The Progressive Loading Protocol: 3 Exercises to Rebuild Your Forearm (Part 3 of 3 - 107C Glossary Series)

Written by Rehab Mechanics

In high-performance strength rehabilitation, clinical tendon biology, and our Physiotherapy & Sports Medicine Glossary, the progressive loading protocol for medial epicondylalgia defines the systematic, 3-phase mechanical reloading framework engineered to transform degenerative, painful collagen into thick, high-capacity tendon tissue without ever removing weightlifters from the gym. In Part 1: Why Passive Rest is Atrophying Your Tendons (107A), we proved why complete rest causes stress shielding and downsizes structural tissue capacity. In Part 2: Modifying Your Splits (107B), we mapped out the exact exercise substitutions and grip adjustments required to keep training your back, chest, and arms heavy. Now, in Part 3, we detail the active clinical cure: the exact 3-phase progressive loading protocol that systematically turns brittle common flexor tendons into ironclad armor. Physiotherapy in Toronto at Queen West Rehab Mechanics assists lifters and functional fitness athletes in recovering from golfer's elbow without quitting weightlifting by conducting comprehensive biomechanical movement assessments to isolate rate-of-force capacity deficits, deploying Radial Shockwave Therapy and manual therapy, and guiding progressive Heavy Slow Resistance (HSR) loading across our primary clinical facility at Rehab Mechanics.

The Patient’s Story / Toronto Context

Across the functional fitness boxes, boutique strength clubs, and industrial barbell facilities of Liberty Village, King West, and Parkdale, dedicated lifters understand that muscle is built through progressive overload. Yet, when an inner-elbow tendon flares up, that same logic is strangely abandoned in favor of passive rest, ice, and fear.

Consider a 33-year-old competitive powerlifter from Liberty Village or a 40-year-old financial director from King West who trains heavy four mornings a week before heading to Bay Street.

They have successfully modified their lifting split: they switched from straight-bar curls to neutral hammer curls, they are using lifting straps on all heavy rows, and their pain during training has dropped into the safe Green Zone (3/10 on the Next-Day Pain Rule).

However, they confront The Glass Ceiling of Recovery.

While their elbow no longer screams during modified pulling, the moment they test an unassisted barehand pull-up, grasp a heavy suitcase at Union Station, or attempt a firm handshake in a corporate meeting, the inner elbow bites with sharp, weak apprehension.

Their tendon has been successfully offloaded, but it has not been rebuilt.

Without a progressive loading protocol, their common flexor origin remains a thin, fragile tissue adapter. Offloading an injury protects it from further damage; only progressive, heavy, direct mechanical tension commands resident tenocytes to pack new Type I collagen fibrils and thicken the tendon's structural cross-sectional area.

Inside our private treatment rooms at Rehab Mechanics inside the Prime Medical Centre at 68 Abell Street in Queen West, we guide lifters through our definitive 3-Phase Forearm Armor Protocol. We transition your tendon from pain-relieving isometrics, to heavy slow eccentric remodeling, to multi-planar rotational capacity—ensuring you return to full, unrestricted barbell pulling stronger than the day you were injured.

☕ Ready to rebuild your forearm capacity and eliminate golfer's elbow permanently? Explore our full suite of clinical services or consult our comprehensive Physiotherapy Topics Index.

Structural / Biomechanical Analysis

To understand why this 3-phase loading continuum is mandatory for tendon recovery—and why jumping straight to heavy forearm curls fails—we must examine tenocyte mechanotransduction, cortical motor analgesia, and the biological timelines of collagen turnover.

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|               THE 3-PHASE PROGRESSIVE TENDON RELOADING CONTINUUM (WEEKS 0 TO 12+)                 |

