff to help your scapulae like face pulls etc.

So yeah prehab is very individual and if you can get a professional assessment then that’s great, but I think alot of lifters share alot of common problems: hips, shoulders etc so most could benefit from similar prehab work.

It’s a continual learning curve, for me anyway, and the more you learn from resources like this the more sense it will all make.

[quote]Lift and Eat wrote:
If, like me, you are much more dominant at pushing than pulling, then prehab should include some stuff to help your scapulae like face pulls etc.

.[/quote]

Ya, but also you should get to the root of the problem. You need to work on your pulling. If imbalances can lead to problems, sure increasing stability and/or mobility might make it better, but you also need to correct the imbalance.

Thats what I was kinda getting at with the pre-prehab work. Like chris said, in a perfect world, a well developed routine that balances out the different movement pattern through full ROM may be enough to keep your body healthy.

But in a non perfect world, you’ll probably need to combine some form of “pre-hab” with that well balanced routine.

As for the OP question about “prehab movements”, if you look at the gray cook book, or the functional movement screen, you can get a good idea of what prehab movements might be necessary.

As far as movements go, i dont think it will hurt any to do something that isn’t necessary, although if your trying to correct a strength imbalance that isn’t there, then you may over correct. Thats why I said if it aint broke dont fix it.

And the same would go for foam rolling and flexibility/mobility training. If your hamstrings are already long, but your hip flexors are tight and you stretch your hamstrings out, its only going to make problems worse.

Hope this helps.

[quote]Chris Colucci wrote:
dankid wrote:
The best thing to do, is to get someone to test you for potential problems.

Very true. Self-diagnosis, especially if you’re inexperienced, can be inaccurate and/or misleading.
[/quote]

Well, any T-Nation readers that are trainers in Nashville?

I did the reverse lunge and facepull things you suggested today Chris. Felt very good.

I agree with the pushups/pulling and less benching. When I programmed my august training I went to full body sessions and only benching heavy once a week, and put in a lot of pulling and upper back work.

The other days I stuck to DB press and push ups. It’s definitely paid off so far. I like this experimenting stuff. Maybe in a year or two I’ll figure out what really works well for me. So far so good, though.

Check out Cressey’s the Prehab Deload:

…Doesn’t have a lot of specific movements but a lot of general strategies to follow for a bit if your shoulder or knees start getting beat up from your usual routine.