building atomic habits the prehab guys

Building ‘Atomic Habits’ with [P]Rehab

This article is going to be a little different than our usual format. Rather than highlighting an exercise, answering a rehab question, or breaking down complex pathology, this article is going to focus on how to build and maintain good habits. Our goal as physical therapists is almost always to change a patient’s habits in some way. Regardless of what has led a patient into physical therapy or to starting a [P]Rehab program, their goal is often to decrease pain, increase function, and reach their body’s full potential, which typically happens by a change in habits! As the new year approaches and many people consider their New Year’s Resolutions, I thought this guidance would be particularly timely.ย  Atomic Habits by James Clear is a New York Times bestseller that highlights some simple strategies to build and maintain good habits while eliminating bad ones. This article will highlight some of these strategies along with their application to fitness and rehab. We are here to discuss everything related to atomic exercise habits!


What are Atomic Habits?

One of James Clear’s first examples in his book is the story of the British cycling team who broke a 110 year drought of Tour de France losses by focusing on a strategy of โ€œthe aggregation of marginal gainsโ€ in which they looked to find ways to improve by 1% knowing that over time this would lead to a more significant increase. The strategy worked – eventually leading to five Tour de France victories in six years. The idea of an ‘atomic habit’ is that small improvements, when compounded over time, can lead to massive changes. As they note in the book, habits are the “compound interest” of self-improvement leading to a snowball effect that can either work for you, or against you.


Compounding Small Habits Over Time

compounding interest over time the prehab guys


How does this apply to [P]REHAB?

The principle of compounding interest is a crucial one, and one that I highlight for patients all the time. Take for example the patient who is recovering from an ACL reconstruction with limits in their knee flexion. At two weeks post-op, they have 30 degrees of knee flexion with the goal of reaching 140 degrees of knee flexion in the next month, or to achieve symmetry with their uninvolved side. Gaining 110 degrees of knee flexion can feel like a daunting task! It will likely hurt the patient to push them into 35 degrees of knee flexion which will lead to more stiffness and muscle guarding that may actually make them lose range of motion! So how in the world are we supposed to get them to 140 degrees!?

Well, if their knee can bend to 30 degrees comfortably, after 1 minute of knee flexion exercises it will likely bend to 31 degrees without too much pain. And if that patient works on that motion 5x throughout the day – they’ve gained 5 degrees of range of motion today! In one week of slow, consistent work toward their goal they will have gained 35 degrees of knee flexion! With consistency, they will achieve their goal of 140 degrees of knee flexion in 3.5 weeks! Therapists and patients alike – please don’t crank on yours or anybody else’s knees! Make it a habit to spend 1 minute, 5x/day and comfortably achieve your goals by using โ€œthe aggregation of marginal gainsโ€ to your advantage!


improving knee flexion after surgery the prehab guys

For many patients, the 1-3 hours a week you might spend in a physical therapy clinic will only produce meaningful change if you’re able to use the principles and education you receive to change your habits the other 23 hours/day, 7 days a week. Regardless of your injury or training level:ย  strength, range of motion, agility, balance, and weight loss, are only achieved through consistency and the best way to achieve consistency is to make it a habit!


How to form an exercise habit

One of the most profound lessons I gleaned from this book is that changing your habits is not about setting a goal and sticking to it, but about changing the way you identify yourself. This means that if you want to start exercising in the New Year, don’t set a weight loss goal for the first month, don’t say you are “trying to get in shape”, rather decide that you are someone who consistently exercises. As the author notes: “Research has shown that once a person believes in a particular aspect of their identity, they are more likely to act in alignment with that belief.”

If you identify as someone who exercises – you WILL find a way to exercise. But if you identify as someone who is trying to get in shape – you will TRY to get in shape – but you’ll likely fail.


Build Your Atomic Exercise Habits With [P]Rehab!

prehab programs the prehab guys atomic exercise habits

We have a wide variety of [P]Rehab Programs that are broken down by body region, anatomy, mobility, and specific activities! Looking to change your lifestyle habits and get into a regular routine of exercising? Our programs can help you decipher what is best for you, ultimately helping you achieve your fitness-related goals!


How to change your identity: The secret to showing up

“Whatever your identity is right now, you only believe it because you have proof of it.” is a quote that really stuck with me. As the author notes, each time you perform an action you are casting a vote for your identity. This means that if you exercise for a week straight, you will start to identify as someone who exercises regularly. If you have back pain that is limiting your function, don’t set the goal of healing your back starting January 1st. Identify as someone who takes care of their spine, act accordingly, and try to improve the function of your low back 1% a day. Changing your focus to forming a positive habit, rather than achieving a long term goal, allows you to enjoy the success of acting in accordance with your identity each day, while the compounding benefits of your hard work begin to accumulate. The paradigm shift of focusing on your identity will not only help you build a new habit, it will help you maintain that new habit through all of the ups and downs that life throws at you.


Protect Your Low Back With Atomic Movement Habits!

low back program the prehab guys atomic exercise habits

No matter how long you have suffered from back issues, it is never too late to start feeling better. We get it, we have dealt with low back issues too! The Low Back [P]Rehab Program is a physical therapist developed, step-by-step program that blends exercise science, current evidence, our clinical expertise, and our personal experiences to provide you with the ultimate solution! Learn more HERE!


