Prehab & Rehabilitation — all lessons
Foundations of MSK Rehabilitation
Principles of injury prevention and recoveryBiomechanics and movement analysisUnderstanding pain science and tissue healingRehab Exercise Strategies
Progressive loading techniquesProgram design for rehabilitationPhased rehab programming: acute to return-to-performancePrehab 121 Protocols (intermediate–late stage)
ActivationEarly strengtheningAdvanced strengtheningPlyometrics in rehabilitationReturn-to-sport exercisesPrevention, Surgery and Return to Sport
Injury prevention programmesThe preoperative phase (prehabilitation)Role of criteria-based progressionsReturn-to-sport testingIntegration with strength and conditioningCase Studies
Case studies and real-world client scenariosProgressive loading techniques
How to load healing and sensitive tissues progressively — isometrics, slow resistance, eccentrics, energy-storage loading and the pain-monitoring model.
Learning objectives
- Sequence loading types from isometric to energy-storage
- Use pain-monitoring to guide progression
- Apply tendon-specific loading principles
- Adjust load, range, speed and volume systematically
Before this lesson
Why this matters
Too little load leaves tissues weak; too much too soon flares symptoms. Progressive loading finds the productive middle.
Loading progression
| Stage | Example (patellar tendon) | Purpose |
|---|---|---|
| Isometric | Wall-sit or Spanish squat holds 5 × 45 s | Load with low irritability |
| Isotonic (slow heavy) | Leg press, split squat 3–4 × 6–15, slow | Build strength and tendon capacity |
| Energy storage | Hops, jumps, bounding | Restore spring-like function |
| Sport-specific | Cutting, landing, sprinting | Return to demands |
Tendinopathy can be viewed as a continuum from reactive to degenerative stages, with load management central to treatment [cook2009].
Pain-monitoring model
In Achilles tendinopathy, patients who continued activity guided by a pain-monitoring model did as well as those who rested [silbernagel2007]. Principle: pain during exercise acceptable at a low level (e.g., ≤5/10 in that study), settling by the next morning, and not increasing week to week.
Variables to progress
Load → range → speed → volume → frequency → complexity. Change one at a time.
Common mistakes and misconceptions
Case study
A volleyball player with patellar tendon pain progresses from isometrics (week 1–2) to slow heavy split squats (weeks 3–8), then hops and jumps (weeks 9–12), returning to full training at week 14.
Further learning: video lessons
Video links are only marked “verified” after a human has watched them. Unverified entries open a YouTube search for that channel and topic rather than a guessed link.
Tendon loading progression
physiotherapy educators (search, e.g. E3 Rehab, Physiotutors)
You will understand: isometric to plyometric loading
Why: Clinician-led practical content; verify the specific video.
Pain monitoring model
physiotherapy educators (search)
You will understand: using pain to guide load
Why: Clinical method.
Knowledge check
Knowledge check · 0/5
1. A typical loading progression for tendinopathy is…
2. Silbernagel et al. (2007) found continued activity with pain monitoring…
3. Energy-storage loads include…
4. Cook & Purdam’s continuum model describes tendinopathy as…
5. Which is a progression of range?
Short-answer & application questions
- Design a 12-week progression for patellar tendinopathy.
- Explain the pain-monitoring model to a runner.
- List variables you can change when an exercise is too painful.
Key takeaways
- Loading usually progresses from isometric → slow heavy (isotonic) → faster/energy-storage → sport-specific.
- In Achilles tendinopathy, continuing activity guided by a pain-monitoring model was as effective as rest.
- Tendinopathy is a continuum; load management is central.
- Progress one variable at a time: load, range, speed, volume, frequency.
Connected topics
Program design for rehabilitation
prehab rehabRole of criteria-based progressions
prehab rehabPlyometrics in rehabilitation
corrective exerciseElbow and wrist
References
- Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J (2007). Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. American Journal of Sports Medicine, 35(6):897–906. RCT check pending
- Cook JL, Purdam CR (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6):409–416. Narrative review check pending
- Khan KM, Scott A (2009). Mechanotherapy: how physical therapists' prescription of exercise promotes tissue repair. British Journal of Sports Medicine, 43(4):247–252. Narrative review check pending
Educational content only — not medical advice. Consult a qualified clinician for diagnosis or treatment.