Why is movement in rehab of painful conditions, whether an acute injury or a persistent issue, often neglected? And why is it a powerful part in the recovery process?
This blog explains the benefits of therapeutic movement and exercise, which gives a more broader scope to exercise/ movement as a modality in recovery, inclusive to biopsychosocial factors that are rarely seen to be key drivers behind pain and restricts our approach in rehab.
Exercise has lots of benefits, often attributed to getting fitter, stronger, faster and an improved endurance, however exercise has a much deeper and powerful benefits that need to be harnesses more effectively within rehabilitation.
Exercise is a form of therapy; whether called physical therapy, exercise therapy, movement therapy. But we know that by moving, in some way shape or form, makes us feel better. Some would say movement isn’t exercise but exercise is defined as an activity carried out for a purpose. So if that purpose is to feel good then any movement that feels good is exercise. It maybe that being in an exercise environment which is social & supportive is adding to the benefits, more on this later.
Within the realm of rehabilitation this movement & therapeutic exercise will take many forms from general movement to specific strength exercises to aid the rehabilitation process. We know that if we load tissues appropriately they respond and will heal, get stronger and tolerate more load. They adapt physically. We focus on this but forget to or don’t grasp the fact we are also adapting neurologically & psychologically.
Sometimes when we are injured we can develop hypoalgesia, when we perceive pain sooner than we would before as the body is on a high alert to threat and knows that there is/was an injury even if the tissues have healed. By performing the appropriate movements and exercises, within an acceptable amount of discomfort or pain, we can train the body and mind to de-threaten movements and get the body to realise that the tissues are healing/healed and those normal signals sent to the brain that are being interpreted as pain are normal and not interpret them as pain. We slowly stop focusing our attention to an area subconsciously, turning our sensitivity to those signals back down to a normal level.
So exercise /movement has the benefits of physically getting the tissues stronger with more capacity whilst neurologically retraining the brain that the tissues are ok with these movements and no harm is coming from it.
The context that we exercise is KEY as this is where the biopsychosocial aspect comes in as the missing aspect we often neglect. We need to exercise/movement to be enjoyable, meaningful, within a familiar non-threatening environment, that’s low in stress, your comfortable in, confident in, stimulating, with appropriate support and has purpose to your goals/needs. These are just some of the factors that need to considered depending on the individual, for them to get the most from the exercise therapy & rehab. Are you using the right language, making it fun, gamifying the rehab, in a safe place, starting at their level, supporting them whilst progressing/challenging them? What are their expectations, concerns and fears of the rehab/ exercise. All of these factors are important but in differing amounts depending on the individual and situation.
It is very easy to be told to do a list of meaningless exercises by a health professional, but can we do this better? The answer is yes. Above are the missing things that can transform our rehab for an injury to chronic pain, it’s the context and tailoring of the exercise therapy to your needs so you get the best from it. Some argue these are the most important aspects to make the rehabilitation truly client centred.
If you have an injury or condition and keen on exploring exercise therapy as part of your rehabilitation, then get in touch as to take a different approach towards rehab.