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Here's a good rehab program to help an injured athlete stay fit

Bruce Tulloh provides advice on how to help an injured athlete maintain a reasonable level of fitness.

An injured sportsman is like a sick lion - no use and a lot of trouble. The coach has to deal with the mind as well as the body in maintaining the athlete's status quo. I heard a story about one of our leading middle-distance runners who went out to a training camp and injured himself on the first day. "Right," he said. "l am on my holidays now," and off he went to the pool hall for the next week. This approach scores high marks for relaxation but very few for intelligence.

The first thing to do is to get treatment, but the very next thing is to redesign the programme and start on rehabilitation. A few days away from the regular training programme can have a very beneficial effect, mainly if the athlete has been training very hard. The injury may force them to take a rest, which the body needs, and they will be much better for it. However, total inactivity is a bad thing, especially since most top-class athletes are accustomed to an organised programme and may lose their sense of direction if deprived of it.

The next step is to decide which movements the injury will and will not allow. If we take for example a lower leg injury to a runner, shin splints, or a stress fracture, then running itself is ruled out as an exercise and so are sports that involve running on hard surfaces. However, it should be possible to construct a programme that will train most of the attributes of a runner so that they can go straight back to running training when the injury has cleared up. It may even be possible to improve their capabilities in some respects those things which they have not had time for.

The attributes, which make a good runner, are:

  • A. An efficient cardiovascular system
  • B. A good power-to-weight ratio
  • C. Strong leg muscles
  • D. Good local muscular endurance
  • E. Good general endurance
  • F. Above-average flexibility
  • G. Strong motivation to succeed

For attribute A, we can recommend cycling, both static and outdoor, swimming, including "wet-vest" interval training or using an ergometer either of the rowing type or the cross-country skiing type. Daily monitoring of their resting pulse rate and use of a pulse monitor to get the required exercise level will maintain or even improve their cardiovascular system.

For attribute B, the athlete needs to weigh himself/herself regularly, watch food intake, and burn off enough calories in the various types of exercise to keep the weight down to its normal level.

For attribute C, weight training using fixed resistance, as in the Multigym or Nautilus systems, is the best thing, but the other activities will help. The attraction of weight training is that it is measurable, and the athlete can work to a schedule and see that they are improving both strength and endurance in the exercises they are allowed to do.

Attribute D may present problems since the athlete will be unable to use the same action in training as they would in running. Cycling on a cycle ergometer is probably the best thing here, as they can increase the resistance and follow a definite programme, e.g. 6 x 2 minutes hard cycling, with an equal-time recovery.

General endurance, attribute E, allows plenty of variety. Still, I would choose walking as the best activity, wearing boots and walking on soft ground to prevent any shock to the injury. The advantage of a prolonged, low-intensity exercise is that it is therapeutic; it allows the athlete time to think; it calms them down and assures them that they are doing something positive.

F is for flexibility, something in which many athletes are lacking. The important thing here is continuity. A series of exercises, depending on the injury, should be planned to last 15-20 minutes a day, generally, after some other type of training has got their muscles warm. It should be possible to make the athlete more flexible at the end of the rehab course than they were before the injury.

What the programme could include

A typical weekly programme might take the following form:

  • Each morning. 30 minutes on a static bike or rowing machine, followed by 10 to 15 minutes of flexibility exercises
  • Monday lunchtime. 15 minutes of weight training in the gym
  • Monday evening. Walk or cycle to pool, 30 minutes swimming
  • Tuesday evening: 60 minutes cycling, with several hard bursts up hills
  • Wednesday: as for Monday, but include 30 minutes of running in a wet vest, 1 minute fast, 1 minute slow
  • Thursday afternoon: 60 minutes fast walk in boots, plus light jogging
  • Friday afternoon: rest
  • Saturday: 1 to 2 hours walking, with 5 minutes flexibility exercises each hour
  • Sunday: 60 minutes hard cycling, 20 minutes steady swimming, 30 minutes walk or jog uphill

The last attribute, a strong motivation to succeed, is the very one which makes it possible for the athlete to work on such a programme, even though they may not be able to train at their usual sport. As with other forms of training, the way to make a long rehabilitation spell tolerable is to periodise it e.g. six weeks on weight and ergometer training, moving on, as mobility improves, to pool and bicycle training, and setting specific targets for these, over three or four weeks.

Specific flexibility exercises, as recommended by the doctor and the physiotherapist, will be part of the programme almost every day. Walking should be started as soon as it is safe, and this can move on to slow jogging on soft surfaces, then running slowly up a gentle slope. Whatever the injury, the athlete and coach should never give up. The training of the will, which stems from overcoming adversity, will make the athlete much stronger in the competitive situation. One has to look no further than Roger Black as an example.

Article Reference

This article first appeared in:

  • TULLOH, B. (2003) Here's a good rehab program to help an injured athlete stay fit. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 2 / June), p. 1-2

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