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|                                                                                                   |

|   [PHASE 1: WEEKS 0–2]              [PHASE 2: WEEKS 2–6]             [PHASE 3: WEEKS 6–12+]       |

|   ISOMETRIC STABILIZATION           HEAVY ECCENTRIC REMODELING       ROTATIONAL & GRIP INTEGRATION|

|   (Analgesia & Quiet Tendon)        (Type I Collagen Synthesis)      (Multi-Planar Sport Armor)   |

|                                                                                                   |

|   • Sustained Static Muscle Pull    • Controlled 4-Second Lowering   • Off-Axis Resisted Pronation|

|   • Zero Joint Glide / Zero Friction• Integrin Strain (4.0–4.5%)     • High Rotational Shear Load |

|   • Down-Regulates Cortical Pain    • Compresses Painful Neovessels  • Dynamic Grip Transfer      |

|              |                                 |                                |                 |

|              v                                 v                                v                 |

|   +--------------------+            +--------------------+           +--------------------+       |

|   |   IMMEDIATE RELIEF |            |   STRUCTURAL GAIN  |           |   FULL RETURN      |       |

|   |   • Pain drops 40-60%|          |   • Tendon thickens|           |   • Barehand pulls |       |

|   |   • Motor drive restored|       |   • Parallel cables|           |   • Hook-grip deads|       |

|   |   • Safe daily loading |        |   • High stiffness |           |   • 100% capacity  |       |

|   +--------------------+            +--------------------+           +--------------------+       |

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1. Phase 1: Isometric Stabilization (Weeks 0–2) — The Analgesic Biological Reset

When an athlete presents with acute or reactive common flexor tendinopathy, jumping directly into heavy moving curls will irritate the sensitized enthesis. Tendons in a reactive state hate two things: compression against bone and high-velocity stretch-shortening cycles:

  • The Neurobiology of Isometric Analgesia: Sustained isometric contractions under heavy resistance ($70\%\text{ of Maximum Voluntary Contraction}$) trigger profound cortical analgesia. Studies by Rio and colleagues demonstrate that holding a muscle under heavy static tension for $30\text{ to }45\text{ seconds}$ stimulates intra-tendinous mechanoreceptors that fire inhibitory feedback to the spinal cord and primary motor cortex, immediately reducing resting tendon pain by $40\%\text{ to }60\%$ for several hours while extinguishing the motor unit inhibition (arthrogenic muscle inhibition) that causes weak grip strength.

  • Cellular Signaling Without Shear: During an isometric hold, the muscle-tendon unit develops high internal tensile force, but the joint angle does not change. There is zero repetitive friction of the tendon origin sliding over the medial epicondyle. This delivers a safe mechanotransductive signal to resident tenocytes, waking them up from disuse without flaring reactive pain.

2. Phase 2: Heavy Eccentric Remodeling (Weeks 2–6) — Aligning Parallel Collagen Cables

Once resting pain settles into the Green Zone (3/10), the athlete must advance to Heavy Slow Resistance (HSR) eccentric loading—the gold-standard mechanical driver of connective tissue remodeling:

  • Integrin Receptor Deformation: As established in The Dose-Response Law: Precision Loading in Physical Therapy (95 of 550 - Glossary Series) and Eccentric Loading for Chronic Tendon Recovery (105 of 550 - Glossary Series), tenocytes are encased inside an extracellular matrix. When you lower a heavy weight slowly under tension ($3\text{ to }5\text{ seconds}$), the tendon elongates by approximately $4.0\%\text{ to }4.5\%$. This mechanical strain physically stretches cell-surface integrin receptors, commanding the tenocyte nucleus to transcribe messenger RNA ($\text{mRNA}$) for procollagen Type I.

  • Neovascular Sclerosis (Closing the Pain Ingrowth): Chronic tendinopathy is packed with abnormal, fragile micro-vessels accompanied by substance P pain-sensing nerves (neovascularization). As detailed in Eccentric Contraction Biomechanics (104 of 550 - Glossary Series), the high tensile tension generated during an eccentric lowering phase physically compresses and pinches these neovessels, inducing localized ischemia that forces the abnormal vessels and their accompanying pain nerves to undergo apoptosis (cellular death)—permanently eliminating the chemical source of inner elbow pain.

3. Phase 3: Rotational Capacity & Grip Integration (Weeks 6–12+) — Rebuilding Sport Resilience

The common flexor tendon does not merely flex the wrist; it anchors the pronator teres, which governs dynamic forearm rotation and resists valgus carrying-angle forces during athletic movement:

  • The Pronation Shear Requirement: In real-world sports—whether catching a heavy barbell clean, swinging a racket, or gripping a deadlift—the elbow experiences high rotational torque. If rehabilitation stops at simple sagittal wrist curls, the athlete remains unprepared for rotational stress.

