Prehabilitation: How to Prevent Injury
Lamentably we all get older; and tendons dehydrate, skin sags, discs bulge, joints wear down, cognition lags, bones weaken, many of us gain weight and injuries heal incompletely. This is part of the natural aging process. However, all is not lost. Daily exercise is the closest thing we have to a fountain of youth. If it were a pill, it would be the single most widely sold and beneficial medication in the world. A daily movement practice promotes health, prevents injury and slows the aging process.
Physical fitness is an essential dimension of health and a well-balanced movement practice is the nutrient of life. From an evolutionary perspective, all human physiological activity is in service of producing critical movements for survival and procreation. Movement is connected to every system of the body and when challenged, they adapt to get better. If a bodily system is not utilized often or regularly challenged, it may fall into disrepair or an injury state. On some level, we are like sharks; if we stop moving, our health suffers and life becomes more difficult.
The human body has over 360 joints that move in multiple directions and 640 muscles attaching and crossing those joints at differing angles. Getting all the moving parts to cooperate and work in a combination that produces efficient, stable movements is a feat of engineering unlike anything else. Within these complex daily movement patterns exist micro and macro variability. Body positioning, movement speed, force utilized, ranges of motion, stances and surfaces all affect variability. Mechanistic joint wearing may become an issue when variability is chronically stagnant, like that of a baseball pitcher's shoulder. It is like a high-traffic carpet area that gets noticeably worn in one path after many years of use. Practicing the same exercises under load, without much variation, may cause breakdowns in the musculoskeletal system that affect injury. Our goal should be to expand our repertoire of movements, not reduce them.
NOTE: Being sedentary is arguably one of the worst things one can do for the human body. Physical inactivity is a leading cause of disease and disability in the world. Sedentary lifestyles increase all causes of mortality, doubles the risk of cardiovascular diseases, diabetes, and obesity, and increase the risks of colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety.
So how much and what type of movement do we need to prevent injury and maintain health? It depends on a myriad of factors like age, prior activity level, injuries, disease rate, compensation, etc. Optimal fitness for health and prehabilitation is different for everyone; however, I will attempt to provide some general guidelines:
Move your body and joints through a controlled full range of motion daily
Strengthen your muscles - you can't go wrong getting strong
Get your heart rate up at least once a day for at least 20 minutes
Participate in a variety of activities throughout the month
Vary your movement patterns/exercises/stretches weekly
Play. Find something physical you enjoy and do it often
Get enough sleep every night 7-9 hrs
Do not play through pain and listen to your body
Warm-up properly before engaging in strenuous tasks
Learn proper individualized form for your body
Don't let your ego drive you in the gym - be smart
Weigh the costs and benefits of each exercise/load
Challenge your balance systems daily
NOTE: There is no such thing as "perfect form" for an exercise. There are certain biomechanical principles that should be adhered to for safe and effective performance. But within these guidelines, individual factors will determine the best form for a given person.
If you owned a $1 million racehorse would you keep it up all hours of the night and feed it junk food and wine? You only have one body to live in the rest of your life and arguably it is worth as much or a lot more than the hypothetical racehorse. You need to be your own advocate and step up. As we get older we need to be smarter about exercise and how we use and rest our bodies. Take care of your brain and body and you'll be rewarded with a longer and happier life.