"I'm not really an athlete." We hear this a lot, usually from someone apologizing as they describe a back that went out lifting a toddler or a shoulder that aches after a weekend of raking. There is an assumption underneath it: that a sports approach is for people in team jackets, and everyone else should expect something gentler, more passive, and less ambitious.
That assumption is worth taking apart, because the principles that work for a hockey player's groin strain are the same ones that work for a grandmother's knee. The sport is just the context.
What a "sports approach" actually means
Strip away the branding and a sports rehab approach comes down to a few ideas.
First, assess the whole system, not just the sore spot. Where a problem shows up is often not where it is coming from. A runner's knee pain may trace back to the hip; an office worker's neck pain may trace back to how their upper back moves. We screen movement patterns in everyone for the same reason.
Second, think in terms of load. Tissue adapts to what is asked of it. Too little and it weakens; too much too fast and it gets irritated. Most injuries, in athletes and non-athletes alike, happen when the demand on a tissue rises faster than its capacity. The sports science version of this is well established: injury risk climbs when training load spikes relative to what the body is used to.1 "No bad exercises, only too much too soon" applies just as well to the first weekend of gardening as it does to pre-season.
Third, treat the person as an active participant with a goal. In sport, the goal is obvious: return to play. For everyone else, the goal might be returning to the garden, picking up a grandchild, shovelling without dread, or finishing a shift without a headache. Those are return-to-play goals. They just do not come with a jersey.
Fourth, measure progress and adjust the plan to how the person is actually doing.
Why non-athletes are often treated differently, and why that is a problem
When someone is not labelled an athlete, the care they receive often shifts toward the passive end: rest, heat, machines, and a hands-on treatment that feels good but asks nothing of them. The unspoken message is that their body is fragile and should be protected.
The evidence runs the other way. Across high-quality clinical guidelines for musculoskeletal pain, the consistent recommendations are to educate people about their condition, keep them active, use exercise as a core treatment, and reserve passive therapies for a supporting role.2 That is true for back pain, neck pain, knee osteoarthritis, and shoulder pain, and it does not come with an age or fitness cut-off.
The Lancet series on low back pain made a similar point at a population level. The problem is not that ordinary people are being pushed too hard; it is that they are being imaged too much, medicated too much, and moved too little.3 Treating non-athletes as too delicate for progressive exercise is not caution. It tends to produce weaker tissue, more fear, and longer recovery.
We have written about this more generally in passive modalities versus active rehab, and the core argument applies regardless of who is on the table.
What it looks like for ordinary life
A few examples from the kind of people who walk into a rehab clinic in Winnipeg.
The desk worker with neck pain. The "sport" is eight hours of sitting and a commute. The load problem is sustained, low-level demand on the same tissues with very little variety. The plan looks like an athlete's: assess how the upper back and shoulders move, build capacity in the muscles that are under-used, change the loading pattern through the day, and progress.
The new parent with low back pain. The sport is lifting an unpredictable twelve-kilogram weight fifty times a day from awkward positions, on poor sleep. That is a serious training load delivered to someone who had no pre-season. The plan involves building hip and trunk strength to meet the demand, not avoiding the lifting.
The retiree with a sore knee. The sport is stairs, curling once a week, and wanting to walk the dog at Assiniboine Park without limping. Knees with arthritis respond well to progressive strengthening, and the idea that they should be rested is one of the most persistent myths in musculoskeletal care.
The first-snow shoveller. Late October or November, a few centimetres of heavy wet snow, and a body that has done no bending-and-lifting for six months. This is a textbook load spike. The approach is the same as returning an athlete to sport after a layoff: build up gradually, and treat the flare, if one happens, as a signal to progress more carefully rather than a reason to stop.
Self-management is the goal, not endless visits
Perhaps the most important feature a sports approach brings to non-athletes is the expectation of independence. An athlete is handed a program and expected to run it. The clinician's job is to design, teach, and adjust, not to deliver every repetition.
That expectation serves everyone. Guidance on back pain care increasingly places self-management at the centre, with the clinician as a coach who builds the person's confidence and skills rather than a technician who applies treatment to them.4 It leads to fewer visits, less dependence, and a person who knows what to do the next time something flares.
So if you have been putting off getting something looked at because you are "not really an athlete," you are exactly who this approach is for. You can see how we structure that across the care we offer; the assessment, the loading principles, and the goal of getting you back to your version of play are the same whether you compete or not.
Everyone has a sport. Yours might just be called Tuesday.
References
- Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med. 2016;50(5):273-280.
- Lin I, Wiles L, Waller R, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020;54(2):79-86.
- Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383.
- Kongsted A, Ris I, Kjaer P, Hartvigsen J. Self-management at the core of back pain care: 10 key points for clinicians. Braz J Phys Ther. 2021;25(4):396-406.