  • Asymmetric Torque and Forearm Stabilization: Using off-axis levered implements (such as a sledgehammer or an unevenly loaded dumbbell) introduces controlled eccentric pronation and supination torque. This trains the pronator teres and flexor carpi ulnaris to act as dynamic physical braces that center the elbow joint and shield the medial collateral ligament ($\text{UCL}$) from valgus tearing forces.

The Actionable Protocol: 3 Exercises to Rebuild Your Forearm

Perform these three clinical exercises in their designated phases. Use the Next-Day Pain Rule: mild discomfort of $1\text{--}3/10$ during or after the exercise is acceptable and expected, provided the tendon settles back to baseline within 24 hours.

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|               REHAB MECHANICS 3-EXERCISE GOLFER'S ELBOW RECONSTRUCTION BLUEPRINT                 |

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|                                                                                                   |

|   EXERCISE 1: OPEN-PALM STATIC BAND / DUMBBELL WRIST FLEXOR ISOMETRIC HOLD                        |

|   • Setup: Forearm supported on bench or knee, wrist resting in neutral extension over edge.      |

|   • Action: Hold heavy resistance statically with wrist cocked in neutral (zero movement).        |

|   • Prescription: 5 sets x 30–45 seconds | Rest: 60 seconds between sets | Frequency: Daily       |

|                                                                                                   |

|   EXERCISE 2: DEFICIT DUMBBELL WRIST FLEXOR ECCENTRIC LOWERING (ASSISTED RESET)                   |

|   • Setup: Forearm on bench, wrist extending off edge, holding moderate dumbbell.                 |

|   • Action: Lower dumbbell slowly over 4–5 seconds into deep extension (eccentric burn).          |

|   • Reset: Use your OPPOSITE healthy hand to lift the dumbbell back to the top (zero concentric).  |

|   • Prescription: 3–4 sets x 10–12 repetitions | Tempo: 4-0-1-0 | Frequency: 3 days/week          |

|                                                                                                   |

|   EXERCISE 3: OFF-AXIS LEVERED SLEDGEHAMMER PRONATION & SUPINATION                                |

|   • Setup: Seated, elbow at 90 degrees supported on thigh, gripping base of hammer upright.       |

|   • Action: Slowly lower hammerhead inward toward midline over 3 seconds; use glutes/hand to reset|

|   • Prescription: 3 sets x 8–10 repetitions per side | Tempo: 3-1-1-0 | Frequency: 2–3 days/week   |

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Exercise 1: Open-Palm Static Band / Dumbbell Isometric Hold (Phase 1: Weeks 0–2)

  • The Clinical Strategy: Induce immediate cortical analgesia, lower resting tendon pain, and stimulate tenocytes without provoking joint friction.

  • Execution:

    1. Sit on a bench with your forearm resting flat along your thigh or a padded box, palm facing upward, with your wrist extending just past your knee.

    2. Grasp a moderate-to-heavy dumbbell or hook your fingers through a heavy looped resistance band anchored to your foot.

    3. Pull your wrist up into slight flexion (15), then open your fingers slightly (an open-palm or hook grip) to emphasize the pronator teres and flexor carpi radialis while sparing pure finger-tip pinching.

    4. Hold this position completely still. Do not allow your wrist to sag or drop.

  • Dosage: 5 sets of $30\text{ to }45\text{ seconds}$ under heavy, challenging resistance. Rest 60 seconds between sets. Perform this daily or immediately before gym training sessions to open a temporary pain-free lifting window.

Exercise 2: Deficit Dumbbell Wrist Flexor Eccentric Lowering with Assisted Reset (Phase 2: Weeks 2–6)

  • The Clinical Strategy: Deliver calibrated $4\%$ tensile strain to the common flexor origin, driving procollagen Type I synthesis and mechanically compressing painful neovessels.

  • Execution:

  1. Position your forearm flat along a bench, holding a dumbbell that represents roughly $70\%\text{ to }80\%$ of your capacity.

  2. Start at the top: your wrist is fully curled upward into flexion.

  3. The Eccentric Drop: Slowly, over a strict 4 to 5-second count, lower the dumbbell downward over the edge of the bench, allowing your wrist to open into full extension. Feel the deep, high-tension stretch across the inner elbow.

  4. The Assisted Reset (Non-Negotiable): When you reach the bottom, do not curl the dumbbell back up using the injured arm. Take your other, healthy hand and physically lift the dumbbell back up to the top starting position. This eliminates the concentric phase entirely, allowing you to load the eccentric lowering phase with significantly heavier weight than you could curl up on your own.

