by Russ Ebbets
We live in a world of dichotomies and they are often of our own making. This either/or life has more than a twinge of self-preservation. With multiple choices, even countless choices, a moment’s analysis can turn into an eternal paralysis. If it is either this or that, up or down, right or left we can make the easy decision and move on, but maturity brings shades of gray.
Politically, you might identify as red or blue, but with any sense at all you are somewhere in the middle. Even gender is not just boy/girl, man/woman anymore. At last count, science has identified a spectrum of 36 sub-types, an alphabet plus 10.
Training and rehabilitation are also a dichotomy. For some, they are essentially the same thing. Sets and reps, goals and achievements are shared components of the two disciplines that can lead one to conclude that, yes, they are the same thing.
What is neglected here is intent. Training for performance is a series of stresses to the body. The intent of these stresses is to create a response that brings the body to a new performance level. This could be documented in an improved race time, more weight lifted or some other increase in volume, intensity or duration of physical work that would allow one to compete and train at the new, higher level. Even the recreational athlete training for general fitness, cardiovascular health or weight or mental stress management does so in a physical state where the athlete proactively pursues a predetermined goal.
The athlete in a rehabilitative state has a different goal, one of return. Rehab is classically defined as a return to a normal state for someone who has been ill or injured. It bears emphasis that one is returning to the “normal” state. While normal might not necessarily be pain-free, it would be without the movement restrictions of being injured. In a rehabilitative state the weekly or monthly training cycles geared towards improvements are put on hold.
Rehab is downtime, specifically a time where focus is shifted from training for one’s performance goals towards regaining a degree of health and fitness that allows one to train for one’s performance goals. And the greater problem here is that this “downtime” detracts from the cumulative lifespan of an athletic career. It is the accumulation of downtimes that might shorten an athletic career or at the very least hinder one’s potential development.
Normal has been mentioned several times without a clear definition. Normal is really a nebulous term. In an athletic sense normal would mean different things to different people. What is “normal” for you may not be normal for me. Using normal in a people-sense the words “usual, typical or average” are nondescript enough as to be almost useless. In truth, Dr. Rodney Dangerfield’s definition seems to work best, “The only normal people are those you don’t know too well,” and we’ll let it go at that.
It is worth mentioning that at the developmental level, training is neuromuscular education while rehab is neuromuscular re-education. This is not just “splitting hairs.” For whatever the reason, be it poor personal habits, poor training habits (too much, too soon) or overtraining, what has resulted is a body breakdown where the body needs to be re-educated to the proper way. This leads to some deeper philosophical questions (what exactly is the proper way?) and also underscores the importance of a coach versed in the art and science of coaching.
With all this in mind below is a chart that dichotomizes training and rehabilitation very neatly:
One of the fundamental principles of performance training is that of conscientious participation on the part of the athlete. Although seemingly a simple phrase it is complex in both facets and layers. Expectations differ greatly as one spans the age and ability levels of the Junior Olympian to elite to master athlete. It is not unreasonable to expect an athlete will face challenges that may be physical, psychological, social, interpersonal, intellectual or familial in their athletic career. But forced to describe the conscientious participation in a word, “intent,” gives a neat summarization. Does the athlete understand the whys for doing the whats?
In a training phase one’s intent would include challenging one’s current limits with work and mustering personal resolve to do what is necessary to achieve these goals. The time-honored virtues of diligence, discipline, punctuality, sacrifice and the application of any number of other virtues help accomplish this goal. But along the way one can expect some bumps, difficulties and possible setbacks that will test one’s resolve, one’s ability to push through. This push will require one to leave a comfort zone to encounter the challenges with the resolve of “I can do this, I will do this.” The hero’s path is never a simple walk through the woods.
While both training and rehab endeavor to get one “better,” better is defined differently by each discipline. Training strives for “better” through improved performances with proactive movement activities. Rehab strives for “better” with a return to normal performance, pre-injury through reactive movement activities. Both involve movements, movements with different intents.
There are inherent risks in all athletic activities whether we are talking about ball and team sports, contact and collision sports or the repetitive motions of running. Prevention in the form of pre-hab training efforts should address a sport’s idiosyncratic problem areas to help mitigate the risks. But if and when an injury occurs, the focus shifts to rehab activities that promote a return to normal and an eventual resumption of performance goal directed efforts.
It bears repeating that injury downtime, as little as one month a year, can prove to be the loss of 10-12 months of training over the course of a career. That is 10-12 months that do not contribute to achieving one’s potential. It is time that has been lost, never to be regained.
It might be seen that the difference between training and rehabilitation is merely semantic, but it is more than that. Dichotomies offer a simplistic view of the world. Nonetheless they are necessary in that they require a choice and subsequent action that will move one from an inactive or unproductive state towards making something happen. This is always with the greater hope that the choice made is more right than wrong.
Russ Ebbets, DC is a USATF Level 3 Coach and lectures nationally on sport and health related topics. He serves as editor of Track Coach, the technical journal for USATF. He is author of the novel Supernova on the famed running program at Villanova University and the sequel Time and Chance. His most recent book, A Runner’s Guide, a collection of training tips and running articles was a 2019 Track and Field Writers of America Book of the Year finalist. He can be contacted at email@example.com.