Many clients who walk through our door will receive exercises as part of their rehab. The reason behind this varies from person to person but is largely dependent on the issue that they present with. A lot of thought and consideration goes into selecting the appropriate exercises. Compliance with rehab exercises is often an issue that we need to try and overcome to assist with recovery. By understanding more about the ‘Why’, next time you see your therapist, you will appreciate the importance of completing those home exercises.
Firstly, let’s talk about load.
Load is a pressure applied to an area of the body. Let’s discuss how this is relevant to your rehab.
The concept of controlled physical load is very important in the world of Physiotherapy and Rehab. Through controlled load we can stimulate the health of muscles, bones, tendons and joints. This type of physical load exists when tissues are put under pressure in our bodies (Yes, we are talking about the exercises your therapist gives you!). Controlled load can help with improving strength, range of motion and quality of healing tissue which in turn will, in most cases, help with pain.
Through controlled load we can stimulate cells in our body to build new and healthier tissues. Controlling the physical load applied to tissues within the body causes biochemical, biomechanical and physiological changes in only one week!
The timing of load alteration (increase or decrease) is very important, particularly with an injury. If physical stress isn’t managed it can cause permanent changes in tissues and result in ongoing pain. In other cases, it can result in faster recovery.
In some instances, we have to initially offload, or decrease the loading, on structures. This is particularly important in the case of unstable fractures. There will be a time when, in most cases, we can load the fractured area. This approach assists with stimulation of osteoblasts (bone building cells) and results in healthier and stronger bone development. Other times where reducing load might be relevant is after surgery or even when an acute injury happens.
After a period of de-loading, we have to get you gradually moving and loading again before resuming normal activity. Gradually reintroducing load through exercises will help to ensure that we don’t aggravate the issue, whilst still increasing your tissue tolerance to loading. Often, we can start at this stage straight away and get you doing functional exercises from the start. Alternately we may have to start with more focused exercises before getting to this stage. Thus, exercises are given in return to activity but the type of exercises will depend on the injured area and the types of activities you are trying to get back to. We won’t give the same exercises to an office worker who likes to bush walk as we would a teenager who plays soccer.
Sometimes exercises are given to address less than ideal movement patterns. These are exercises such as postural or positional corrections, or even stabilising exercises. We may not be directly loading the painful or problem structure but addressing a contributing factor. If we don’t address these issues you may have ongoing pain, or even be setting you up to have the same issue down the track.
In most cases, our patients will leave with exercises at some point in their journey. This is as we have carefully considered your injury/problem and the tissues involved. We know that certain tissues and injuries need to be loaded in a specific way, at an appropriate time to stimulate health, strength and movement. It is important that you follow your therapist’s advice regarding these exercises.
Our exercises are designed to help you get better, and though we may be here to help/guide, you have to put in the work to get there!
ABOUT THE AUTHOR
Renae has a Masters of Physiotherapy and a Bachelor of Exercise Science. Renae works at both our Devonport and Ulverstone clinics and her professional interests include musculoskeletal injuries (particularly sporting injuries), Clinical Pilates and hand therapy, where she completed two courses in 2019.
Renae’s personal interests include fishing, camping and cycling.