  • Dosage: 3 to 4 sets of 10 to 12 repetitions. Tempo: 4-second lowering, 0-second pause at bottom, 1-second assisted reset. Frequency: 3 days per week (e.g., Monday, Wednesday, Friday), providing the mandatory 48-hour collagen remodeling window (The Dose-Response Law).

Exercise 3: Off-Axis Levered Sledgehammer Pronation & Supination (Phase 3: Weeks 6–12+)

  • The Clinical Strategy: Restore rotational capacity across the pronator teres, rebuild multi-planar forearm armor, and bridge the gap to unrestricted heavy deadlifts and chin-ups.

  • Execution:

  1. Sit tall with your elbow bent to 90 and your forearm supported comfortably on your thigh.

  2. Grasp the handle of a light sledgehammer (start with a 2-to-4-pound hammer or a dumbbell loaded with a plate on only one side) close to the head. The hammerhead points straight up toward the ceiling at a 12 o'clock position.

  3. Controlled Pronation: Slowly, over a 3-second count, allow the weight of the hammerhead to fall inward across your body toward 9 o'clock. Resist the rotational torque using the muscles on the inside of your elbow.

  4. Once your palm is facing downward (pronation), pause for 1 second, then smoothly reverse the motion back to the top. To increase difficulty as you progress, simply choke further down the handle—lengthening the external moment arm (human biomechanics and lever arms).

  • Dosage: 3 sets of 8 to 10 slow repetitions per side. Frequency: 2 to 3 days per week as an accessory finisher at the end of your upper-body training sessions.

Long-Term Prognosis: Why Consistency Beats Intensity

One of the greatest points of frustration for weightlifters recovering from golfer's elbow is expecting a tendon to heal at the same speed as skeletal muscle:

  • The Biological Timeline of Collagen: Skeletal muscle bellies are packed with rich micro-capillary networks and turnover protein within $7\text{ to }14\text{ days}$. Tendons, by contrast, are bradytrophic tissues—their baseline metabolic rate and blood supply are roughly $1/10\text{th}$ that of muscle tissue.

  • The 12-Week Minimum Remodeling Cycle: Peer-reviewed collagen turnover studies prove that synthesizing new Type I procollagen, cross-linking fibrils via lysyl oxidase, and remodeling the tensile stiffness of the common flexor origin requires a minimum of 8 to 12 weeks of consistent mechanical loading.

  • The Consistency Law: You cannot "rush" a tendon by doing 20 sets in a single day. Pushing an overloaded tendon through extreme fatigue simply spikes matrix metalloproteinases and degrades tissue. True tendon adaptation is a slow, steady accretion of daily mechanical signals: consistency beats intensity every single time. Stay committed to the 3-phase protocol, monitor your 24-hour next-day symptoms, and by month three, your elbow will possess higher structural capacity than before your injury.

Clinical Red Flags

While executing this 3-phase loading protocol restores high-level lifting for the vast majority of athletes, clinicians and lifters must remain vigilant to rule out neurological and structural emergencies:

  • Progressive Ulnar Nerve Paresthesia (Cubital Tunnel Alert): If loaded eccentric exercises or pronation drills trigger numbness, tingling, or electric shocks radiating down your inner forearm into your pinky and ring fingers (does numbness in your pinky finger mean cubital tunnel syndrome?), the ulnar nerve is compressed or subluxating across the medial epicondyle. Immediately halt deep elbow flexion loading and consult our clinical team for nerve mobilization.

  • Acute UCL Instability (The Throwing "Pop"): An audible "snap" or tearing sensation on the inside of the elbow accompanied by medial joint-line bruising, swelling, and a feeling that the elbow is unhinging inward under valgus stress, signaling a tear of the ulnar collateral ligament requiring urgent orthopedic review.

  • Next-Day Pain Exceeding 5/10 with Morning Stiffness: Pain that escalates week-over-week or wakes you from sleep, indicating that your current resistance is exceeding local tissue capacity and requires immediate dosage de-escalation (The Dose-Response Law).

