April 12, 2021
Dr. Tyler Ideus

One of our guiding principles here at LPSM is that people have the ability to care for themselves through education and, at times, with short-term, hands-on conservative care.

With this in mind, I’ve felt quite compelled recently to share how I define “rehab,” or “performance rehabilitation.” I’ve noticed these terms becoming more trendy marketing terms rather than technical terms, and I think it needs to be addressed.

So, what is “rehab?” And, as an educated consumer of health care, how do you know you are getting quality, comprehensive rehab that will truly help you reach your goals?

True “rehab” is much more than an exercise anyone can look up on YouTube or read from a sheet and do on their own. 

In true rehab, individualization is key. 

The exercises themselves, the grouping of exercises, the level of the exercises and how they are performed all need to be unique to each person’s issues, tissue characteristics, body type and body awareness. 

To expand a bit specifically when it comes to characteristics of soft tissues, someone may have very strong, robust connective tissue that allows them to get away with more stress on their muscles – perhaps they can compensate in the weight room or throw more pitches. However, if you’re someone with less robust tissue healing characteristics, you have to be far more diligent about not only your rehab, but also your technique, programming and recovery.

All of this absolutely needs to be considered in designing a true rehab program. Guidance about how to increase, or “level-up,” the difficulty of the exercises should also be considered throughout the rehabilitation process.

Your rehabilitation program should also be challenging, rewarding and demonstrate at least some improvement over the course of a few days to weeks.

As Alaetra, an LPSM patient, recently shared regarding her rehab with me: “They weren’t just the stationary [exercises] like every person usually gives you.”

To accomplish all of this, we must start with a very thorough evaluation. 

As an example, when it comes to rehab for low back pain, the following should be considered in the evaluation:

  • Joint/skeletal structure
  • How the brain decides to coordinate muscle activity
  • Daily demands such as work postures or sports techniques

Given the outcomes of each of these, prescribed exercises may address the following, each at different levels, frequency and reps:

  • Body awareness (feel what is right versus what wrong is)
  • Tissue tolerances
  • Workload capacity
  • Connective tissue structure
  • Balancing asymmetries

Beyond the evaluation and the exercise program, to know if you are receiving quality rehab, you can consider how you are being educated within your experience. If you and your therapist cannot clearly explain if your exercise is therapeutic-based, stability-based or performance-based and what it does from a brain, muscle, connective tissue and joint standpoint, it is NOT specific and would not fit the term “rehab.” Instead, it will be considered generic exercises.

Another indication of quality is the credentials of the provider. Given the current rate of scientific research output, technologies being created and innovative options being pushed forward each year, continuing education is a must.

How I’ve laid all of this out should demonstrate the other guiding principles here at LPSM:

  • “Health care” is helping people truly understand their issue at the root cause, how they got there and educating them about how to correct it.
  • The systems of the body can never be separated — one system affects all systems.

Learn more about my overall philosophy at http://sportsmedlincoln.com/drtylerideus/.