In 2011, Matt Forte, star running back for the Chicago Bears, made an appointment with physical therapist David Reavy. "His knee was bothering him, and he didn't know why," says Reavy, who works with top NBA and NFL players. "He disregarded that soreness as normal, and like most athletes, he walked it off, because that's what he was told to do." After all, an achy knee isn't so bad for an NFL running back — especially considering that Forte was a four-season veteran in a sport in which many running backs average just two and a half years.
Within minutes Reavy could tell that Forte's problem had little to do with a bum left knee. It turned out that the 218-pound athlete's body was radically unbalanced. A year earlier, Forte had pulled his left hamstring, which caused his left quad to weaken (the reason for his knee pain). The couplet of a weak quad and a tight hamstring, in turn, pulled Forte's pelvis into a backward tilt. That tilt made it harder for his abdominal muscles to engage, which undercut his ability to stabilize and balance. And because of the weakness in his core, Forte's lats weren't firing properly. "He was essentially playing a professional sport on one leg and at half his body's capacity," Reavy says.
Using a combination of deep-tissue massage and movements designed to "wake up" the muscle fibers in Forte's quads, abs, and lats, Reavy worked to balance Forte's body. And to ensure the same injuries didn't come back, he created a 15-minute routine of activation exercises to keep the running back's body aligned and his muscles fully firing. Says Forte: "Dave was telling me things about my body, making connections, that no one else had before; he found the root of the problem."
Reavy's prescription is something fitness pros call prehabilitation — a regimen of exercises and stretches designed to prevent injury (and thus the need for rehab) by creating more balance, flexibility, and strength. If Forte's experience is any indication, the results are powerful. Last year, he rushed for 1,339 yards, received for 594, and scored 12 touchdowns. It was his sixth and best season yet. "I do the moves, and I feel lighter, and the next day at practice I'm jumping and running better," says Forte, now 28. "It's changed my career. I hope to play 12 years in the NFL, which is unheard of for my position."
Even if you're not a pro athlete, a little prehab can go a long way. Many of us suffer from nagging aches and pains in our shoulders, backs, hips, and knees — and yet continue to shoot hoops, play tennis, or work out at the gym. Often we have imbalances that we don't even feel (the most common: glutes that don't fully engage during squats or while running up a hill, because of days spent at a desk). Without intervention, those old injuries, sore spots, and turned-off muscles can lead to serious problems, such as meniscus tears, arthritis, and slipped or ruptured discs. "Before you try to add strength, power, or speed, you must address muscle balance," says Reavy. "When people do it backward, that's when they break."
The idea makes common sense, yet prehab remains pretty rare. "It doesn't burn calories, it takes time, and it can hurt — there's pain that comes with addressing a tight muscle or scar tissue," says fitness therapy expert Jill Miller. "A lot of us just want to get to the gym and lose weight." But that mentality is beginning to change, among gymgoers and therapists alike, says Dr. Peter Gorman, a physical therapist who works with Olympians, NFL players, and pro tennis players at CourtSense, a tennis club and fitness center in northern New Jersey. "For years, most therapists and doctors have been practicing reactive medicine," says Gorman. "Now it's not about saying, 'I'm the best at treating an ACL injury, but I'm the best at preventing an ACL injury.' "
Gorman estimates that 90 percent of sports-related injuries are due to training and playing with muscle imbalances, though many of them are tough to detect. He's developed a high-tech way to uncover them. His device is called OptoGait, and it measures an athlete's rhythm, balance, strength, and power. Two one-meter-long lines of electronic sensors are placed on the floor to create a lane, and an athlete stands between them and performs exercises like jumping or marching in place. The sensors detect whether the athlete is lifting one foot off the ground faster than the other or has more explosive power on one side. After a series of tests, Gorman can tell which muscles are and aren't firing, and can personalize his therapy accordingly. The tool provides such a training edge that pro athletes from skier Ted Ligety to sprinter Mo Farah to outfielder and 2013 National League MVP Andrew McCutchen have used the OptoGait to fine-tune their bodies.
These days, there are many ways to pinpoint imbalances. You can ask for a basic movement screening test, for one, in nearly any gym or physical therapy office. The most popular was developed by physical therapist and strength coach Gray Cook. His Functional Movement Screen (FMS) consists of seven basic movements — think squat, lunge, twisting the torso — and acts as a common standard to judge movement patterns. On Cook's website, FunctionalMovement, you can locate a trainer or PT near you to administer the test, or you can use his pared-down 10-minute video to test yourself. "It's the American way to find shortcuts and hacks, but there's no getting around being able to perform these movements — they're essential for any athlete to perform well," says Cook. Each movement in the DIY test is pass-fail, and if you do fail, Cook provides simple solutions and exercises to address asymmetries.
So how do you know if you need prehab? For physical therapists like Chris Delehanty, owner of Physiofitness in New York City, that's like asking how you know if you need to go to the dentist. "You get a checkup to prevent cavities, right? This is the same idea," he says. "It's not just for injured old people or for post surgery, it's for an athlete. You can get a basic functional movement assessment, then get a plan to stay healthier and in your sport longer. That can happen in one session," says Delehanty. He laughs, "We're not shoveling any shit here."
Perhaps the best reason to embrace prehab is to discover the same thing Matt Forte did: what your body is actually capable of doing. "Guys come to me saying, 'My flexibility isn't that great,' or 'I'm not made to be a fast runner,' " says Reavy. "Well, no — you've just developed so many restrictions by reinforcing the same bad movement patterns that you've reduced your ability to do those things well." Correcting your unique imbalances provides the physical equivalent of a clean slate, says Reavy. "Then you can find out exactly how strong, fast, and fit you can really be."
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