Does Exercise Rehabilitation actually work?
Have you been seeing your Podiatrist and they keep going on about exercises as part of your treatment?
Are you in pain and wondering why you’re being asked to work the sore spot more?
Or are you free from pain and wondering why you’re still being asked to complete some exercises?
Did you know that between 14-70% of clients won’t do the exercises they’re prescribed by a health professional?!?!
Yet, they’re such a key part of your treatment and recovery journey!
Let’s talk exercises and Podiatry!
What Does the Evidence Say?
Musculoskeletal conditions can be challenging to manage.
Common problems encountered throughout your recovery journey that can prevent effective treatment include overuse of medical imaging, overuse of surgery, overuse of opioids, and failure to provide appropriate education and advice.
Best Practice Guidelines for musculoskeletal injury management recommend the following:
- Care should be patient-centered and include shared decision making with effective communication between the client and the clinician.
- A physical examination should be undertaken where strength and mobility are assessed.
- Education regarding the condition and management options needs to be given.
- Management regarding physical activity/exercise should be given.
What Happens When We Get Injured?
Pain is a complex phenomenon made up of biological, psychological and social components.
Our bodies are amazing structures, able to change and adapt depending on the stressors we put on them.
Everyone has an individual ‘neurosignature’, whereby the components influencing pain are in homeostasis and we are able to go about our normal activities without pain.
When we have an injury, inflammatory, neurological and hormonal changes occur, changing our neurosignature and interrupting homeostasis.
These changes to our neurosignature include:
- Biological changes
- Tissue changes and adaptations
- Joint factors
- Social changes
- Reduced physical activity
- Strength and balance problems
- Altered movement patterns
- Psychological changes
- Fear of movement
- Perceived incapacity to return to normal activities
If we cannot return our neurosignature to homeostasis after injury, this is when pain can persist and becomes more difficult to treat.
How Does Exercise Rehabilitation Work?
The research shows us that appropriate loading applied to tissues in accordance with their tolerance capacity can have many positive effects in improving the health of the tissue.
These effects include:
- Protein synthesis (the building blocks and fuel source for many bodily tissues)
- Muscle growth
- Bone remodelling
- Collagen synthesis (the main structural component in many connective tissues)
As well as the physical effects that exercise rehabilitation can have, it also has positive psychological effects in helping you to realise what your body is capable of and that the pain is often less or more manageable than predicted.
Both the physiological and psychological benefits of exercise all help to return our neurosignature to homeostasis, leading to pain reduction, improved tissue health and getting you back to doing the things you love!
Should Exercise Rehabilitation Be Painful?
One of the biggest barriers stopping us from doing our prescribed exercises is pain and the fear of making something more painful.
But as we know, exercise has many great benefits including pain reduction!
So if an exercise you’ve been prescribed to do is painful, should you continue?
Well, the evidence shows us that pain is not actually the best indicator of tissue damage.
The evidence shows us that exercise programmes that are painful help to facilitate the re-conceptualisation of pain by addressing fear, avoidance and catastrophizing behaviours.
They are also more effective in pain management in the short term then programmes that do not elicit pain.
However, we do have to find a balance between working the tissue appropriately and keeping you comfortable.
Your podiatrist will work with you to develop an appropriate exercise program and will continue to monitor this with you.
As a rule of thumb, if the exercises you’ve been prescribed elicit some pain that is no more than a 4-5/10, and as long as the pain is settled before you’re ready to do the exercises again, then you are okay to continue.
What Can Podiatrists Do?
Here at Complete Podiatry, we complete a thorough assessment with every client, including listening to your story and your concerns, establishing your goals, and then assessing joint range and quality of movements, functional movement testing and strength testing.
This then allows us to provide you with the education you need to understand what is causing your pain, what we and you can do to help, and what to expect over your treatment journey.
We will make an individualised ‘Management Plan’ with you to guide you on your healing journey.
There are three phases to our management plans:
- Offload the damaged tissue- this is done through footwear changes, custom foot orthoses, paddings and insoles.
- Improve the health of the damaged tissue- this is done through our manual therapies such a shockwave treatment, therapeutic ultrasound, dry needling, foot mobilisation, etc.
- Make the tissue stronger- this is where an individualised exercise rehabilitation program is set addressing the deficits found during the assessment.
Through this model of care, we can ensure your damaged tissue is protected appropriately and allowed to heal while returning you to your ‘normal’ movement patterns and getting you back to doing the things you love doing.
Through ongoing review and progression of exercises, we can continue to strengthen and improve the health of the tissues over time to help prevent future injury.
All the while, this is helping to return your neurosignature back to homeostasis.
What’s important to remember is that everyone responds to injury and treatment differently and that your road to recovery is a complex one where you will have periods of more intense pain, and periods of less intense pain and this is all normal.
And while you may think that you’re not improving because you’re having pain, improvement is measured in many forms including your strength, ability to participate in your chosen activities, and your feelings/emotions regarding your pain.
As you can see, exercise rehabilitation is a HUGE part of your journey to recovery and not something to be dismissed!
We Are Here To Help
For injuries of the feet, ankles and legs, it is vitally important you seek out help from a skilled Podiatrists so they can structure an appropriate rehabilitation plan that will have you up and moving and back to the life you want to live as soon as possible.
You can book an appointment for a comprehensive assessment with one of the Podiatrists at Complete Podiatry here.
Once this is done, we will develop a structured management plan that outlines our best advice for how to effectively progress your rehabilitation and help you to return safely and pain-free to the life you love.
I'm so confident we can help with your rehabilitation that I'd love to chat with you personally, it's what I'm passionate about!
Contact us on 8330 0004 or send us a message on our website.
Yours in helping to build amazing lives from the feet up.
Podiatrist at Complete Podiatry