The basics of exercise prescription

They say that exercise is the best medicine. Your doctor says you need more of it, that your condition and overall health will improve.

But what if you don’t know where to start?

An injury or condition might make you nervous to start exercising on your own. You could go too easy and not see any results, or go to hard and make your symptoms worse.

But you don’t need to do it alone! With an exercise prescription, you can get the guidance and coaching you need to start a safe, effective exercise program. Your path to better health starts here.

What’s involved?

After a thorough assessment to test your current abilities, strength and weaknesses, your therapist will develop a custom exercise program for you. Using a progressive application of exercise, your program will help you gradually increases your tolerance to activity. Your therapist will supervise your exercise during in-clinic sessions—providing instruction, guidance and corrections along the way—and provide a program for exercise at-home.

Your program may include stretching or flexibility routines, as well as exercises for nerve mobility, muscle strengthening, pain-relief, balance and proprioception (body awareness).

The intensity of your exercise prescription will depend on your current situation and future goals. For those recovering from surgery, the exercise may be quite light. For those with a work or sports injury who wish to regain a certain level of performance, the exercise may start easy but build up to activities like repeated heavy lifting.

Other components

Your therapist will not only prescribe what exercises to do in your program but also how to do them, with specific instructions on elements such as:

• Workload or speed
• Duration
• Frequency
• Intensity, measured through target heart rates (THR) and estimated rate of perceived exertion (RPE)
• Necessary precautions (i.e. movements to avoid, supportive equipment or devices to use, etc.)

Can exercise really help with pain?

Exercise has been shown to boost the immune system, helping you heal faster from acute injuries. For chronic conditions, exercise can help improve your pain threshold and manage symptoms.

Exercise prescription example: Shoulder rehab

If you have a shoulder injury or have developed a shoulder condition—such as rotator cuff tears, dislocations or frozen shoulder—your physiotherapist may include the pendulum or Codman exercise in your prescribed program.

This exercise copies the movement of a clock pendulum, using gravity and momentum for a passive range of motion in the joint, avoiding muscle contraction. There are different variations of this exercise that are conducted while standing, lying down and using weights. The exercise promotes healing without straining newly repaired tissue in the area.

Your physiotherapist will teach you the movements, giving specific instructions on how long and how many times to repeat each variation. They will make sure you’re doing the exercise correctly, reducing your chances of re-injury. Once you get comfortable with the movements, your therapist can provide ways to make the exercise more challenging, so you keep moving your recovery forward.

Get guidelines for shoulder rehab exercises, like the pendulum exercise.

Additional resources

Can exercise really accelerate wound healing?

For a full list of general guidelines, check out emedicine.com’s Exercise Prescription section

Read about studies that connect exercise and pain relief