Primary Source Proof (PubMed / NIH)

Extensive peer-reviewed sports medicine, tendon histology, and physical therapy literature confirm that isometric loading induces immediate cortical analgesia in tendinopathies, that eccentric and Heavy Slow Resistance training stimulates Type I collagen synthesis, and that long-term tendon remodeling requires a minimum 12-week loading cycle.

The Rehab Mechanics Corrective Protocol (Part 3 Execution)

Inside our Queen West clinic at 68 Abell Street, Part 3 of our Golfer's Elbow blueprint focuses on progressing your loading parameters, verifying force symmetry with digital dynamometry, and graduating you back to unrestricted heavy barbell lifting.

  • Step 1 — Baseline Rate-of-Force Telemetry:

  • Digital Dynamometer Testing: Measuring your peak isometric wrist flexion and forearm pronation force using handheld digital dynamometers to calculate your exact Limb Symmetry Index (LSI). We target an $\text{LSI} \ge 90\%$ before clearing you for unrestricted barehand pulling.

  • Step 2 — In-Clinic Shockwave & IMS Acceleration:

    • Acoustic Cavitation: For stubborn, fibrotic scars that have resisted loading, we apply Radial Shockwave Therapy directly over the medial epicondyle to restart stalled healing and accelerate collagen remodeling.

    • Intramuscular Reset: Utilizing clinical dry needling (IMS) over hypertonic pronator teres and flexor carpi radialis motor endplates to discharge endplate noise and restore resting tissue compliance.

  • Step 3 — Periodized Return to Unrestricted Heavy Lifting:

    • The Weaning Schedule: Systematically weaning you off lifting straps as your tendon capacity expands, transitioning from neutral-grip Swiss bars back to standard straight-bar barbell deadlifts, heavy rows, and weighted pull-ups across Toronto gyms.

Related Conditions We Treat

Related Blogs

Services Used in Treatment

FAQ Section

  • Why do isometric holds reduce inner elbow pain almost immediately? Heavy isometric holds ($30\text{--}45\text{ seconds}$) stimulate intra-tendinous mechanoreceptors that send inhibitory feedback to your spinal cord and motor cortex. This cortical analgesia reduces resting pain by $40\%\text{ to }60\%$ and removes motor unit inhibition without creating friction across the tendon.

  • Why must I use my other hand to lift the weight during eccentric wrist curls? Using your opposite hand to lift the dumbbell resets the exercise without performing a concentric contraction. This allows you to overload the eccentric lowering phase with significantly heavier resistance—stretching tenocyte integrins and compressing neovessels without straining the muscle during lifting.

  • What is the purpose of using a sledgehammer or levered weight in Phase 3? A sledgehammer places the weight far away from your hand, creating an off-axis rotational torque. This eccentrically strengthens the pronator teres and forearm stabilizers through pronation and supination, preparing your elbow for real-world sport and heavy pulling.

  • How do I know when to progress from Phase 1 to Phase 2? You are ready to advance from isometrics (Phase 1) to eccentric lowering (Phase 2) when your resting elbow pain is consistently in the Green Zone (3/10) and holding static loads produces zero next-day pain escalation.

  • Can I do these rehab exercises on the same day as my upper-body gym workouts? Yes. Perform Exercise 1 (Isometrics) before your gym workout to take advantage of its pain-relieving effect during lifts. Perform Exercise 2 (Eccentrics) and Exercise 3 (Pronation) at the very end of your workout as an accessory finisher so forearm fatigue does not interfere with heavy compound pulling.

  • Why does a tendon take a minimum of 12 weeks to fully heal? Unlike skeletal muscle, which has rich blood flow and heals in weeks, tendons have very slow metabolic turnover. Synthesizing new Type I collagen, cross-linking protein fibers, and increasing tendon stiffness requires at least 8 to 12 weeks of progressive mechanical loading.

  • What should I do if my inner elbow pain spikes to a 6/10 the morning after an exercise? If pain escalates into the Red Zone (>5/10 or morning stiffness worse than baseline), you exceeded your current tissue capacity. De-escalate your weight by $20\%$, take one day off from loading, perform gentle isometrics, and hold that weight steady before advancing.

  • What is the Rehab Mechanics approach to permanent tendon durability? We combine comprehensive movement assessments with targeted Shockwave Therapy, clinical dry needling, and a progressive 3-phase loading continuum to permanently expand your tendon's structural load capacity across Toronto.

