Building Capacity From The Start

Recovery often begins with small, gradual steps. In the early stages, building capacity is not about pushing limits, but about introducing movement in a structured and sustainable way. 

When this process is delayed or unstructured, it can impact confidence, tolerance to activity and overall recovery progression. 

To explore this further, we spoke with our Exercise Physiologist Justin Brunner, who shares their clinical perspective on how capacity can be built effectively from the start of recovery. 

Why building capacity early matters

Why is it important to start building capacity early in recovery? 

Delay is always something that I think should be avoided, don’t put off what you can do now for tomorrow right? But speaking rehabilitation specific, I think early recovery is important as it helps to ensure we are building confidence and minimising any movement or pain phobias, and all of this is going to have a compounding effect over the course of one’s recovery journey!

Starting at the right level

How do you determine the right starting point for someone in early recovery?

As clinicians, we all have our own ideas, thoughts, and guidelines on where someone should be starting. However, listen to the individual, they will likely tell you where their starting point is! Unless they’re too eager and want to start at something likely too difficult for them which risks aggravation, start where they feel comfortable and want to start. No starting point is too small, capacity and confidence can be built from there.

Gradual progression

What does safe and effective progression look like in the early stages? 

Much like the starting point, early safe and effective progression in the early stages is guided by the individual. How do they feel progressing to the next step? We can guide them on graded increase and next steps, but ultimately it is their program and recovery journey. We as clinicians can help instil confidence and guide to a more accelerated pathway to recovery, but they need to be comfortable with progression and feeling confident with their safety. In summary, I think safe and effective progression ultimately looks like confidence building. The injury will heal, instead early on, help the individual pave the way and work within what is safe, from there the pain scores, ROM, which ever metric you want to choose, will come if we as clinicians keep an eye on it for the individual.

Confidence in movement

How do you help individuals rebuild confidence in movement? 

Most importantly for me, it’s giving permission for the individual to move. I find a lot of the time, issues arise from fear of the pain or movement. It’s about education on the nature of the injury and pain, understanding what the individual’s beliefs on their injury and pain is, and helping to provide additional education and expanding on it for the individual. Confidence is helping them understand their injury and removing some of the unknown for the individual, and from there giving some guidelines on the temporary limits and how to explore and restore their movements.

Preventing setbacks

How can early structured rehabilitation reduce the risk of setbacks or delayed recovery? 

As mentioned, once confidence and autonomy returns to the individual through early recovery and graded return to their movements, they’ll understand where their limitations lie which can help avoid things like flare ups. I’ll use flare ups here as an example of a usual ‘setback or delay in recovery’.

An important piece to remember though is that although we can reduce flare ups, they are ultimately a part of recovery and recovery is not this linear journey. I like to picture it to the individuals I see like a stock market, (let’s assume a good economy!) the stocks can fluctuate up and down, and on some days may even look like a loss and step back, but when you look at the grand picture, it is growing and improving.

So, although we can’t remove flare ups entirely, but do our very best to prevent them with early rehabilitation, what we can also learn from early rehabilitation are our tools to manage flare ups. Once we learn how to manage and control our flare ups, things get a lot easier, and this is also a powerful confidence building tool of itself!

If you’re avoiding everything like the plague, however, you’ll struggle to learn any of these things or regain your body’s autonomy. Finally, here we’re talking about reducing delays in recovery, ultimately, there’s less delay if we remove the delay right at the start and get started with early recovery!

Conclusion

Building capacity early in recovery can support more consistent progression and reduce the likelihood of long-term complications. 

A structured, individualised approach helps ensure movement is introduced safely, with gradual progression aligned to each person’s tolerance and goals.