In this post we discuss whether you need rehab or training and what the difference is.
Let’s start with a quiz. Here are three scenarios for you. Which do you think require rehab and which require training?
Have you got pain or discomfort in an area of your body as you read this?
Is your lower back aching for example, or are the tops of your shoulders sore?
Most of us have an area of our body that gives us some level of discomfort now and again.
If you go to the gym later today and exercise in the hope of feeling better, is this rehab or training?
How about this situation. You’re training for a particular event when you fall over and break a bone in your foot.
The bone needs to be rested so it can heal but you are cleared to train as long as you don’t put load through your foot.
Essentially you are training around an injury. Is that rehab though or training?
Lastly try this one.
5 years ago you hurt your back and it hasn’t been right since.
You’ve had a detailed investigation including an MRI but it didn’t show anything of great significance. Your doctor said your spine just shows normal wear and tear for a person your age.
A physio gave you exercises to use and said getting stronger might help. That was some time ago though.
Are you still doing rehab even though there doesn’t seem to be an injury? Or is this now training?
What do you think?
It’s quite difficult to decide isn’t it?
Scenarios 2 and 3 are based on real life examples. I didn’t ask either person whether they required rehab or training, we simply started to apply exercise in a manner that respected their circumstances.
In the second scenario we focussed on maintaining the client’s strength whilst we waited for her fractured bone to heal.
Once her consultant had confirmed the bone was strong enough to load, we began addressing her foot and ankle directly.
In the third scenario it was helpful to know there were no underlying structural issues contributing to this client’s pain.
Nevertheless their pain had implications for how we approached exercise. Most importantly to ensure we didn’t make their immediate situation worse.
So what is rehabilitation?
The noun rehabilitation comes from the Latin prefix re-, meaning “again” and habitare, meaning “make fit”. The word therefore suggests there’s an element of restoration to a former state.
The WHO describe rehabilitation as;
“a set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interaction with their environment”.
That’s a relatively broad definition that would cover everybody from children with life changing conditions, to older adults suffering with the normal loss of muscle that comes with ageing.
It’s worth noting this definition could also be used for training.
Appropriate training can be used to restore and indeed optimise function in individuals with both health conditions and disability.
So what’s the damn difference already?!
As you can see it’s a muddy picture.
Perhaps the biggest difference is related more to the person seeking assistance than the approach.
I would suggest the more serious and acute the condition, the more important it is to seek specialist help related to that condition.
Let’s look at this question through an example to help illustrate my point.
You’re playing football in the park and you jump for the ball and land awkwardly.
Your knee immediately swells up and you’re unable to weight bear through it.
Does this require a training solution or a rehab one?
It’s obvious there may be damage to the structure of your knee because of the amount of swelling and pain you’re experiencing.
You need to go to the hospital and get yourself checked over by a medical professional.
Post medical intervention.
Unfortunately you discover you’ve ruptured your anterior cruciate ligament and you need surgery to repair it.
Following the surgery it’s necessary to carefully strengthen the muscles around your knee, without disrupting the healing process.
Is this a rehab process or a training one?
You need a practitioner that understands how much loading is beneficial to your knee at each stage of your recovery. This is clearly a rehab process.
A few months pass and whilst you’re largely back to your activities something doesn’t seem right. Your knee still feels unstable in certain positions and you’re also experiencing pain in your other knee for some reason.
Do you need more rehab or training?
The healing process is largely complete so the issues you’re experiencing likely relate to the function of your muscular system. The solution therefore is a training process.
What can happen is people get stuck applying passive rehabilitation techniques such as stretching and massage to a situation that is better suited to careful and considered resistance training.
I’ve heard the phrase rehab is merely training done right. There’s a lot of truth in this.
For issues where there’e no obvious tissue injury, training is often the most effective solution.