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REVIVE, BOOST, REBUILD PHYSICAL THERAPY

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RBR PHYSICAL THERAPY
700 Exposition Place, #151
Raleigh, NC 27615
Telephone: (919) 848-3636
www.tmjnc.com
 

David J. Conti, DPT, NCS, CSCS is the owner of Revive, Boost, Rebuild, Physical Therapy, LLC (RBR PT), and an adjunct professor at St. Augustine’s University, in the exercise science department. He has practiced physical therapy for almost 10 years with a clinical focus on both orthopedic and neurologic patient cases.

 

In addition to being a certified strength and conditioning specialist, he is also one of only 57 PTs in NC who is board-certified in neurology. He enjoys helping patients with customized plans of care, specific to their given needs. Certified athletic trainer Carolyn Mathiot, ATC, LAT, has joined the practice and provides a wealth of clinical knowledge on identifying specific movement patterns as well as appropriate strengthening techniques to achieve functional goals.

 

RBR PT treats patients, from infants to geriatrics. RBR PT is known as an inclusive clinic and a strong community resource.

Done Right, Movement Is Therapeutic

Weight loss, physical fitness, aerobic endurance, cardiopulmonary health, disease/injury prevention, physical rehabilitation, mental health and wellbeing: whatever your personal inspiration, it should come as no surprise that movement is indeed a vital component to the achievement of that specific goal. The question, however, is to which parameters should we subscribe? There are many options regarding exercise type, intensity, frequency, duration, and progression that may leave the lay person short on answers, at risk for injury and in turn, low on motivation. While the concept of a truly “optimal” plan can be challenging if not elusive, this article should assist in the avoidance of that overwhelming feeling associated with exercise selection.

David Conti guides a client through an exercise routine.

Before learning how to choose the most appropriate plan, it may be helpful to first address some common misconceptions. There are several frequently shared philosophies that, at the very least, require some further investigation. Included among these head scratchers are some clichés like, “no pain, no gain,” “If some is good then more is better,” and “Pain is weakness leaving the body.” Consider instead the counter of “no pain, no pills” and “pain is often a warning signal to modify the approach.” Correcting some of these antiquated concepts would be a great step in the direction of improving overall health and wellness.

Beware of the Blanket Approach

Every person is an individual with a specific set of needs, conditions, circumstances, genetics, health history and goals. Each of these variables should be considered within the process of constructing an optimal exercise program. Despite what the latest exercise fads and late night infomercials may teach you, the one-size-fits-all concept is an overly simplified pipe dream. The number of patients that I’ve treated, following an ambitious yet misguided or under-informed attempt at jump-starting their physical health, is staggering. Every few months there seems to be a new discovery within the world and “business” of physical fitness. People need to be leery of a broad scope approach to exercise that claims to be optimal. It is perfectly fine to ask the question, “Optimal for whom?”

The truth is, optimal and practical rarely coexist and the line between beneficial and detrimental can be razor thin. When selecting a form of training, the “best” choice is contingent upon the aforementioned variables, including your personal goals and your current physical status.

Furthermore, if the exercise that you are attempting requires a movement pattern that you are not capable of, then it is simply not the appropriate choice for you. Every movement pattern has a set of prerequisites with respect to range of motion, flexibility, strength, and balance. If you are lacking in any of these requirements, then you will find yourself applying a compensatory strategy to complete the task. Forcing the round peg into the square hole can be dangerous and counter-productive.

Order of Operations

It is important to consider the phases of your workout. Muscle and joints respond best when warm, so preparing them via low intensity movement is key. The warm-up phase may take between 5-10 minutes and should include movement patterns that are similar to the ones that are to be used within the exercise program. These patterns promote an increase in blood flow and bring the body to a ready state, which can maximize results while minimizing injury risk.

Upon completion of the warm-up, the exercise program is initiated, with a variable duration depending on the goal. For example, strength and power programs can be relatively short compared to programs to enhance endurance and flexibility. The considerations for the overall volume and intensity are also specific to the goal, and it is also helpful to include a cool-down phase at the conclusion of an exercise program. This phase is short, lasting approximately five minutes, and is helpful in promoting an accelerated recovery and minimizing the impeding soreness that is frequently experienced.

How Much is Too Much?

Decisions on intensity, duration, and frequency should be carefully made before initiating a program. The following is a simplified way to think about these options.

If the goal is to increase cardiopulmonary or muscular endurance, then the intensity should be relatively low allowing for duration to be high. If working with weights, the resistance should not exceed 67 percent of your maximal capacity and, if performed aerobically, your heart rate should not exceed 80 percent of your age adjusted maximum. Generally, this theme includes high repetitions (>12) and short rest intervals (<30 seconds) that don’t allow the system to fully recover before initiating a subsequent set. These programs may be performed three to four times weekly.

Strength-based programs generally apply a significantly increased load of between 85-100 percent of the maximal capacity. Repetitions are much lower, with one to six being the target, while rest intervals increase considerably to allow for greater recovery before resumption. Strengthening of specific muscle groups may be performed 1-2 times weekly.
Flexibility programs are the easiest of all. The general rule to increase muscle length is to apply a low load, long duration stretch. In other words, a mild to moderate intensity stretch is held for a minimum of 15-30seconds. When performed correctly, flexibility programs can be completed daily without detriment.

In closing, exercise selection requires an honest, introspective assessment of the prerequisites that are currently possessed. It includes information regarding your health history, identification of potential prohibitive factors, and of course the selection of an overall goal to be achieved.