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off season training, rehab, pre-hab

Off season training, rehab and pre-hab - For coaches, the off-seazson is the time to plan for rehab, pre-hab and rest

For any team sport, the off-season is a fantastic opportunity for players to rest and recuperate from the physical and emotional demands of a tough competitive season. It is a chance for players to get away from the environment that has become their ‘second home’ for much of the year. It is also the time to actively manage any injuries sustained, and to work on maintaining the physical capacities developed during the season.

The key to a successful and productive off-season is knowing what to prioritise, how much to do and when to rest. Although rugby union is used as the example here, the principles are equally applicable to any team sport. There are five essential components to off-season activity:

  • surgery for active injuries
  • screening – identify new and pre-existing injuries and institute rehabilitation plans
  • core stability and flexibility
  • strength and conditioning
  • time off, away from sport

What is a season?

The length and intensity of an athlete’s season varies widely, even within a single sporting family such as rugby. In the UK, Rugby Union is played on most weekends. Elite level teams usually come together some time in early July for pre-season training for a season that starts in early September and runs for nine months, ending late May.

So the ‘off season’ in the UK generally lasts five weeks during June and early July. International players involved in overseas tours, though, cannot take a break until their return in July, when they may get four to five weeks off (at the discretion of their club).

Compare the UK’s two-month (July and August) pre-season period with the three to three and a half months enjoyed by top-level Australian rugby players (and for that matter Rugby League and Australian Rules Football). These teams convene in November and start competitive play in late February to early March.

The Australian and New Zealand Super 12 seasons wind up in late May. They are immediately followed by the southern hemisphere international season, which runs until the end of November.

During these six months, the international sides play nine to 11 games, leaving plenty of time for preparation and rest. Those not involved in international games continue to play club rugby (Australia) or take part in the national provincial competition (New Zealand) until November.

Australian Rules Football has a mandatory eight-week break in the off-season (which generally commences in September). The first five weeks are strictly free of organised training, followed by three weeks of ‘volunteer’ train-ing, at the discretion of individual players in consultation with the club. This innovative idea was brought in by the Players’ Association to prevent coaches from calling in players too early for pre-season training.

In short, Australian team sport players tend to enjoy much longer off-seasons and pre-seasons, for rest, recuperation and preparation.

Principles of off-season management

End of season surgery

Playing in a very demanding contact sport such as rugby is taxing on the body and mind. Injuries are sustained and these need to be managed within the context of a season. Some may require surgery to alleviate a condition or restore an athlete to full fitness. In other cases, a player can play with injuries that are not overly dysfunctional, and surgery can wait until the competitive season is over. Examples would be minor cartilage (meniscal) tears of the knee, ankle arthroscopy, hernia repairs or Gilmore groin repairs, labral tears in the shoulder and minor wrist surgery.

At elite level, these conditions are identified during the season and the player is sent for an orthopaedic consultation with a surgical specialist. Ideally, an early off-season appointment is booked for surgery, and the player plays out the season. This should enable enough time for rehabilitation before the next season, or at the worst, soon after its start.

Most surgical procedures will require the player to be around for the first 10 days after their operation, to rule out post-op infections, to enable the surgeon to do any necessary follow-up and to allow the physiotherapist and conditioning coach to plan and explain their rehabilitation plans. After this, players may disappear for a few weeks for a well-earned break.

Screening and ‘maintenance’ injuries

Players not needing end-of-season surgery (hopefully most of the squad), should be able to leave for their holidays equipped with pre-hab/rehab plans. These need to attend to any injuries sustained during the season, and any other longstanding health or fitness issues. For example, a player with minor shoulder instabilities not suitable for surgery will need to work on their rotator cuff strength during their time off. All plans must be practical: short enough that the player will commit to following the regime, and simple enough to be done with little or no equipment, in, for example, the confines of a hotel room.

Players, therefore, will need to be screened so that off-season plans can be drawn up in good time. In the context of a team sport, you should start musclo-skeletal screening two to four weeks before the end of the season so that all players are properly assessed. It is impossible to fit this screening work into a Sunday and Monday after the last game of the season, when the players’ only concern is ‘Mad Monday’ at the pub.

It is beyond the scope of this article to detail an entire end-of-season screening, but the key areas are joint stability and flexibility.

