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May 2018

“How much do I have to do my home exercises?”

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“How much do I have to do my home exercises?”
by Mike Klobucher, DPT, FAFS

This might be one of the most common questions we hear on a daily basis as physical therapists, and it is undoubtedly an important question to answer. It is important because we most effectively make lasting changes in our bodies through repeated movement. The body responding to this cumulative stimulus is what allows us to get stronger, become less sensitive (i.e. painful), improve flexibility, and refine our movement patterns. It would be lovely if a therapist could lay their hands on you and produce these same outcomes, but unfortunately, that simply isn’t the truth. Now, manual therapy (i.e. hands-on treatment) certainly has a large role in most of our treatment strategies at i’move, but it is typically in an effort to help the patient be more successful with what they ultimately do to change their situation…that being exercise. So, if exercise or movement training is important, how much do you we have to do to reach our goals? Three sets of ten reps sound familiar? How about three sets of nine or eleven reps? Why not eight sets of five or one set of fifty? The most honest answer to this conundrum is: we don’t know for sure. Now that you have ultimate confidence in us, let’s explore a few things surrounding this issue.

First, we can’t know for sure at the outset because it depends what the goal is. If it’s increased power or strength, you’re probably looking at lower reps and higher loads. If it’s increased endurance, you’re probably looking at higher reps and lower loads. If it’s more mobility you’re after, it’s probably going to take even more repetition. And if it’s changing, refining, or improving a certain movement pattern, research would suggest it’s probably going to take thousands, if not tens or hundreds of thousands of reps.

Second, there is plenty of evidence now that no two people will respond exactly the same to any particular exercise regimen. Therefore, the individual and all that makes them unique is going to play a role in determining the right amount of exercise including their personal schedule, pain sensitivity, current fitness level, and past experiences. We prioritize the individual , not a protocol.

Finally, we are usually seeing people in pain, and this needs to be taken into account as well when determining what the right amount of exercise is. It is important to “poke the bear,” so to speak, but crucial not to make it too angry. For example, we don’t consider it effective if someone recovering from an injury grits their teeth to finish their arbitrary three sets of ten but cannot walk normally for the rest of day due to increased pain. Is that effective exercise?

In the end, at i’move we use the general principles that have been researched regarding exercise volume but then really aim to come alongside the individual to test and experiment to find unique strategies that help you reach your functional goals without entering the pain cave. We are patient and committed to taking this journey with you because your goals are our goals, and no one, including us, can honestly say they know the right amount of exercise for you without investing in you and experimenting to find success. We abide in one-on-one individualized care because we believe that only by making this effort can one really discover their movement potential.

Ask a Physical Therapist To “Screen” Your Movements This Spring

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Ask a Physical Therapist To “Screen” Your Movements This Spring

Let’s talk about the last time you—or someone close to you—interviewed for a new job. Chances are that the first step was a phone screen with your potential employer, and when you passed that portion of the process with flying colors, you were then invited for an in-person interview. At that stage, the employer probably asked you to answer a series of questions and to demonstrate your skills through a test or two. The process is set up in a way that narrows down the options until the most suitable candidate is found. Makes sense, right?

Just as job recruiters screen applicants to find the best fit for an open position, your PT will ask you to perform a series of exercises so that she can observe and understand your body mechanics to uncover any issues or limitations. Used in combination with a full evaluation and assessment, these so-called movement screens are just one tool in identifying the most appropriate treatment or prevention program for you. But unlike that test you may have taken during a job interview, the screen is not testing your skills or abilities, it’s simply a way of identifying how your body functions during a variety of movements.

Now that spring is in full swing, it’s the perfect time of year to make an appointment with your physical therapist for a movement screen. The warmer weather means more time spent outdoors participating in sports and other recreational activities that may be physically demanding. A PT checkup that includes a movement screen will ensure that you’re physically able to engage in popular spring and summer adventures, whether it’s exploring in the woods, tending to your garden, or swimming at your family’s lake house.

Physical therapists perform movement screens for a variety of reasons, including:

• To identify areas of strength and weakness
• To uncover issues or rule them out
• To determine readiness to begin a safe exercise program
• To improve sport performance (for both novice and elite athletes)

A movement screen is something that you can have done whether you have a nagging injury or are simply ready to kickstart your activity level after a long hiatus. Gaining an understanding of how your body performs during basic exercises such as squats and lunges helps your PT ensure that you can safely jump on a bike or into a pool this summer. And just like an employer screens candidates to identify the one individual who is likely to thrive on the job for many years to come, a movement screen can help you develop a lasting and fulfilling relationship with the activities you enjoy most.