Understand your pain, plan your recovery

Neck

The Prehab Guys

1. Upper trap stretch with chin tuck: sit on the hand of the side to stretch. Bring your ear toward the opposite armpit, adding a chin tuck at end range. Hold 30 seconds, 2 rounds each side. Aim: decompress cervical joints and lengthen the upper trapezius.
2. Deep neck flexor activation: lie on your back, tuck chin firmly, lift your head one inch off the surface. Hold a few seconds, 10 reps. Aim: strengthen the deep neck stabilisers (longus colli and capitis) that are often underactive in people with persistent neck pain.
3. Banded neck strengthening: on hands and knees, resistance band looped behind the head above the ears. Push shoulder blades away, tuck chin, resist the band pulling the neck forward. 10 reps. Aim: build posterior and anterior neck strength together in a loaded, functional position.

Lower back

The Prehab Guys

1. Cat camel: on hands and knees, round the spine upward fully (breathe out), then let it drop into extension (breathe in). Start small, increase range gradually. Aim: restore segmental mobility across the lumbar and thoracic spine.
2. Side plank, knees bent: forearm side plank with knees bent, hips stacked, lift and hold for 10 seconds. Progress to a full side plank, then to slow top-leg lifts. Aim: strengthen lateral lumbar stabilisers (quadratus lumborum, obliques, glute med) without axial load.
3. Walking: short, regular walks at a comfortable pace, building duration gradually. Aim: gentle cyclical loading that most backs tolerate well, especially after sitting.

Loaded exercises like deadlifts belong in a supervised programme; that's what sessions are for.

Shoulder

The Prehab Guys

1. Isometric external rotation (phase 1, high pain): stand sideways to a wall, press the back of your hand into it as if rotating the arm outward. Shoulder blade pulled back. Hold 30 seconds, 2 rounds. Aim: reduce acute rotator cuff pain through pain-inhibiting isometric loading.
2. Side-lying external rotation with dumbbell (phase 2): lie on your side, elbow bent at 90°, rotate the arm upward slowly (3 seconds down, 1 second up). 2 sets of 15 reps. Aim: rebuild rotator cuff strength through range once acute pain has settled.
3. Banded row with scapular set (phase 3): pull a band to a high row position, drawing the shoulder blade back and down first. 3 sets of 10 reps. Aim: integrate the rotator cuff with the scapular stabilisers in a functional pulling pattern.

Knee

The Prehab Guys

1. Fire hydrant with rotation (patellofemoral pain): loop band above knees, split stance at a wall, drop into a half-squat and rotate the torso 30° each way while keeping the knees tracking outward. 10-15 rotations per side. Aim: challenge hip, ankle, and rotational stability to reduce load on the kneecap joint.
2. Spanish squat isometric (patellar tendon pain): power band looped below the knee and anchored to a fixed point. Upright torso, knee-dominant squat position. Hold 30-45 seconds, 2-3 times. Aim: load and desensitise the patellar tendon; effective for both pain relief and tendon adaptation.
3. Rear-foot elevated split squat (IT band or lateral knee pain): rear foot on a bench, slow tempo (3 seconds down, 3 seconds up). 8-12 reps. Aim: strengthen the quad and glute in hip extension to reduce stress on the lateral knee structures.

Hip and glutes

The Prehab Guys

1. Side-lying leg lift isometric hold: band just above the knees, side-lying, lift the top leg up and back and hold for 45 seconds. Drive through the heel, do not rotate the pelvis. Aim: load the gluteus medius tendon with a sustained isometric, which is effective for both pain relief and tissue stimulus.
2. Side plank with hip abduction: side plank position, actively lift the top leg slow and controlled. Aim: increase load on the outer glute through a functional position; modify by bending the knees if the full side plank is too much.
3. Single-leg fire hydrant (standing): stand on one leg, keep that knee tracking over the foot, and lift the other leg out and back. Aim: the working glute is the stance leg; challenges hip stability under body weight.

Ankle and foot

The Prehab Guys

1. PNF dorsiflexion drill (shoes off): kneeling with foot on a bench, slide the knee forward to end-range dorsiflexion. Push the foot down for 10 seconds (calf), then pull the toes up for 10 seconds (shin). 3-5 rounds. Aim: use post-isometric relaxation to improve dorsiflexion range lost after a sprain.
2. Peroneal band work: resistance band around the outside of the foot below the pinky toe. Perform slow eversion against the band (20-30 reps), or hold isometrically for 10-30 seconds. Aim: strengthen the peroneal muscles that control inversion and prevent re-sprain.
3. Single-leg balance with anti-inversion band: band anchored at hip height to the outside, stand on one foot and resist the band pulling into inversion. Hold 30-60 seconds, progressing to trunk rotations or heel raise. Aim: restore balance and lateral ankle stability under load.

Thoracic and mid back

The Prehab Guys

1. Kneeling thoracic extension: arms on an elevated surface, let the chest drop toward the floor. The low back rounds slightly to isolate the mid-back. Aim: restore extension in the thoracic spine, which reduces compensatory loading on the neck and lower back.
2. Wall angel: back against the wall, knees slightly bent to prevent low back arching, raise arms overhead keeping them in contact with the wall throughout. Aim: active end-range thoracic extension, also challenges shoulder mobility.
3. Thoracic bridge rotation: in a bridge position, rotate your chest toward the floor as far as possible on each side. Aim: restore thoracic rotation, which is often the first motion lost with prolonged sitting.

Elbow and wrist

The Prehab Guys

1. Isometric wrist extension: elbow at 90°, wrist at about 20-30° of extension, hold the position. Use your opposite hand to add resistance. Aim: calm the extensor tendons without loading them through range; effective as a pain reliever in the acute phase.
2. Wrist extension with weight: forearm supported, wrist drops into flexion then lifts slowly up into extension. Use a light dumbbell, a bag with some weight, or a broomstick. Aim: progressively load the extensor carpi radialis brevis, the most commonly affected muscle in lateral elbow pain.
3. Wrist extensor stretch: bring the wrist into flexion with the opposite hand, then rotate the elbow inward until you feel a pull along the outer forearm. Aim: restore length to the wrist extensors. Note: use caution if the tissue is currently very irritable.

Foam rolling: mid back

The Prehab Guys

1. Segmental mid-back rolling: roller across the mid-back, hands behind head or crossed on chest. Work one small area at a time, lift the hips to move up or down between segments. Aim: restore mobility through each thoracic level rather than sweeping past them.
2. Full sweeps: once you have worked each segment, roll from the mid-back up to the shoulder blades in a slow continuous pass. Apply as much pressure as is comfortable; there should be no sharp pain.
3. Thread the needle with roller: seated on heels, one hand on the roller for support, rotate the opposite shoulder toward the floor as far as possible. Take a deep breath at end range to gain a little more rotation. Aim: combine self-myofascial release with active thoracic rotation.

TFL and IT band release

The Prehab Guys

1. Locate the TFL: find the bony prominence at the top of the hip (iliac crest) and place the ball just below it, toward the front-outside of the hip. This is not the IT band itself but the muscle that feeds into it.
2. Roll back and forth: with hips on the ground, move back and forth across the muscle. To increase pressure, lift the hips off the ground to load more weight into the ball.
3. Change direction: roll both perpendicular and parallel to the muscle fibers to cover the tissue fully. Aim: reduce tone in the TFL, which contributes to lateral hip and knee pain when overactive.