Inquisitive.me

We don’t only rehab. We also prehab.

“What the hell is prehab?” you might ask.

Fair question.

Prehabilitation usually means preparing for a planned surgery. You’ll also hear “prehab” used for training that aims to reduce the risk of injury or reinjury.

The common idea? Prepare your body for what you’re going to ask of it.

In Austria, preventive physiotherapy is available without a doctor’s referral as a private service. Preparing for surgery after an injury can fall under treatment, so the same rules don’t automatically apply. But paying out of pocket for prevention? So much for encouraging people to stay healthy. Anyway, I’m leaving that particular Pandora’s box closed today.

Most people who come to me for prehab already have surgery scheduled.

We use that time to work on strength, movement and muscle control. Depending on how much time we have, that might mean building some strength or preserving what’s already there. Going into surgery with more capacity can give you a better starting point for recovery.

And then there’s the preparation people don’t necessarily think about.

I once worked with a patient who was scheduled for ACL surgery. We’d tried conservative rehabilitation after her injury, but her knee remained too unstable for what she needed to do. Surgery became the next step.

Before the operation, we practised walking with crutches and using them on stairs. We talked through what the first few days might look like, which exercises she could begin within her postoperative instructions, and what her first goals would be.

Stairs are enough of a nuisance on crutches. Learning how to use them while you’re sore and exhausted doesn’t make them more entertaining.

When she returned to my practice after surgery, she could already fully straighten her knee. She knew what to work on and had been able to start.

That doesn’t mean prehab guarantees a smooth recovery. But she wasn’t spending those first days wondering, “Am I allowed to move this? What should I actually be doing?”

Knowing what comes next is part of the preparation.

The same thinking can be useful in sport.

People often ask hw to avoid injuries. Warming up is a good start. But what about the demands of the sport itself?

Have you gradually built up to the distance you want to run?

Have you practised the repeated changes of direction your knee will face on the football pitch?

Has your shoulder had a chance to build up to a full tennis match’s worth of serves?

You can’t answer all of that with a few arm circles and a light jog.

This kind of preparation can include strength, balance, coordination, jumping, landing and practising movements your sport demands. Sometimes that means working on the rotator cuff or hip muscles. Sometimes it means building strength more broadly or gradually introducing faster, more demanding movements.

It also means looking at how you train.

Too much, too often, too quickly, with too little recovery: that’s a pattern worth paying attention to. Injuries have multiple contributing factors, but how you build and recover from training is something you can influence.

And one common pattern looks like this:

Something starts hurting. You stop training completely for a few weeks. It feels better, so you pick up exactly where you left off.

Unfortunately, feeling better doesn’t necessarily mean you’re ready for the same workload again.

That’s where guidance can help. What can you keep doing? What needs adjusting? How do you build back up? When does something need a closer look?

You don’t need little injuries to improve. You need a training challenge you can recover from—and a way to respond when things aren’t going to plan.

I think of progression like climbing a mountain. The climb can still be demanding, but manageable steps are easier to work with than repeatedly trying to scramble up a ledge you can barely reach.

Preparation gives you a chance to build those steps before you need them.

That’s why I enjoy this part of my work so much. We can prepare for the practical challenges of surgery, build towards the demands of a sport, and help people understand how to adjust along the way.

You can’t control every part of recovery or prevent every injury.

But there’s a lot you can prepare for—and you don’t have to wait until something goes wrong to start.

🧪 Let’s Experiment

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You play the sport. But do you train for what it asks of you?

Knowing the rules and owning suspiciously expensive shoes are a start. Let’s look at the preparation.

🎯 Try This:

During your sport this week, notice three things it asks your body to do: quick stops, repeated jumps, a long climb, or serve after serve.

Pick one you’d like to feel better prepared for.

Then bring that to a physiotherapist: “My sport involves a lot of ___. How can I prepare for that?”

You don’t need to arrive with an exercise plan. That’s something you can work out together.

🧠 Final Thought:

You don’t have to wait until something hurts to ask how to prepare for it.

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