The Difference Between Rehab and Training

Oftentimes, you’ll walk into your standard physical therapy clinic and be given 3-5 “rehab” exercises on a sheet of paper to do as homework. The expectation is that those “rehab” exercises will help your pain. Now if you are an active individual that trains or exercises regularly, you may become frustrated when those exercises do not help. Now, you start to miss out on training because you still have pain. The missing link here is that the exercises you are given are usually specifically targeting a muscle group and do not account for the training/exercise that you normally do. No amount of clamshells are going to help you deadlift or squat pain free.

In my opinion, there is no difference between a rehab exercise and a training exercise. Just because a physical therapist gives you an exercise, it does not mean that it is a rehab specific exercise. What’s important is finding a physical therapist that understands your goals and lifestyle to appropriately prescribe certain exercises and work with your pain. The best exercise to improve your ability to deadlift is most likely a deadlift just like the best exercise to improve your bench press is most likely a bench press. However, you’ll never find someone describe these as rehab exercises. 

A better way to think of rehab could be described as training in the presence of pain. For me personally, I am never one to tell a patient of mine to stop exercising/training unless it is absolutely inappropriate because of a red flag. Oftentimes, you can still train with a good intensity in the presence of pain. It just comes down to finding the right movements for you at that time. In the meantime, you and the physical therapist work to address your deficits with supplemental exercises or modifications to your current training. For instance, let's say you are dealing with low back pain, which prevents you from bending forward. In your training, you have a lower body day and you're still wanting to hit your glutes. So instead of doing deadlifts, maybe we try reverse lunges with dumbbells that will still require you to engage your core and give your glutes the appropriate stimulus you need to continue to progress. Another example would be someone with pain when pressing overhead. While we could avoid that movement entirely, a better option would be to try a landmine press that still incorporates some overhead motion and will tax the shoulders as well. 

Rehab or physical therapy does not have to be complicated. Exercises like squats, deadlifts, bench press and many more have been around forever for a reason. The reason being they are very good at what they do in the sense that they hit all the major muscle groups and develop strength and resiliency to live a long, healthy life. These exercises should be part of your rehab and your training because it is all the same in my eyes. Sure, there is a time and place for highly specific exercises like heel raises or step downs if you are dealing with some tendon pain and that is where the expertise of a physical therapist comes in.

If you are someone who has been missing out on training or exercise because of pain, the team over at Loon State Physical Therapy is able to help. We serve the twin cities communities with locations in Lake Elmo, Linden Hills and Minnetonka. Feel free to call us at (612) 405-8503 or book online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.

Loon State Physical Therapy approaches physical therapy with a fitness forward approach and specializes in treating the active adult. We look forward to working with you!

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The Physical Activity Guidelines, Exercise, and Pain