Atomic Exercise Habits: Habit Stacking

Early on, when trying to establish a new habit, pairing it intimately with a habit you already have can be extremely helpful. In this regard, it helps to be really specific. Tell yourself that you will workout immediately after your morning coffee, rather than “after work”. Creating the habit of coffee: workout; coffee: workout; coffee: workout creates a level of automaticity that will cut out distractions and make working out the simplest choice. Clinically, when patients struggle to consistently perform their exercises, I have found that they have an easier time remembering when I suggest they do so while they brush their teeth. Most people brush their teeth 2x/day for about 2 minutes apiece, without much thought or effort. For most patients with Achilles tendinopathy, 4 minutes of calf exercises a day will form a habit that will start to improve their symptoms in a few weeks. Moreover, once a habit is formed and you’ve “casted enough votes” for your new identity as someone who cares about the health of your Achilles – you’ll likely start to act in accordance with this new identity and start to spend more time rehabbing that ankle!


[P]Rehab Your Achilles Tendon!

achilles prehab program atomic exercise habits the prehab guys

The Achilles [P]Rehab Program is the ultimate resource for those looking to strengthen, protect, and optimize their achilles tendon. This program is designed for active individuals looking to improve their performance that may be dealing with an Achilles weak link. With this 3-phase program, you will build up your Achilles tendon to handle anything life throws at you! Learn more HERE!


Habit Tracking: ‘Never break the chain’

Now that we have established that focusing on creating a habit is the key to long term health and fitness, let’s talk about some strategies for maintaining a habit. A habit tracker is a simple but successful way of tracking progress and increasing motivation to stick with a new habit. In its simplest form, this can simply be a calendar on your fridge with an ‘X’ through each date that you performed your exercises. This can help you maintain a habit for two primary reasons:

  • The satisfaction of checking something off your to-do list provides you with a positive reinforcement that will make you want to repeat the action.


  • The visual cue of a week or month’s worth of checked boxes will provide you with more evidence to support your new identity as someone who exercises, cares for the spine etc.


  • This provides you with motivation to “never break the chain” and to get back on track checking boxes after missing a day.


Imagine looking at a row of checked boxes without wanting to check the next box. It might seem like a silly thing, but the magnetic pull of a visual cue can make a huge difference.


The Secret of Starting Small

The final and perhaps most important lesson I learned from this book is the secret of starting small. Starting a new exercise routine, changing your diet, or finally addressing a nagging injury are ominous enough tasks on their own. When you add in the time commitment accomplishing these tasks will likely take – it can feel next to impossible! For this reason, it is crucial that you make your new habit as small of a time commitment as possible. James Clear calls this his “two-minute rule” in which no new habit should take up more than two minutes of your time. I will take this a step further and say to start with one minute. No matter how busy you are, you can always afford to spare an extra minute. And while one minute of exercise might not be enough time to address all of your health concerns, it’s enough time to establish a habit. And, as we have noted above, habits have a tendency to snowball. Once you have formed an exercise habit and you start to automatically perform your 1 minute of daily exercise, it is extremely likely that you will begin to expand this habit into a more meaningful routine.


progressive overload acute chronic workload ratios the prehab guys atomic exercise habits


Closing Thoughts On Building ‘Atomic Habits’

Creating positive sustainable habits is the key to long term improvement of your health and wellness. Some tips for creating and maintaining exercise habits include:

  • Focus on establishing a habit that is consistent with someone who cares about their long term health and fitness first, rather than striving toward a particular goal.


  • Utilize a habit tracker (or X’s on a calendar) to provide visual proof of your new identity as someone who prioritizes their exercise routine consistently


  • Utilize “habit stacking” early on to pair your new exercise habit with a prior habit such as brushing your teeth or your morning coffee.


  • Start small – begin by exercising for 1 minute each day for 2 weeks – this low barrier to entry will allow you to establish a habit without much of a time commitment and will likely lead to a snowball effect once the new habit becomes more automatic.



atomic exercise habits build atomic habits the prehab guys


This January, don’t start a New Year’s resolution that you will give up by February. Start a New Year’s habit by giving this one minute morning mobility routine a try every day after you brush your teeth. Track your progress on a calendar, “don’t break the chain”, and I am willing to bet that you’ll be doing more than one minute of exercise per day by February.

Atomic Exercise Habits: Try This Mobility Flow!


About The Novel Atomic Habits

If you would like to learn more about the novel Atomic Habits by James Clear , click on the link HERE!



  1. Clear, J. (2019). Atomic Habits An Easy and Proven Way to Build Good Habits and Break Bad Ones.


About The Author

Tommy Mandala, PT, DPT, SCS, CSCS

[P]Rehab Writer & Content Creator

tommy mandala the prehab guysTommy Mandala is currently a Doctor of Physical Therapy and Board Certified Sports Clinical Specialist in New York City. Prior to that, he completed a sports residency at the University of Delaware where he had opportunities to work with their Division I baseball team, as well as the Philadelphia 76โ€™ers NBA G-league affiliate, the Delaware Blue Coats. A former high school baseball player, this experience drove his interest in treating the throwing athlete and led him to pursue a rotation at Champion Sports Medicine in Birmingham, Alabama to learn from leading baseball researchers in the American Sports Medicine Institute. While Tommy has a special interest in throwing athletes and ACL rehab, he believes that everyone should train like an athlete. As the son of an FDNY firefighter, he also has a passion for treating the occupational athlete. One of his favorite aspects of his job is teaching patients the proper form to allow them to continue doing the things they love in spite of an injury.

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

  • Paul Grant
    Posted at 09:26h, 23 December Reply

    That article rocks. Thank you. It’s a generous and kind approach to self-discipline and re-creation all laid out with embedded guides to putting the principles into practice. I’m already acting on it, as the saying goes, when the student is ready, the teacher will appear.

    • Tommy Mandala
      Posted at 10:31h, 01 January Reply

      Thanks a lot for the comment Paul! Really happy to hear that you found some value in it! Thanks for reading!

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