Therapeutic exercise is a form of bodily movement aimed at correcting a physical impairment, restoring normal function and promoting a state of well being. It has to be tailored to meet the specific goals, capabilities and precautions relative to the client. Physiotherapists use therapeutic exercise to improve range of motion, flexibility, strength and endurance and cardiovascular health. Therapeutic exercise has been found to be helpful in cases of arthritis, low back pain, stroke, knee and shoulder injuries.
In the case of someone with a frozen shoulder or someone who has had a limb immobilised in a cast following a fracture, therapeutic exercise may be aimed at improving range of motion and flexibility. Passive range of motion is performed first by the physiotherapist during the acute stage when the patient may be still experiencing pain. It involves moving the part gently through the available range. As pain decreases, we would apply gentle stretching near the end to facilitate increased movement. We would later assist you to perform the exercise and trains you to use the unaffected limb to move the affected one. This is known as active-assisted range of motion.
With increased range of motion, we would instruct you in performing active range of motion which also improves range of motion and flexibility. Slow, measured movements without bouncing are preferred, as they are less likely to tear the tissues. Heat and ultrasound may be applied prior to exercise to loosen up the muscle and promote ease of movement.
Therapeutic exercise for strengthening can take the form of isometric contractions or resistive exercise. Isometric exercise may be indicated when there is little available range of motion, but strength needs to be maintained or increased. It involves contracting the muscles without moving the part. In resistive exercises, you may use weights, resistance bands or push against a stationary force, such as a table or wall.