Flexibility and core stability programmes

The off-season period is a fantastic opportunity for players to work on major musculoskeletal imbalances in flexibility, stability and joint control. The focus should be on posterior chain strengthening and flexibility (see SIB 35 and 36). In my experience, players create a multitude of soft-tissue problems early in the pre-season by packing in too much over too short a time-frame. They will attempt to lift heavy, sprint and clock up running mileage at the same time as working to improve their posterior chain and groin strength and flexibility. This presents a lot of stress to a musculo-skeletal area that traditionally gets very little attention in strength and conditioning programmes.

A pro-active approach is for the athlete to conduct a lot of their pos-terior chain strength and flexibility work in the off-season, in preparation for the demands of pre-season training. As the need to conduct speed and strength work is reduced during the off-season, the extra time should be spent on strength and flexibility in these areas.

Furthermore, the off-season period is also a good opportunity for players to maintain or develop functional abilities in abdominal wall core stability. Much has been written about this area in previous Sports Injury Bulletin articles and other publications.

Strength and conditioning

All strength and conditioning programmes should be designed to cover the six ‘S’s:

  1. strength
  2. speed
  3. stamina
  4. suppleness
  5. skill
  6. size (hypertrophy)

Particular capacities will tend to dominate at particular points of the competitive season and will vary between sports (a footballer has no need for size, for instance). For a rugby player, training for the capacities of size and strength is best done in the pre-season, whereas speed and skill develop over the course of a season.

So which capacities are best suited to off-season development? In my opinion, players need to maintain their capacity for speed, while strength and stamina can afford to drop a little. Obviously, without a structured training environment skill levels will drop, but because skill development is such a central focus of the competitive season, this should not be a problem.

It is because both straight-line speed and speed while changing direction are so neurally driven, that an athlete should maintain some off-season exposure to this discipline.

Speed training three times a fortnight is an intelligent way to allow the neuro-muscular system to regenerate after the demands of the competitive season, while still providing enough of a stimulus to maintain elements of the capacity.

A short low-volume session over a two-week period (eg Monday, Friday and following Wednesday) should provide the necessary exposure. This can be immediately followed up with a little conditioning running.

This should be alternated with a session focusing on strength/cross training/flexibility, also undertaken three to four times over the two-week period. In this way, the athlete should only need to train six or seven times in 14 days.

Table 1 below shows an ideal plan for an athlete wanting to maintain the capacities of speed, strength, stamina and suppleness. It can be modified to suit individuals who need to focus on one or two areas such as fat loss or hypertrophy.

Table 1 Sample off-season 14-day training cycle
Day Activity 1 Activity 2 Activity 3
Week 1:
Monday Speed Running -
Tuesday Rehab/pre-hab* - -
Wednesday Strength Cross Train Flexibility
Thursday Rehab/pre-hab - -
Friday Speed Running -
Saturday Rehab/pre-hab - -
Sunday Rest - -
Week 2:
Monday Strength Cross Train Flexibility
Tuesday Rehab/pre-hab - -
Wednesday Speed Running -
Thursday Rehab/pre-hab - -
Friday Strength Cross Train Flexibility
Saturday Rehab/pre-hab - -
Sunday Rest - -
*Rehab/pre-hab refers to the individual management plan the physio sets to manage identified injuries from the preceding season

Time away

Many large corporations ‘force’ their employees to take a period of leave every year, with no option to carry over and accrue holiday entitlement over several years. They do this because studies in human resource management show that productivity rises if employees take time away from work once or twice a year. In effect, the employee is removed from the workplace to rest and recover, a very sound concept that should apply also to athletes.

The player should be encouraged to take time out during the off- season, well away from the environment they live in for 48 weeks of the year. The support professionals should source alternative training venues suitable for the off-season maintenance programmes they have designed.

Even Malaga and the Maldives have fully equipped gyms. The athlete should therefore be able to conduct a simple rehab/pre-hab schedule before hitting the beach for the day.

Off-season plans, the key points

  1. Identify and plan off-season surgery well before the end of the competitive year. Surgeons are busy people, so don’t expect a player to be seen two days after the season finishes and have surgery the next day.
  2. All players should have a simple and equipment-free rehab programme they can carry out by themselves. Be creative, so that everything can be done with what is found in a hotel room.
  3. Focus on the maintenance of speed above all else. Include some strength and conditioning work, but not if it compromises speed training.
  4. Encourage players to get away from their familiar environment and routine. There are plenty of cheap flights to exotic locations, so encourage players to go away with their families and friends.

off season training, rehab, pre-hab