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Raising the Bar in Rehab

Posture and Exercise

Published October 18, 2012 12:10 PM by Lisa Mueller

Many times, regardless of the patient's diagnosis, I'll discuss posture during one of our treatment sessions and the impact correct posture can have in reducing pain. The problem is that once my patients hear the word "posture" roll off my tongue, they (sometimes) quickly respond by saying, "I know, I know. Sit up straight." Same thing happens when we talk about exercise. Patients have heard it before from many people, including their parents, doctors and therapists.

That's one of the challenging parts of my job -- trying to change the reputation of the word and the connotation it carries for the patient and help that person understand not only why those things are important, but also how posture and exercise can seriously improve health and well-being. I try to rewind and explain the basics. I have them stand in front of a mirror and see the differences between standing up straight versus slouched. I use force diagrams to show the increased pressure at their low back. Like any kind of education I provide during a treatment session, I try to adapt my conversation to the learning preferences of the patient. Sometimes it's effective, other times not.

Another article was released this week highlighting the benefits of exercise for patients with cancer in building up a better immune system and ultimately protecting against future cancers. Experts from the University of Nebraska Medical Center will present the preliminary results at The Interactive Biology of Exercise meeting this week. Even without reading the article or understanding the research design, it's yet another piece contributing to the long list of benefits of exercise.

When I get stressed or overwhelmed, I start prioritizing my to-do list, tackling the most important things and pushing off what I can. Exercise is usually at the bottom of the list. I've tried to make exercise more of a priority during those periods, but then I find myself running and reminding myself of all the other things I need to take care of, and before too long I feel bad about running because I should really be doing something else. Exercise seems like the most optional of my lists, although even I need to make it more of a priority. That, and drinking red wine.

How do you change your patient's opinion about exercise or posture? If a patient perceives to be "nagged" about it from multiple healthcare providers, is there a chance our education could backfire?



Good point.  It's a good idea to remind patients of all the little opportunities they have to complete their home program, even when sitting at a red light!  Thanks for sharing.

Lisa Mueller October 24, 2012 9:46 AM

I will be graduating in may with my dpt degree. During my clinical rotations I would try to establish at home rehab exercises that would fit into a patient's everyday activities if the traditional posture exercises weren't being done by my patients.

For example while patient is waiting at a stop light could do "W" scapular retraction exercises, while watching tv do "W" exercises.

If patient lacks shoulder flexion, try putting dishes away concentrating on preventing shoulder elevation.

I saw more achievement in non compliment patients when they did exercises that fit into their own busy schedule.

Michelle Sifft, Physical therapist - Student, NIU October 23, 2012 3:40 PM
Dekalb IL

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