A physiotherapist plans therapeutic exercises for an individual. These therapeutic exercises help the patients in improving their physical fitness, prevent any impairment in the body, reduce the health related risk, and make the person healthy.
The physiotherapist plans the exercises according to the condition of the patient. They start by listening to the problem of the patient, check the past and present medical history, examine the patient properly, and then make a provisional diagnosis. According to this provisional diagnosis, they plan a treatment procedure.
- Types of Therapeutic Exercises:
- Exercise – Safety and Environment:
- Which Exercises Should You Opt For:
- 1. Range of Motion Exercise:
- 2. Stretching Exercises:
- 3. Aerobic Exercises:
- 4. Balancing Exercise:
- 5. Aquatic Exercises:
- 6. Strengthening Exercises:
- 7. Breathing Exercises:
- 8. Relaxation Exercises:
- What Happens When You Stop Exercising?
- Physiotherapy for Hips:
- Physiotherapy for Neck:
- Physiotherapy for Knee Pain:
- Physiotherapy for Shoulder Pain:
Types of Therapeutic Exercises:
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Exercise – Safety and Environment:
Every exercise should be done in the presence of the physiotherapist. Physiotherapist fills an examination form having detailed history about the patient. Usually the patients are not accustomed to the physical exertion and this may lead to injury. There are medications, which can affect the patient’s balance and coordination. Hence, such patients should be over cautious while doing the exercises.
Exercises should be planned carefully for elderly patients or heart patients. Always perform exercises in the protective environment. There should be bars or walls and the physiotherapist or family members present around elderly patients or the patients with balance impairment. The equipments used during exercise should be well maintained. They should be in the proper working condition. A patient must be aware of their signs of fatigue. If the patient feels any discomfort during the exercise, they must inform their physiotherapist. They should be informed about the risks before the exercises. They should be informed about the importance of rest after the exercise. The repetitions of the exercises should be done accordingly. Gradually they should be increased.
Which Exercises Should You Opt For:
1. Range of Motion Exercise:
These exercises are performed to increase the range of motion of the joints. These help in maintaining the joint movement. There are various self assisted range of motion equipments that help to increase the range like pulley, wand, T- bar, skateboard, powder board, finger ladder, wall climbing and ball rolling.
2. Stretching Exercises:
These are performed to maintain the flexibility of the body. Stretching exercises are performed for all joints.
3. Aerobic Exercises:
There are three components of exercise program:
1. Warm – Up Phase:
Start with warm up exercises before doing for the heavy exercise. The purpose of warm up phase is to reduce the risk of injury by increasing the muscle temperature. This helps prevent arrhythmia in cardiac patients during exercise. Usually this phase is for 10-15 minutes. Go for slow walking. The heart beat must be upto 20 beats/minute of the target heart rate.
2. Aerobic Exercise Phase:
This is the conditioning part of the exercise program. This is the phase when you can increase the exercise level. This should be within the tolerance level. It should not be so hard that it evokes clinical symptoms. Certain exercises for the aerobic phases are:
a. Continuous Exercise:
In this kind of training the exercise routine is performed continuously. In a healthy individual, continuous training is the effective way to improve the endurance.
b. Interval Exercise:
In this type of training, the exercise is followed by rest interval. In a healthy individual, interval training improves strength and power.
c. Circuit Training:
It is a group of exercises which are performed without any break. These are a set of exercises, which are done one after other, and the last exercise is followed by the first exercise. It is an effective method to improve the strength and the power in individuals.
3. Cool- Down Phase:
It is necessary, to enhance the recovery period and to prevent myocardial ischemia, arrhythmias or other cardiovascular complications. The period should last 5-10 minutes.
4. Balancing Exercise:
To maintain the balance of the body. This helps in preventing falls. This includes – standing with eyes closed, standing with a narrow base of support, standing on one leg, standing on one leg with eyes closed, and exercises using wobble board with the help of a physiotherapist. Other exercises like standing with joining tip of the toe and heel.
5. Aquatic Exercises:
Exercises done in pools. They facilitate a range of motions, strengthening, stretching and induce relaxation. This minimizes the risk of injury. Certain aquatic equipments can also be used like collars, belts, rings, buoyancy belts floating belts, swimming bars, kickboards and hand paddles.