How Physiotherapy Helps

  • Structuring a clear, evidence-based 3-phase loading protocol that guides your tendon from acute pain relief to full strength

  • Inducing immediate cortical analgesia and restoring motor unit drive using heavy isometric holds

  • Stimulating tenocyte mechanotransduction and procollagen Type I synthesis via slow eccentric lowering

  • Mechanically compressing and obliterating painful neovascular nerve ingrowth within the common flexor tendon

  • Rebuilding multi-planar rotational capacity across the pronator teres using levered off-axis implements

  • Empowering Toronto weightlifters with objective telemetry and clinical literacy so they lift heavy without fear of reinjury

CTA — Contact Us Today

Contact Us Today — All you have to lose is the pain. Stop letting golfer's elbow hold your gym splits hostage or waiting around for passive rest that never works. Book a comprehensive Full-Body Biomechanical Assessment with our clinical team today to start your 3-Phase Forearm Armor Protocol and rebuild an unbreakable foundation. Located inside the Prime Medical Centre at 68 Abell Street, Queen West (Explore our Services or browse our Physiotherapy & Sports Medicine Glossary). Email: info@rehabmechanics.com | Phone: (416) 533-3900

About the Author

Mr. Sanjay Attwala (B.Sc., M.Sc., RPT) is a Registered Physiotherapist, clinical director, and the founder of Rehab Mechanics in Toronto. With over 15 years of registered clinical practice and a deep specialization in complex musculoskeletal rehabilitation, Sanjay synthesizes rigorous international academic training with advanced evidence-based therapeutics to guide his clinical practice and patient education initiatives.

Academic Background & Credentials

Clinical Expertise & Philosophy                                 

Sanjay’s clinical approach rejects passive symptom management in favor of identifying underlying biomechanical root causes. His diverse expertise spans advanced manual therapies, personalized corrective exercise prescription, and modern physical modalities. At the Rehab Mechanics Toronto Queen West clinic, a routinely diagnoses and treats complex conditions including:

  • Spinal & Discogenic Pathology – Cervical, thoracic, and lumbar disc injuries, sciatica, and sacroiliac joint (SIJ) dysfunction.

  • Upper & Lower Extremity Injuries – Rotator cuff tears, frozen shoulder, tennis/golfer’s elbow, carpal tunnel syndrome, and complex ankle/foot pathologies.a

  • Perinatal & Pelvic Health Rehabilitation – Specialized assessment and rehabilitation protocols tailored specifically for women during pregnancy and the post-partum period, addressing pelvic girdle pain, diastasis recti, and core stabilization.

  • Specialized Rehabilitation – Pelvic health therapy, TMJ dysfunction, post-surgical rehabilitation (including Total Hip and Total Knee Replacements), and custom orthotics dispensing.

  • Shockwave Therapy: with advanced cutting edge technological devices to suit your needs.

Interdisciplinary Practice & Patient Care

Sanjay practices an integrated model of healthcare, working closely alongside medical doctors inside the Prime Medical Centre on Abell Street to streamline patient recovery pathways. He maintains a human-centric, communication-first clinical framework, ensuring that care remains fully customized rather than automated. His clinical caseload encompasses a broad operational spectrum under Ontario's regulatory frameworks, including:

  • Motor Vehicle Accident (MVA) Claims – Rehabilitation navigating Ontario’s statutory accident benefits schedule.

  • Workplace Safety and Insurance Board (WSIB) – Occupational injury management and return-to-work screening.

  • Extended Health Care (EHC) & Private Practice – Multi-tier insurance coordination and long-term athletic development plans.

Commitment to Research & Community

Outside of his clinical caseload at Rehab Mechanics and his additional practice affiliations in Etobicoke, Sanjay is an active health writer and community educator. He translates contemporary peer-reviewed medical research into accessible, actionable guidance on his professional blog. As a dedicated father and husband, he mirrors his professional advice in his personal life, focusing on structural mobility, cross-training, and longevity to help his family and his community thrive. Naturally he takes he a keen interest in rehabilitation for women who are pregnant and post-partum.

Disclaimer:

The information provided on this blog is intended for educational and informational purposes only. It does not constitute medical advice, diagnosis, or a treatment plan. Always seek the direct advice of a Registered Physiotherapist, physician, or other qualified health provider regarding any medical condition or physical rehabilitation routine.

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