Building In Prehab When Planning Workouts – With Dr. Dave Tilley

Hi All,

Today we’ve got another great piece by Dr. Dave Tilley. Since this is #3 I won’t give much preamble. But as always he has great things to say.

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If you had your way of planning workouts how much time would you ideally devote to rephab/prehab work?

After a lot of trial and error, my boss and myself have found success with implementing pre-hab work in 3 ways. This includes

1) A Pre-Warm Up and During Warm Up: Like I noted above, I have our girls come in 10 minutes and run through a one page sheet related to mobility/activation/movement prep from above. I think it’s really important to do before a warm up. This is called a “RAMP program”, which I have learned about from some great rehab specialists through continuing education. I have just tweaked it and tried to get a generic one for my gymnasts.  Along with this, I have remolded our warm up program to be try and encompass dynamic mobility. After reading and researching a lot, I personally believe in active mobility work rather than static stretching or some of the things I did growing up. I think most gyms do a great job of this already. At the end of the warm up every day before events, I have our girls go through a series of core stability/control drills, and jumping/landing drills because I think there really important.

2) Integrated Into Event Work As Side Stations: Along with the warm up I like building in more specific drills to events, which directly relate to the focus of the event. For example, I work Turkish Get Ups into most of our pirouetting/blind/long hang workouts to teach the gymnast overhead control. I also work in single leg stability, or knee prevention drills during leap and dance days because proper single leg control is really important to prevent issues like ACL tears, overuse knee injuries, and so on. Another example is putting in core stability and rotary control drills we do twisting on floor.  Along with all the great twisting drills we have as coaches, I think some of these more find tuned position drills can help tune into overall shape awareness, twisting control, and reflexive core activation. These are just a few examples, but having them built into circuits has worked really well for us, and helps us be time efficient.

3) 15 Minute Chunks During The Week: I do think that there is huge value in taking the time to teach the gymnast why they need pre-hab, and why they need to take care of themselves. Empowering the gymnast to be educated about the “why” for the rationale behind things based off of good science really makes them buy in and want to actively take part in pre-hab. If you have the skill set, taking 15 minutes to explain proper jumping/landing form, core stability drills, soft tissue work, and so on makes things easier down the road. You can start to develop a base of pre-hab that the gymnasts are educated on during workouts, and also your giving them tools for how to take care of themselves throughout their gymnastics career. I have patients of mine take their home program with them and work it in 3x/week before practice as a maintenance program to encourage lasting results and lowered re-injury risk. The girls I coach have actually grown to like pre-hab, and a ton of them come in early because they understand the benefit. I really encourage gyms to team up with local healthcare to be involved in this process; it can be huge for your gym.

I think between these three different areas, you can build in a lot of really productive time that has carry over for developing gymnastics but also helping to address common injury risks with gymnasts.