â–¶What is prehab and how is it different from rehabilitation?
Prehab is preventive: identifying risk factors before injury and designing exercises to address them (e.g., weak glutes → single-leg hip-thrust progressions to reduce ACL risk). Rehab is reactive: treating a diagnosed injury (e.g., post-ACL surgery → 6-9 months of ROM, strength, agility, and sport-specific drills to return to sport). Prehab is the coach's domain (strength coach, performance coach, athletic trainer); rehab is the PT/ATC domain, with coaching support. The best practice layers prehab onto every training program: every athlete gets glute activation, ankle mobility, and scapular stability work regardless of injury history.
â–¶How do I identify injury risk via movement assessment?
Use FMS (Functional Movement Screen) or custom movement patterns: watch a deep squat (knees caving = weak hip abductors, ACL risk), a single-leg hop (asymmetry >10% = weak leg, injury risk), and a trunk-stability test (poor core control = lower-back risk). Pair with force-plate testing (vertical jump asymmetry >5% flags weakness). Combine data: if squat shows right-knee valgus AND force plate shows right-leg 12% weaker, that athlete is high-risk. Design prehab: single-leg RDL, clamshells, glute-bridge progressions for 4-6 weeks, then retest. Progress to sport-specific moves once strength is balanced.
â–¶What is an ACL injury return-to-sport protocol and what are the gates?
Typical timeline: weeks 1-6 ROM and quad activation (quad sets, straight-leg raises), weeks 7-12 bilateral strength (leg press, squat), weeks 13-20 single-leg strength and control (single-leg squat, step-down), weeks 21+ plyometrics and sport-specific cuts (lateral bounds, direction changes). Clearance gates at each phase: Phase 1 gate = full ROM, no effusion (swelling); Phase 2 gate = bilateral strength >90% symmetry; Phase 3 gate = single-leg strength asymmetry <10%, hop-test asymmetry <10%, Y-balance asymmetry <4 cm; Phase 4 gate = plyometric power asymmetry <10%, sport-specific agility test at 100%, and psychological readiness (confidence + motivation). Do not rush; a second ACL tear is common in athletes cleared early.
â–¶How do I manage training load to prevent overtraining and injury?
Track weekly load via RPE × session duration (arbitrary units) or wearable accelerometers (Catapult, Humon). A safe progression: increase load ≤10% per week. If a player ran 800 'load units' last week, cap this week at 880. If load jumps 30% (e.g., from 800 to 1,040), injury risk spikes. Monitor trends: if load is high AND resting HR is elevated AND HRV is low AND mood is poor, reduce volume immediately—this is overtraining syndrome. Include deload weeks (60-70% intensity, lower volume) every 4-6 weeks to allow adaptation.
â–¶What is proprioceptive training and why does it reduce injury risk?
Proprioception is body awareness—knowing where your joints are in space without looking. It is mediated by joint receptors that send signals to the brain. Proprioceptive training (balance drills, unstable-surface exercises, reactive drills) re-educates these pathways post-injury or pre-injury. Examples: single-leg balance on a BOSU ball, reactive single-leg catches, or sport-specific cuts with eyes closed (to heighten proprioceptive reliance). Studies show proprioceptive training reduces ankle sprain recurrence by 30-40%. It's high-value prehab because it requires minimal equipment and builds neuromuscular control, not just strength.
â–¶How do I know if an athlete is ready to return to sport after injury?
Use multi-criteria clearance gates: 1) physical (strength symmetry >90%, ROM full, no pain during sport-specific testing), 2) performance (sprint speed, agility, plyometric power within 5-10% of pre-injury baseline), 3) psychological (athlete confidence >8/10, no fear of reinjury, motivation high), 4) medical (physician clearance, imaging normal if applicable), 5) graduated exposure (practice before game, light play before full contact). Never clear based on one metric; if strength is 95% but confidence is 4/10, the athlete is not ready. Use a formal clearance form and communicate with coaching staff, medical team, and athlete's family.
â–¶What is the difference between pain and injury, and how do I coach through mild pain?
Injury is structural damage (torn ligament, fractured bone, muscle tear); pain is the sensation that may accompany injury but can exist without structural damage (e.g., delayed-onset muscle soreness, DOMS, is normal pain without injury). Modern pain science teaches that pain is multifactorial—tissue damage + fear + stress + sleep + mood all modulate pain signals. Mild pain during training (e.g., 3/10 soreness the day after hard squats) is often normal and coachable. Severe pain (8-10/10) or pain that worsens mid-session = stop. Use a pain scale: 0-3/10 is coachable and often resolves with warm-up; 4-6/10 is caution (modify or reduce); 7-10/10 is stop and refer to medical staff. Progress gradually; if pain drops from 6/10 to 3/10 over 2 weeks, continue the protocol.