When you exercise, it is not just how much you do or how hard you work which is important, but how you perform an exercise.  To put it more succinctly, exercise quality is as important (and sometimes more important) than exercise quantity.  Any exercise is designed to place physical stress on the body tissues.  By challenging the body tissues, they change (adapt) and become better able to cope with the stress.  For example, if the challenge is resistance (lifting weights, or pulling bands for example) your muscles adapt by becoming stronger.  If the challenge is cardiovascular (running or swimming for instance), your heart and lungs become more powerful.  Of course, when you work tissues you are subjecting them to stresses which they are not used to, and so if challenged too much they may break down resulting in injury.  This is why the method of performing an exercise is important.  The exercise technique, your body alignment, and the way you move throughout an action can all be important when you work out – more so when you are using a new and unfamiliar exercise, or when you are recovering from an injury.

 

How do I look?

When you perform an exercise, how do you know if you are doing it incorrectly?  Well, you can compare to others in your class or gym.  You might even be learning from a video or book at home, so you can see the ideal technique and you can compare to that.  Sounds good, but it has one fundamental flaw.  Sometimes, what you think you are doing is not what you actually are.  In our physiotherapy clinic, we often see people who lift their arm in a certain way or bend their back to a particular angle as they move without even knowing it.  What we feel our bodies doing is often quite different than the reality of a movement because we develop movement habits.  It’s a little like walking after you have sprained your ankle.  It hurts to bend your ankle forwards (dorsiflexion), so we compensate by twisting our leg and rolling over the inside of the foot.  Over time, this movement becomes a habit (habitual gait pattern) and is more familiar to us that the original correct action.  It is not until someone points out the limp, and identifies actions to correct it, that we change.  We have developed an altered movement pattern (dysfunction).

What we feel our bodies doing is often quite different than the reality of a movement

When performing an exercise, the same situation can occur.  Each time we go to the gym or attend a class and perform an action, we reinforce the technique – in other words it becomes more and more familiar and seems so ‘normal’ to us.

In a class situation the instructor may be able to identify the change in movement quality, but only if the class is small (close supervision) and only if they are focused on you at the time.  This is where a personal trainer (PT) comes in.  They will be focused on you, working with you alone (1-2-1) so will be looking at each movement you perform.  In addition, because they assess your movements and get to know you, they can often spot subtle changes before they lead to larger exercise mistakes.  Working with a personal trainer might seem expensive compared to gym membership or class fees, but it can be money well spent if it can improve your exercise technique, so you perform better or reduce the likelihood of injury.

Who’s looking at me?

If you are looking for a PT, how do you find one?  Well, many gyms and local papers advertise PT’s, but as yet the profession is not well controlled.  Your PT may have trained at a university and have a first (BSc) or second (MSc) degree – or they may have been trained by the gym itself over a couple of weekends or have attended online courses with little practical input.  Whilst paper qualifications alone do not guarantee  quality, it takes time  to learn about the human body, exercise technique, and exercise science – and time to gain experience working with clients under supervision.  Although there is no requirement for a PT to join a particular organisation the register of exercise professionals (REPS) does list those who may not have university qualifications (and many who do) at various levels.  Qualifications are listed by number representing their ‘difficulty level’ with level 3 qualifications being roughly equal  to A levels, and level 4 equal to the old HNC.  These are the most common levels seen in PT.   Level 5 is roughly a diploma or foundation degree, and level 6 a degree (BSc or BA).  Higher university qualification can also be scaled for comparison, with level 7 being a masters degree (MA, MSc) and level 8 a doctorate (PhD).

Horses for courses

If you are young, fit, and healthy you probably require more motivation than anything, but if you have suffered an injury or have a medical condition (pathology) you will require closer supervision and will probably be better with a PT who has a therapy qualification (sports therapist, or sports rehabilitator).  They will know how to teach you and give consideration to your injury or condition.  Importantly they will also know when you need more specialist input from a physiotherapist, or when you need to be referred to your GP.

So, why can’t you just work with someone who knows the gym exercises such as a partner or friend?  Well, knowing the exercise technique and being able to perform it is very different from being able to teach it.  A fundamental part of PT training is learning the principles of teaching.  Observation, programme planning, teaching technique, methods of motivation, health and safety considerations – the list goes on.  Safe to say that a professional PT or therapist is very different to a friend who simply uses the gym alongside you.

The bottom line is that you need to firstly determine what you want from a PT and then select one who can help you achieve your aims.  Your first stop should be to talk to a few PT’s and discus your needs (and concerns).  Be honest and open and they will be as well.  Selecting and working with a PT is as the names implies a personal thing.  You will develop a relationship with them and they will get to know you ‘warts ‘n all’ so find one who suits you and it will pay dividends.

Selecting and working with a PT is as the names implies a personal thing

What we offer

At the Norris Health clinic, we’ve tried to cover as many bases from the PT world as we can.  We have an onsite rehab gym, so patients generally receive a progressive rehab programme as part of their physiotherapy treatment.  With that, they will often have one or  two exercises to practice at home to maintain benefit between treatment sessions.  OK, these exercises are not supervised, but we are seeing patients regularly, so we can re-check practice, and home exercise reduces the cost of the total therapy package.  We then have onsite sports therapists who take over the rehab once the patient has been discharged from physiotherapy.  They can construct and supervise the programme on a 1-2-1 basis and liaise with the physiotherapists directly.  When the patient is discharged from  our care we have a list of PTs in the local area who we can refer to in the knowledge that the standard of care will be maintained.  For those who want to continue with us, we change from rehab to a strength and conditioning (S&C) programme which still takes into account the injury in the needs analysis (a technical term for determining what a person requires of a programme – in other words it is personalised and not simply off the shelf, one size fits all).  This set up works for us.  It provides a good treatment outcome, reduces the overall financial cost to the patient, and provides a wide patient choice.  Like to know more?  Let’s talk 01260 290564 or email info@norrishealth.co.uk