As physiotherapists, the “physio” in our name can be considered to refer to physiology. This is the study of the function of the human body. According to definition we “promote, maintain, or restore health through physical examination, diagnosis, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion”.
Broadly we can achieve these aims through both passive and active interventions. Passive interventions refer to those which are performed on the patient, whereas active interventions refer to those which are performed by the patient.
Passive interventions include modalities such as dry-needling, taping, strapping, manual therapy mobilisations and tractions, electrotherapy and heat and ice packs. These are especially useful when the goal of the therapy is pain relief and in situations where the injury is in the acute stage.
Active interventions broadly include improving the core components of fitness; muscle strength, cardiovascular fitness, muscle endurance, body composition, and flexibility. With these, we may be targeting functional deficits following an injury or disease, or we may be improving overall fitness as a preventative measure against ill-health. For example, leading up to a surgery a patient will undergo “prehab” to markedly reduce the required recovery time post-surgery.
With any intervention we might employ in physiotherapy, we want you to have a body that feels fit and strong. We want you to feel capable of performing any activity required of you, be that on a sports field, at work, or generally, with your tasks around your house and garden. Building a sense of capability between you and your body is what we call self-efficacy.
Active interventions come in especially useful here as you get to witness how your body responds when demand is placed upon it. For example, when the goal is to strengthen a particular muscle group, we will gradually increase the amount of repetitions, sets, intensity or frequency at which you perform the exercise.
This means that over a period of a few weeks you will witness the muscle become stronger and be capable of handling a higher workload. This planned gradual increase in workload over time is what we call progressive overload.
When it comes to selecting exercises for you as a patient, we like to make use of shared decision making. This means we decide, with you, which exercises will be of best-fit and can be easily integrated into your lifestyle while also achieving the treatment objective. We value your input so highly because consistency is of utmost importance in long-term exercise rehabilitation.
A lot of the work we do as physios will target a specific injury, functional deficit or source of pain a patient has. However, as we all know, keeping active in general is a considerable part of leading a healthy lifestyle. There are guideline amounts of physical activity which will broadly illustrate what we should aim for. Different recommendations exist for different age ranges as follows (taken from the HSE guidelines*):
Ages 2-18: should be active at a moderate to vigorous level for at least 60 mins a day. Bone- and muscle-strengthening and flexibility work should be done three times a week.
Ages 18-64: Five days a week of moderate intensity activity (or 150 minutes a week)
Ages 65+: Five days a week of moderate intensity activity (or 150 minutes a week). Aerobic activity, muscle strengthening, and balance should be focused upon.
