Therapeutic Exercise

Everything you need to know

Returning to normal daily routine after surgery, an accident, a fracture, dislocation, back pain, sciatica, neck pain or other health problem is a significantly precarious phase.

All these conditions even if the pain is gone leave a considerable problem which is the lack of strength, endurance, muscle atrophies and the general reduction of the physical condition of the affected person.

The need for a gradual return to professional, family, sports and social activities requires a very carefully planned exercise program.

Therapeutic exercise ensures the transition from the phase of incapacity due to the specific health problem, to the phase of reinclusion in normal life. It is the intermediate stage through which all people with a health problem, whether they have undergone surgery or not, must go through with the goal of achieving 100% of the abilities they had before their health hazard and the goals they set for themselves.

It is the bridge between pathology and health and that is why this bridge must ensure a safe and secure transition without the risk of re-injury or deterioration of the patient’s health.

What is therapeutic exercise and how does it differ from simple training?

Therapeutic exercise is training with various means such as weights, resistance bands, exercises on land or water, under the constant supervision of a specialized professional.

The training program is determined in an individualized way and is always based on the limitations that may exist when there is a health problem.

Basic differences between therapeutic exercise and that done in mass sports areas

It is aimed at people who have a history of a health problem such as back pain, neck pain (cervical syndrome), frozen shoulder, accident (fracture, dislocation, sprain), surgery (hip replacement, knee replacement, meniscal surgery, anterior cruciate ligament surgery, shoulder arthroscopy, etc.), systemic disease (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, etc.).
Due to the pre-existing pathology that often coexists with a strong fear of movement, the exercise must be completely adapted to the limitations that exist due to the pain or the possible instructions of the doctor for partial loading of the affected limb.
Before the start of the exercise there is, and is considered necessary, communication between the physical therapist and the doctor in order to determine the safety limits within which the exercise can be organized.

The physical therapist must have the ability of clinical examination to identify possible problems, both in the strength of some muscles and in the movement of some joints, in order to find the appropriate exercises that the practitioner can perform with their appropriate degree of difficulty so that the exercise improves the strength and endurance of the patient – exerciser, but on the other hand to be completely safe for him.
The physical therapist constantly supervises the patient – trainee interaction, not leaving him alone to carry out the exercises on his/her own, but corrects his technique where necessary. and If any discomfort arises, the therapist will immediately intervene to modify the exercise so as to avoid patient injury –but at the same time not to stop the practitioner’s training. Maximum security is thus provided.

What equipment is used in therapeutic exercise?

RAK or exercise cage

The RAK (exercise cage) is a very useful gym accessory used in a variety of exercises.

For example, it is used to rest rubber bands on it, rest the bar with weights, do single weights, and generally put together a program of exercises for the whole body.

θεραπευτική άσκηση: RAK - κλωβός άσκησης

Total Gym

One of the most useful exercise equipment, because body weight is used and one can do exercises with very low intensity resistance. It is suitable for patients in pain who cannot do exercises in a standing position or with weights, for people after surgery who must put on some load on their feet, or for older people with conditions such as osteoarthritis and other sports injuries.

Θεραπευτική άσκηση: Total Gym

The Total Gym is a device that ensures the transition from partial loading as we say, that is, exercising with a small load, to full loading. It is used in procedures such as meniscal removal, anterior and posterior cruciate tears, Achilles tendon rupture, Achilles tendinopathy, knee, hip arthroscopy, hip arthroplasty, knee osteoarthritis, knee arthroplasty, shoulder dislocation, shoulder tendinitis, shoulder arthroscopy, shoulder arthroplasty, cervical syndrome and low back pain or sciatica and hamstring strains and other sports injuries.

Exercise benches (plyometric boxes, Plyo box)

They are used for the trainee to sit on and do exercises with tires, weights, to support his legs and do exercises for sprains, training and improving jumps, etc.

Θεραπευτική άσκηση: Σκαμνιά εκγύμνασης

Trampoline, unstable hemispherical base, support for abdominal exercise

Trampoline and unstable hemispherical base are used to improve balance and muscle reaction speed after lower extremity injuries and operations such as sprains, muscle strains, anterior cruciate, meniscal, posterior cruciate, collateral ligament surgeries, hip and knee arthroplasties, tendinitis, sports injuries, trochanteritis, etc.

The abdominal exerciser is used to isolate and train the abdominal muscles with the aim of not straining the neck, while the exercise is aimed at the abdominals.

