“What Exercise is Good for…”

As a Physiotherapist, one of the most common questions I am asked by family, friends, and neighbors during casual conversations is what exercises are good for whatever is ailing them at that moment. For example, “I have low back pain. What exercises should I do for it?” or “My doctor says I have arthritis in my knee, what exercises should I be doing?”

I understand the reasoning behind the question. Since exercise and movement are often the solutions to many joint and muscle problems, it is reasonable that there should be common exercises prescribed for common conditions. However, asking this question would be similar to asking my car mechanic this: “I have a problem with my engine. What parts and service are necessary to fix it?” Or if I were to ask a chef, “I would like to make a great dinner. What ingredients do I need to do so?” In other words, the questions are too broad and to answer them well, more specifics and details would be required. A good mechanic should ask me several questions about how my engine is behaving, what kind of problem am I noticing and the location of the problem and then he would at the very least, start my engine and perhaps take it for a test drive. He would then have to open the hood or crawl under my vehicle to perform an inspection. In the same way, the noted chef would ask me what kinds of foods I would like to eat, for what occasion am I cooking and for how many people, if I had any cultural preferences or food allergies. The list of questions would go on and on until we can arrive at a mutual decision.

The same then goes for low back pain or knee arthritis or shoulder pain. Whenever a patient arrives for an assessment, a thorough history is required. Where is the problem? When did it start? How did it start? What makes the symptoms better and what makes it worst? Does the patient have other health conditions? What kind of treatments have been tried and failed? What medications and tests have been prescribed? These are some of the common questions that have to be asked and most clinical impressions or diagnoses can be determined from a good history alone.

After a thorough history, a physical examination is then performed which may support, negate or refine the impression generated from the history. If there have been radiological tests done, then these are reviewed as well. After all this information gathering, a working diagnosis can then be generated and a treatment plan can be created and discussed with you, the patient. Once a consent for treatment is received, the treatment can then proceed.

As you can see, the assessment of any health problem or condition needs to be thorough, detailed, and analytical. The determination of a working diagnosis can be a complicated process and oftentimes in the treatment of any health condition, a proper diagnosis is confirmed depending on the success or failure of the treatment. In other words, if the mechanic replaces the timing belt on your vehicle and if it cures the problem, then the problem was with the timing belt. However, if it does not resolve the problem, then the original working diagnosis of a poor timing belt was not correct. If such a problem solving approach needs to be done with machines, human beings are infinitely more complex and challenging!

Lastly, of course, the success of any treatment in human beings unlike machines takes time, patience and effort. Cures in medicine are rare and it is the same with rehabilitation. Fractured bones take weeks to heal, muscles take months to strengthen and the achievement of any skilled movement takes years of practice. Patience, persistence and perseverance are the keys to any successful endeavour of the human body but for those who endure, they will often be rewarded.

Submitted by Albert Chan and Karen Chan

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