Exercise Selection
One of the top questions I get from clients is “Which exercise should I do for ______?” The question is understandable, we all want to know what the best choice in a given circumstance would be. Exercise selection certainly affects outcomes, and the right exercise does exist, but the context of a client’s situation has a profound impact on the decision. Ultimately, it’s tricky and we need to collect data before making a choice on which exercise would be most effective.
Every client has unique circumstances and gaining an understanding of those details makes for better exercise prescription. First and foremost, the emotional aspect of the situation takes precedent. A person’s state of mind has a massive influence on physical manifestations of pain and mobility or their perceptions of their capabilities. Re-assurance and developing confidence in movement can be an effective strategy to tackle this aspect of pain.
If that is not an issue, then looking into the mechanics of their movement quality becomes a useful tool. I assess this via range of motion measures and by watching clients move themselves through space. Those data points provide a helpful guide as to what positions they can attain without overt compensations and counterproductive movements. We need these pieces of information to make better choices on which exercises to prescribe.
Once an exercise is then performed, the coaches eye becomes key. Assessing the quality of the movement and how it may or may not be the right thing to do in the current environment guides future decision making. If I prescribe an exercise after collecting the initial data points, and the client is unable to achieve the desired outcome, we can re-measure, inference what happened and develop an explanation as to why. This guides the choice for the next exercise. Every decision and piece of information informs the subsequent, and the art of coaching takes over from there.
Exercises, whether it be for fitness or rehab, contain a ton of information. The decision to perform each movement has rationale and monitoring the performance of movement provides clarity on what comes next. Providing clients with the perfect single exercise is a challenge, and sometimes impossible. We need context and sufficient detail to make the best decision we can in a given circumstance.
Austin Ulrich, Physical Therapist
