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These are of various kinds in which the patient takes over, following the therapist’s instructions, in trying to mobilise joints and strengthen muscles.

The type of exercise prescribed depends on the patient’s condition, on how long the patient has been out of action and on how fit the patient needs to be to return to normal life. What is suitable for one patient is not necessarily right for another.

If any exercise causes pain it may be aggravating the condition, so tell the physiotherapist when you find a movement painful. The exercise may have to be adjusted accordingly.

Some exercises are designed to strengthen and mobilise the spine when it is extended. Others strengthen the abdominal muscles; sideways bending and rotation (twisting) help to mobilise the spine. To do this, the therapist may provide manual or other resistance to particular movements.

Spinal exercises in a hydrotherapy pool in warm water, allow movements with gravity eliminated.

Some physiotherapy departments adopt the ‘back school’ approach in which exercises are carried out in groups. Classes with others help to raise morale and individuals can encourage and support each other. The competition often has a stimulating effect. Physiotherapists try to ensure that exercises match the age and needs of the individual.

If you have been taught to do the exercises and are expected to do them at home, make sure that you do them. Do them regularly and carefully, and for short periods at a time – if you have forgotten to do your morning session, do not do twice as much in the evening to catch up! Doing your exercises to music or while listening to a regular radio program may help to remind and motivate you. If rest is suggested during or after a set of exercises, this is important and should not be skimped.

Isometric exercises-It is possible to contract the muscles very strongly but not move the joints at all; this happens in arm wrestling. This muscle action is called isometric exercise. The method has a particular benefit for back pain. Where inflammation of joints makes moving them painful, a special range of isometric exercises can be used which strengthen the muscles by bracing them without moving joints.


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