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Musculoskeletal Problems & Exercise

Margarita Gurevich

Is physical exercise effective when it comes to the treatment and management of musculoskeletal problems? The answer is very straightforward – most definitely.

As physiotherapists we see patients with a wide range of musculoskeletal problems, such as:

• back, neck and joint pain
• cervicogenic headaches (headaches that occur as a result of neck problems)
• scoliosis
• arthritis
• fibromyalgia
• sports injuries
• other related injuries

How, though, does exercise help? Is it always safe to exercise? Are there other treatment options which might sometimes be required besides or instead of exercise? We will consider the answers to these questions in this article.

Question #1

Why is exercise so effective when it comes to musculoskeletal conditions?

The main reason is that exercise helps to strengthen the relevant muscles which are required to improve the particular condition. For instance:

• Strong core and postural muscles are very important for scoliosis
• Strong buttock and hip muscles are required for hip osteoarthritis

Overall having strong muscles helps to speed up the recovery and reduce the likelihood of future flare ups.

Also exercise helps to release the ‘feel good’ hormones – endorphins and opiates which boost the mood. This, in turn, also helps to speed up the recovery as the patient is more likely to stick to the treatment plan and be an active participant in their recovery process.

Question #2

Is it always safe to exercise and are there instances when other treatments are more effective at certain stages of the recovery?

While the prescribed treatment varies depending on which kind of problem the patient presents with, one thing remains unchanged; exercise is the only long-term solution for most pathologies. Why is this so? Simply put, most treatments which we do as physiotherapists have a short-term effect and their main purpose is to reduce the intensity of the presenting symptoms so that the person can begin to exercise without exacerbating their condition.

For example, when a patient has had a flare up of his/her knee osteoarthritis and now has significant pain and inflammation in the knee. As a result, the patient cannot bend/straighten their knee without aggravating the pain. We know that it’s important for the patient to strengthen the muscles which support and stabilize the knees. Squats would be very effective at this.

Would it be wise, however, to encourage the patient to start doing this exercise? Not at the moment. The first step would be to reduce the pain and inflammation. Several physiotherapy treatment methods, such as electrotherapy, ultrasound, SCENAR therapy and others could be highly effective during this stage. Once the symptoms are under control the focus should shift away from these hands-on treatments towards exercises done either independently at home or under the supervision of physiotherapists, such as hydrotherapy and Clinical Pilates.

Another important consideration is that while it might not be safe to do some exercises, this does not mean that you shouldn’t do any exercise. Going back to the above example, while it wouldn’t be appropriate do perform squats as this would exacerbate the condition, it would still be important to do exercises to strengthen the muscles of the legs and specifically the knees. The same is true for other musculoskeletal conditions.

Your physiotherapist would be able to give you the appropriate exercises following a thorough assessment. This would ensure that you will be doing exercises which will not aggravate your condition, and which will help to speed up the recovery as well as reduce the likelihood of future flare ups.