Neurophysiological pre-training protocols for performance and pain - a case report

Abstract

In the strength and conditioning domain, various methods are used to enhance range of motion (ROM), reduce pain, and enhance athletic performance. Among many popular interventions is the use of neurophysiological pre-training protocols, such as post-activation performance enhancement (PAPE). This case study aimed to detail the effects of a PAPE prescription and the accompanying neurophysiological mechanisms. While attempting to generate leg drive in a competition bench press position, a 35-year-old male powerlifter with 20 years of lifting experience complained of severe 9/10 right-sided hip pain. A gluteus medius dysfunction and abduction/extension intolerance were diagnosed. Using PAPE principles, a treatment strategy was designed targeting hip adduction to access hip extension better and restore appropriate ROM with leg drive. The participant reported 0/10 pain on the subsequent warm-up sets after the first six rounds of seated adductor isometric hold. The participant then performed a 220 kg 1 rep max bench press with an adequate ROM, leg drive, and no pain. More research should be done on neurophysiological rehabilitative strategies. This case study sheds light on the possibilities and calls for further research into the protocols and mechanisms discussed above.