Τραμπολίνο, ασταθής ημισφαιρική βάση, στήριγμα για άσκηση κοιλιακών

Resistance bands

They are used in infinite combinations depending on the color which determines the hardness-resistance, the length which also modifies the resistance and the angle they are placed. It is a very flexible way of exercising as long as one knows their particularities, because their resistance increases sharply as we stretch them.

If one uses short length bands then the resistance starts very quickly when we make a movement and although the band is hard, there is a risk of pain or even injury especially if one is already in pain, has been operated recently, has a problem with a nerve resulting in weakness of the muscles, and generally if one is not at some acceptable level of fitness.

That’s why we prefer long-length and relatively low-hardness tires at the start of a rehabilitation program.

Λάστιχα αντίστασης

McGill exercises

The characteristic of the McGill exercises is the simultaneous contraction (tightening) of the abdominal and back muscles.

The philosophy of this training is based on the fact that a strong “core”, i.e. the set of muscles located around the waist (lumbar region), must be trained enough to keep the body “stable” and controlled when we need to make movements with the extremes.

It is an exercise method very useful for people who feel that their body does not support them sufficiently, that they have reduced strength in the muscles of the abdomen and back and describe that their waist feels “cut in half”, they do not have the strength to stand up when they bend down, they cannot perform some more demanding exercises that require the activation of several muscle groups together.

Here are some examples of McGill exercises:

What should you watch out for?

Very often after someone visits their doctor, a treatment with drugs or physical therapy will follow, which in many cases will lead to relief of these symptoms.

An instruction we hear given to patients very often is to swim in the sea especially in the summer, or go to the gym. Even worse, some suggest that sufferers simply look up some exercises on the internet and do them at home.

Let’s take a look at some very basic details that people should know so that they are not misinformed:

1. Bathing in the sea.

The sea and water in general is a great way to exercise under certain conditions. If someone has undergone surgery and is not allowed to put all their body weight on their leg, water exercise is very useful because it is the transition stage through which they will return to their normal activities.
If someone is unable to exercise normally due to surgery, a fracture or any other health reason, exercising in the water can help them maintain their aerobic capacity and fitness.
But we must know that because man is not a fish, exercising in water is a state of “necessity”, a transitional state, when he cannot exercise on land for health reasons. Real recovery is always done on land, with specially designed exercises for the gym, the field, or the home.

2. ‘go to the gym’

It’s an instruction we hear all too often from doctors to patients. Here there is a very important detail that must be taken into account. Gyms serve what we call the “average healthy person”, i.e. people who do not have any particular health problem or symptom.

The exercise program given is based on certain characteristics of the trainee such as age, body type, previous relationship with exercise, etc. What happens especially in mass sports venues, is that there is no possibility for the trainee to have a coach next to him all the time who will corrects and directs him to the correct way of performing the exercises. Consequently, the correct technique required is left to the experience of the practitioner and depends on how busy the gym is, the level of training of the staff etc.

Also often, the program given is not modified in an individualized way especially when the trainee has gone through some health problem and needs to return to the sports activity.

3. The internet coach – youtube

Here the problem is huge because not only is there no supervision of the trainee by a coach, but also because the trainee does not know with what criteria to choose the exercises.

It is possible that the exercises will not help with the specific strengthening required or even be inappropriate and cause aggravation or injury. The exerciser has someone to correct them when they do them at the gym or the clinic?, to modify the program if something goes wrong either because an exercise is difficult or because the exerciser is in pain, or because of a combination of factors that might make the workout dangerous.

Therapeutic exercise at Manual Physiotherapy

Manual Physiotherapy is a Physiotherapy Clinic, founded in 1999 by Physiotherapist Konstantinos Sakellariou. A space staffed by a team of scientists of various specialties and equipped with modern physical therapy and therapeutic exercise infrastructures, so that it can effectively cover the entire spectrum of rehabilitation services for musculoskeletal diseases. Kostas Sakellariou has 31 years of experience in physical therapy and 19 consecutive years of teaching in internationally recognized postgraduate specialization programs in Manual Therapy.

At the Manual Physiotherapy Center we can help substantially – either preventively or therapeutically. We all share the same vision of fully recovering our patients and returning them quickly and safely to the activities they used to do before the onset of their problem.

How may we help you? Get informed!

Take your first step towards solving the issue that concerns you in regaining your physical health and functionality.

Call us at 210.77.84.822 (Ζografou) and 216.0035521 (Glyfada) to inform you how Manual PhysioTherapy can help you, or book an appointment by filling out the appointment form!