Load vs. Capacity: Rehab Progression
If we knew nothing else about rehab, but knew the concept of load vs. capacity, we could take patients, clients, and athletes all the way from injury or post surgery back to sport. There are so many concepts that floating around in rehab. Most geared around what is right. Or what is more right than the other thing. Currently, its made even more difficult by the onslaught of continuing education marketing touting that their product is the best way and the only way. Even though it is sometimes difficult to sift through all the jargon and see past the continuing education marketing madness, there is one principle that is tried, true, and will outlast all the “latest and greatest.” That principle is Load vs. Capacity.
Load Vs. Capacity:
In sport and rehab, load is a demand or stress applied to the body. Capacity is how much of that demand or stress the body can take before breaking down. Essentially, every movement someone performs has a certain capacity associated with it. When the stress or demand on that movement becomes too great breakdown occurs. In the ideal situation, capacity and load should be equal. To increase capacity you need to increase demand slightly beyond capacity slowly over time. This will increase load and capacity together. But when a load is applied to quickly, or the load is well beyond the current capacity, tissue breaks down and injury occurs.
Where the Rubber Meets the Rehab:
This is where this concept really plays a part in rehab. When someone becomes injured they must unload that injury for it to heal. Unfortunately, removing a load or stress on a movement or body part because of injury also causes capacity of that movement or body part to decreases. Its that age old concept of “use it or lose it.” So what do we typically see in poorly designed return to sport programs? We see a blatant disregard for the capacity that a sport requires. Once pain free movement is achieved all is assumed well, and they jump back into their sport. This is why we can see so many repeat injuries.
When load has to decreases and capacity follows we have to be diligent about slowly reloading sport specific movement patterns to rebuild tissue tolerance and capacity. When capacity is low it is much easier to load well beyond the capacity of an athlete. If we have not relaid the foundation of tissue tolerance after injury it wont be long before that athlete begins to struggle with pain and dysfunction again. In the upcoming video NRG Physio will break down load vs capacity. As a follow up we will begin to break down types of load and how to incorporate those into the rehab process. REMEMBER THIS: When pain is gone, the problem is still there. The only way to fully restore someones movement health is to fully restore to mobility, movement control, and capacity to move well.