6. Strengthening Exercises:
The strength training exercises are used to strengthen the muscles. Resisted bands, weights, thera bands and tubes can help with these.
7. Breathing Exercises:
Try to get in a comfortable position. Then inhale through the nose and exhale through the mouth as if blowing the candle.
8. Relaxation Exercises:
Various exercises like deep breathing exercises, meditation, pranayama, tai chi and others help relax the body and mind.
What Happens When You Stop Exercising?
Exercising is helpful for many reasons. There are many negative effects of not exercising.
- It increases weight – this may lead to diabetes, joint pain and high cholesterol.
- Coronary heart disease
- Weakening of muscles
- Increased risk of cancer like colon, breast and prostate.
- Bones weakening- exercises helps to strengthen the bones. Exercises help to overcome osteoporosis.
Physiotherapy for Hips:
1. Stretching Exercise:
- Bring both knees towards the chest and grasp the thighs firmly until the stretch sensation is felt in the back hip region. Repeat this exercise.
- Stand with the hip extended and knee bend and grasp the ankle. Maintain the position and not let the back arch or side bend during the stretch.
2. Strengthening Exercise:
- Lift one leg to 45 degrees. Hold for 5 seconds and then down. Repeat with another leg.
- Lie on the side and lift the leg up the couch. You can bend the bottom leg. Hold for 5 seconds. Repeat on the other side.
- Try to squeeze the buttocks together. Hold for 5 seconds and release it. You can do this exercise in standing or lying position.
Physiotherapy for Neck:
- Sit in a comfortable position. Keep both hands on the forehead and press the forehead in front into the palms while not moving the head. The position of the head should be neutral.
- Sit in a comfortable position. Press one hand against the side of the head and attempt to side bend, as if trying to bring the ear towards the shoulder but not allowing the head to move. Repeat on the other side.
- Sit in comfortable position and bring both hands at the back of the head near the top of the head. Press the back of the head into both hands without moving the head.
1. Chin Tuck in Exercise:
This can be done in sitting and standing position, try to draw your chin straight back in towards the neck. Hold this position for 5 seconds and repeat it 10 times twice a day.
2. Self Stretching Exercise:
Try to touch the head to left shoulder and with the left hands try to force the head further feeling the stretch. Repeat on another side.
Physiotherapy for Knee Pain:
- Keep a towel roll under your knee and try to press the knee for 5 seconds and repeat it 10 times.
- Keep a towel roll under your heels and try to press the heel for 5 seconds and repeat it 10 times.
- Keep a towel roll in between knees and try to press the towel. Count for 5 seconds and repeat it 10 times.
- In a sitting position, try to extend the knees and hold for 5 seconds and repeat it 10 times. You can progress this by holding the knee at the different angle.
Physiotherapy for Shoulder Pain:
1. Exercises to Increase Joint Motion:
These exercises help in certain conditions like frozen shoulder or post fracture stiffness. This includes
Wand Exercises – lie on the table. Hold a bar and move the arms up.
Perform these exercises in standing position. Stand with bar. Try to move hand apart from the body.
2. Pendulum Exercise:
Standing with trunk bend at the hip 90 degrees. The arms hang loosely downwards. A pendulum trunk or swinging motion of the arm is initiated by having the patient move the trunk slightly back or forth.
3. Gear Shift Exercise:
Sitting with the involved arm at the side, holding a cane or wand with the tip resting on the floor to support the weight of the arm. The patient is instructed to move the pole forward, backward and diagonally.
4. Stretching Exercise:
- This exercise can be performed in either sitting or standing position, bring right arm close to the left shoulder and apply over pressure to right arm by pulling the arm towards the chest. Repeat with another arm.
- Stand with your back to the table, both hands grasping the edge with the fingers facing forward, try to squat while letting the elbows bend.
- Stand facing a corner or open door, with arms in a reverse T or V against the wall, lean the entire body forward from the ankles, the degree of stretch can be adjusted by the amount of forward movement.
Exercises are very important part of life. One should do regular exercises under proper guidance. Take all the safety measures. Increase the intensity of these exercises under the proper guidance of physiotherapist.