I my practice I have been utilizing exercise as an important component of treatment since 1989 when I established my rehabilitation center. In my opinion there are several key concepts that lead to long term benefit. They are based on the latest scientific evidence.
- All joints need to move freely
- Shortened muscles need to be stretched
- Strengthening of the opposing shortened muscle
- Develop the correct strength ratio between the front and back muscles
- Retrain proper recruitment patterns which are critical (for example many back pain patients when lifting will contract the hamstring muscle first, then skip the biggest muscle the gluteals and go right to the back muscles) This places much greater load on the spine and often results in continued re-injury
- Form is essential
- Balance exercises to enhance unconscious control of recruitment patterns
In review: we start with making sure all the joints are not restricted in movement, we then assess and re-pattern abnormal movement and then progress to the enhancement of stability and endurance. Finally we stress strength, power and agility training.
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