Injury rehab: taking a smooth approach

Getting the best out of your training to produce maximum fitness and performance gains is a complex process. As regular readers will already know, research has identified endless permutations of training approaches that can be utilized to deliver ultimate performance and blending these together in a carefully designed program, supported by optimum nutrition is absolutely essential for success. When injury strikes however, even the most meticulously planned program amounts to nothing. As that heard-earned fitness slips away, the overriding requirement is to speed injury healing and then rehab the athlete back to fitness as fast as possible! With that in mind, one of the most important goals of athletes (and their coaches and trainers) should be firstly, to try and prevent the occurrence of injury, and secondly, to understand how to rehabilitate any injury that does occur as rapidly as fully as possible.

Speed, resistance and distance

When it comes to injury rehab, the use of strength and conditioning is an absolutely crucial tool in the box. Using strength and conditioning exercises can not only help build muscle and tendon strength and resilience, it can also help eliminate any biomechanical imbalances that may have contributed to the injury in the first place. Muscular overload is necessary for any strength and conditioning protocol (all of which require the application of external resistance), and there are many ways to achieve this. In broad-brush terms, the applied resistance can be categorized as follows:

·        Isotonic – muscles work against constant weight/loading (eg lifting free weights or using machine weights).

·        Isometric – muscles work at a constant (fixed) position regardless of load (eg core strengthening exercises such as holding a static plank position).

·        Isokinetic – muscles work at a constant velocity regardless of load. No matter how hard you exert force, the speed of movement of the muscle being used remains the same.

In most strength and conditioning settings, isotonic loading is employed thanks to the ubiquitous use of free and machine weights, which are conveniently adjusted and relatively inexpensive. However, in theory at least, isokinetic (sometimes called ‘isovelocity’) training devices offer some distinct advantages. In particular, isokinetic training allows maximum tension and loading to be applied to a muscle at all points through its range of motion; this is in contrast to conventional resistance (isotonic training), where the loading has to be chosen for a particular range of motion, meaning that at other points in the movement, the loading is less than optimal. An example of this is biceps curls, where, due to the physics of levers and muscle architecture, the muscles can exert high levels of force in the 60-120 degree range, but far less above and below this movement range (see figure 1).

Figure 1: Elbow angle and muscle force during biceps curls*