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Advice on Aftercare & 'Prehab'

Updated: Jan 15, 2021

How are your New Year’s resolutions going? 🎉🎊 Have you fallen off the wagon yet? 😜 Normally health and fitness related goals for the New Year are very short lived, and unfortunately, it’s often the same story with the aftercare I prescribe to my patients – they start off with all the best intentions, but it never ceases to amaze me just how quickly some people can give up (often after just a few days), despite their desperation to want to recover from an injury and return to activity as soon as possible 😒 Therefore, here’s some tips of how you can improve your adherence to this.

But first, a quick psychology lesson, below is a picture of the ‘Stages of Change Model’, which is often applied to exercise to explain the stages individuals go through when increasing their exercise adherence (originally designed around quitting smoking). To summarise these stages:

1️⃣ PRE-CONTEMPLATION – The individual is not intending to change their lifestyle

2️⃣ CONTEMPLATION – The person is thinking about changing their habits

3️⃣ PREPARATION – The individual is putting plans in place to change, and might be already making small adjustments, but not to the extent they are needed

4️⃣ ACTION – The individual has succeeded in making the intended change to their lifestyle (this is the stage in which people most likely relapse!)

5️⃣ MAINTENANCE – The new habits are maintained for at least 6 months and are more likely to stick

6️⃣ TERMINATION – Often missed out, this stage represents the individual who is so firmly established in their habits that they are extremely unlikely to ever relapse – for example, this is common in those who have always exercised since childhood and therefore developed a life-long habit

7️⃣ RELAPSE – Can occur at any stage

The Stages of Change Model describes the process of lifestyle alteration
"the ‘Stages of Change Model’... is often applied to exercise to explain the stages individuals go through when increasing their exercise adherence"

Firstly, have a think about what stage you are in, and then where you need to be 🤔 If you are not where you need to be, here is some advice of how to get there and more importantly, stay there!

✔️ HAVE A PLAN! – One of the key reasons people discontinue their new habits is because they have high expectations but no clear plan of how to achieve them. I can help you with this to a certain extent, for instance, I can tell you what to do, and I now offer my patients videos reminding them of how to perform the exercises I have shown them. However, remember that I have a lot of clients, and each of them have different routines and schedules, so it is up to you to formulate the best method for you of how to integrate them into your routine – don’t just ‘wing it’, or you’ll never find the time! 📆

✔️ DON’T DO TOO MUCH TOO SOON! – Research has shown that the quicker a person progresses through the stages above, the more likely they are to relapse. We see this all the time – for instance, those who go from doing nothing at all to going to the gym every weeknight. Perhaps they also go on an extreme diet. This is obviously not sustainable, so instead of doing 30 minutes of aftercare per day and giving up after 2 weeks, why not apply the ‘little and often’ approach, whereby you just do 5-10 minutes? After all, although a greater benefit will be achieved from doing more, this way is still much better than nothing, and over the course of the year will result in a much greater amount of overall engagement. Although I would much prefer the little and often route, another way of doing it (particularly if you know you always give up very easily), is instead of aiming for little and often every day, do 5-10 minutes twice per week. Again, it’s much better to do twice a week and sustain it, than quit after 2 weeks of overdoing it!

✔️ ESTABLISH A SUPPORT NETWORK – Injured or not, we could all benefit from doing more strength and technical work to improve performance and prevent injuries occurring in the first place! Therefore, why not challenge some of your friends and family to do it with you? After all, many find it more motivating to exercise with others 👨‍👨‍👧‍👦

✔️ SET YOURSELF REMINDERS! – If you know you easily forget to do things, setting a reminder e.g. on your phone, will help to establish a regular pattern and make you more easily stick to it. Another method could be to put post-it notes on your TV, computer, fridge etc. 📆⏰📺📱💻

✔️ BE SELF-MOTIVATED – A good quality for a fitness/medical professional to have is to be an effective motivator. However, whilst this is beneficial, it is ultimately up to the client to make the change themselves. Being self-motivated is essential to being a successful athlete, which is something my athletics coach says all the time. This also applies to life in general. Again, I have a lot of clients, and I can’t be with each and every one of them every day to remind them to do their aftercare. I am simply the facilitator – I do my best to motivate people, and I give people treatment and the knowledge they need to improve, but I can’t strengthen your muscles for you. Therefore, it is your responsibility to take control and carry it out – the phrase ‘taking a horse to water’ springs to mind.

✔️ DON’T FEEL BAD IF YOU LOSE IT – Following on from the previous point, don’t feel despondent if you do lose motivation, AS THIS WILL HAPPEN 🙁 We all lose motivation from time to time, so don’t feel guilty about it. More importantly though, it’s those who know how to recognise this droop, pick themselves back up, and get back on track who are more likely to succeed. When it gets tough, remember why you started – to better yourself, improve your performance and reduce injury. Regarding the latter – think how bad you felt when you were injured last time – do you really want to go back there just because you didn’t do enough aftercare?

✔️ MORE IS REQUIRED TO BEGIN WITH – When I first see a patient, they are usually very weak in certain areas, but with good aftercare adherence this soon changes. Take comfort in this, as once enough strength is achieved to solve your issue, your weakness is no longer a weakness, so you’ll find it’s no longer rehab. You’ll then just need to do a bit of ‘prehab’ for maintenance every now and then (albeit still on a regular basis) as routine strength and conditioning, and flexibility and technical work etc.

✔️ USE LOCKDOWN! – Many of us are lacking motivation due to sports clubs being suspended, but let’s not think of what we can’t do, let’s think of what we can! Lockdown has presented a great opportunity to use our extra time to focus on things we don’t do enough of, and this includes aftercare, most of which you can do in your front room. Lots of us have spent hours roaming the internet attempting to find online workouts we can do at home, so why not take the same attitude with your aftercare? 🤷‍♂️ Online workouts tend to be very generic, but all of my clients have exercises which will provide the extra benefit of being tailored to their own weaknesses!

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