THERAPEUTIC EXERCISES

Therapeutic exercise can reduce pain and improve muscular strength, balance and range of motion.

One of the key therapies to improving low back pain has been shown to be movement. There are a lot of ideas about core exercises and low back pain, but the key seems to be applying some focused movement to your rehab.

Shoulders can have limited motion in which case we use certain exercises to help regain mobility. Shoulders are often unstable and need therapeutic exercises to retrain the muscles and nervous system to help stabilize the affected shoulder.

A key to a lot of low back and lower extremity problems are the hips. If our hips are tight they can cause the low back and sacroiliac (SI) joints to move more to make up for the loss of movement. This can lead to a host of repetitive injuries. Hips can be weak which can lead to problems in the knees when running.

SI joints can be restricted or hypermobile. If restricted we often use mobilization and manipulation therapies. However if they are hypermobile, which is often the case in chronic SI joint problems, then they need a focused stabilizing exercise program.

Sprained ankles often have ligament and proprioceptive nerve injuries. These often need help stabilizing the muscles and ligaments but also retraining the proprioceptive nerves.

Feet are often weak due to wearing shoes on hard surfaces. We can “wake up” the feet with barefoot exercises and gain a surprising amount of input, mobility and function.

The jaw (TMJ) has a large amount of nerve endings which can affect balance issues, neck tightness and painful jaw. There are certain maneuvers and exercises for the TMJ that can help TMJ syndrome problems.

The body does not develop repetitive stress syndromes or postural distortions in a single day. Thus, it takes educated, focused exercise and other therapies over the long term to help these conditions out.

One of our goals in providing exercise was to provide the adjunct of mobility, stability and strength after we worked on joint and muscle alignment. We found patients gained more benefit from their treatments, we could shorten treatment plan times from around 20 to 30 visits to 8 to 12, and patients were able to use the exercises later to help if their problem flared up.

Therapeutic exercises help patients have an active role in their own care.

There are many ways to describe physical rehabilitation including functional movement, corrective exercises, rehab exercises, e-cise, therapeutic movement, movement therapy, mechanotherapy and medicomechanical.

We have drawn on many ideas for our exercise therapy and are constantly adding to, developing new and altering previous exercises for focus on the particular patient and problem.

We have appreciated the ideas of Stuart McGill, Gray Cook, Gary Gray, Geoff Maitland, Brian Mulligan, Robin McKenzie, Vladimir Janda, Karel Lewit, Craig Liebensen, Pete Egoscue, Don Harrison, Prague school of Rehab, Ida Rolf, Ido Portal, Nick Tumminello, Kelly Starrett, Naudi Augilar, Bret Contreras, Rafe Kelley, CrossFit, MovNat, Darkside Strength, Juggernaut Training Systems, Breaking Muscle, Mark Cheng, Mike Reinold, Charlie Weingroff, Eric Cressey, Katy Bowman, Tom Myers, Jean-Pierre Barral, BKS Iyengar and many others.

Using therapeutic exercise is not new for treating multiple types of health conditions. Egypt, Greece, Rome, China, India and Japan, for example, developed different systems of movement for health benefits. Different individuals have developed other systems as time has gone on. Per Henrik Ling developed Swedish Medical Gymnastics, Joseph Pilates developed a system of physical fitness called Contrology, Rudolf von Laban developed a dance methodology, Irmgard Bartenieff advanced this dance methodology with a rehab background, BJ Palmer experimented with exercise equipment at his chiropractic school, Florence Kendall advanced physical therapy, Frederick Alexander developed posture exercises for actors and singers, Moshe Feldenkrais contributed slow controlled movement exercises, BKS Iyengar systemized yoga, Pete Egoscue developed new ideas in rehab and Vladimir Janda greatly advanced balance rehab, Karel Lewit enabled further work from manual therapy and Jack LaLanne popularized fitness.

Dr Michael Van Antwerp is a Certified Strength and Conditioning Specialist. Dr John Keefe, IV has had training in FMS and SFMA with application of therapeutic exercises.