Having adequate answers for any problem sounds so good that, without deepening much more, it already helps us to understand how difficult it is. Know what prescription of exercise is what each person needs, eliminating all uncertainty, as if we took the miraculous therapy from a … Vademécum of training is, of course, quite unrealistic.
If you have gone to a physiotherapist at some point in your life, something quite likely, almost certainly proposed an exercise table to help your rehabilitation. I bet that one of the first questions he asked you in the later sessions was that “how has I gone with the exercises?” That a professional who asks this question is already indicating that things do not always work as they are planned to do.
I write these lines in the category of ‘Expert Patient’ Since twenty -eight years ago I had a serious knee injury (the famous triad) and accumulate many hours of consultations, tests, rehabilitation, discomfort, pain, good days, bad days and a long etcetera. When someone passes through a small ordeal of this type it is normal for other people in the same situation to ask you ‘What exercises did you do?’, ‘Is it normal to continue hurting me?’, To name two of the most classic and reasonable doubts that anyone can have.
The treatment of any physical condition implies a relative measure of the result obtained based on a real person, with different needs and functions. The rehabilitation of a knee to return to be a world of ski champion is valued and addressed in a completely different way from that of someone who simply wants to walk or go up and down stairs without anything.
In my experience, rehabilitation and prescribed exercise has been more an adaptive situation, which is progressively perfected, than a prescriptive simply established at the beginning. We add things, remove things and adapt things in an iterative process as we measure the answer in the chosen results. The intensity, frequency and type of exercises can be adjusted according to the person, their desired needs and results. In my humble opinion, feeling comfortable with that is key to ending up being successful because you have to be open to script and course changes to continue progress.
You may change your mind about what the problem is or what is coming well, as you advance in your Test process and personal error. The initial intervention and its parameters are just a beginning, a test to see what happens next, but this often does not take into account because we believe that if a doctor or a therapist says it is because there is an absolute certainty that the following will be B. That is not so.
Even the exercise designed for high performance is becoming less prescriptive. It has already been shown that physical adaptations can occur from a lot of ranges of repetitions and loads. Effort and intensity seem to be key to physical adaptations, these parameters are rarely measured in rehabilitation research.
It is a joint learning process
From my point of view, the therapist – patient relationship should understand this trip as a learning process, instead of a failure or a reflection of not knowing what to do. The idea that there are successful responses or actions in advance is often harmful, since it can undermine the confidence in the therapist’s ability or the coach and create expectations that are different from reality.
The data collected in research can sometimes be used as an uncool tool, as the clinical experience can also do, of course. It can be assumed that the specific condition of each individual, the treatment and effect of the treatment will all be consistent with what is written in an article. But if we observe more closely the presentation of the data, it also has its own estimate of the variability, so perhaps we can only know how it affects in each case after the application and not before.
Unfortunately, it is much more attractive to proclaim the four winds that a treatment works, and if you do it in record time and effortlessly, let’s go. It is the key to any salehumos full of followers on social networks. Bias and polarization are the kings of the Mambo today.
In my opinion, the great therapist or the great coach is not the one with the best recipe or the best plan, but the one who knows what to do when things do not come out as planned. Someone who can adapt and adjust accordingly to the situations and people he treats.
#prescription #exercise #adequate
