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Are You Doing Your Home Exercise Program?

If you have ever been to see a physiotherapist, you were probably given a hand out with a couple of exercises for you to do at home between physiotherapy sessions, but did you actually do them?!

Studies have shown that up to 50-70% of clients DO NOT do their exercises!

Exercise is a crucial part of your physiotherapy treatment, and so neglecting it can massively affect your chances of a full recovery. Why your exercises are so important and why does your physiotherapist bother selecting the exercises, teaching you them, giving you a hand out and then ask you about them at every appointment? Keep reading to find out!

Understanding the role of your Physiotherapist

Physiotherapists are specialists in body movement and movement dysfunction. If you come to us with a pain, we will assess the painful area, as well as the surrounding areas to try and identify where the pain is coming from and most importantly – WHY.

Often the pain you are feeling may be referred pain from another structure or may be the result of a weakness or stability issue in another muscle group, leading to compensatory movement patterns. Physiotherapists aim to correct such biomechanical dysfunctions, to not only reduce your current symptoms but also prevent them from re-occurring. In order to do this, we may need to focus on increasing muscle strength in certain muscles to improve their load capacity, improve the range of movement through stretching and lengthening of muscles and improve how well certain muscles are ‘firing’ throughout a particular movement pattern. How do we achieve this? – EXERCISE!

Manual therapy V Exercise therapy

Many people believe physiotherapy is a purely manual based profession, and expect that their physiotherapist will perform only manual techniques to relieve their symptoms, which will in turn ‘fix’ their issue. Physiotherapists can perform techniques such as massage, mobilisations, manual stretching techniques, dry needling and various electrotherapies such as ultrasound or laser. Although these techniques all have their place within physiotherapy and can be very beneficial to reduce pain, assist the healing process and reduce stiffness, they are really only reducing the symptoms without tackling the why.

Therapeutic exercise prescription, in the form of a Home Exercise Program (HEP) is one of the most important aspects of physiotherapy and has the most evidence available to support its efficacy.  Physiotherapists use exercise in the same way your GP uses medication – we prescribe specific exercises with a recommended “dose” and frequency with the expectation that our clients will comply with our prescription, as they would your GP. In order to achieve a change in muscle strength/length/endurance and load capacity, a muscle needs to be loaded gradually and regularly.

Current guidelines suggest the following:

Type

Frequency

Intensity

Time/Duration

Aerobic (cardio) 5 days/ week Moderate 30 minutes
Resistance (strengthening) 2-3 days/ week 60-70% of maximum capacity or 40-50% for older adult. 8-12 repetitions for 2-4 sets with rest in between.
Flexibility (stretching) 2-3 days/ week Until feeling of tightness Hold 10-30 seconds, 2-4 times aiming for total of 60 seconds per stretch
Balance 2-3 days/ week Not yet determined 20-30 minutes

Typically you will see your physiotherapist 1-2 times per week for around 30-40 minutes, during which time we may need to re-assess, adapt exercises, teach a progression of an exercise or perform manual therapy to relieve your pain. Therefore in order to achieve any long term changes within the muscles, it is essential that clients work together with their physiotherapist and ensure they are complying with the HEP – otherwise, you may be just wasting your money and setting yourself up for re-injury!!

Take home message from this article? – DO YOUR HOME EXERCISES!

REFERENCES

1: Beinart NA, Goodchild CE, Weinman JA, Ayis S, Godfrey EL. Individual and intervention-related factors associated with adherence to home exercise in chronic low back pain: a systematic review. The Spine Journal, 2013, 13:1940–195

2: American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2014.

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