How to choose “best” exercise for a condition?

Being an exercise prescription specialist, I get asked questions daily around “what is the best exercise” for (insert every injury and condition under the sun). Truthfully, on a general population level there is no one “best” exercise that will “fix” your injury or condition. With so much medical information readily available at our fingertips, I find a lot of my patients, friends and family fall into a habit of going on Dr Google to assist with their injuries, not really knowing why or if the exercises are effective. Today, I am going to give you a few steps I use with my patients that I use to “funnel” exercise selection, so you end up with effective and appropriate exercises that will work long term.

Step 1:  What are the general needs?

First, you need to think about what are you trying to achieve with the exercise? Is it strength, endurance, hypertrophy, stability, proprioception, or a mix? What muscle or muscle groups are you trying to load? This will give you a very large starting selection of exercises to trial and pick from.

Step 2: What are your individual needs?

What are your goals or the goals your allied health professional has set for you? Do you have any troubles or specific tasks you want to improve? Do you need to create an adaptation? What equipment is available? This will start to filter some exercise options around types of movements you want to target and what equipment you can use to assist with this.

Step 3: What is your tolerance?

Do we need to be mindful of pre-existing injuries? Are there any abnormal movement patterns we need to correct? Are your symptoms stable? What movements exacerbate your symptoms? This will start to refine our exercise selection and we will be able to prioritise movement patterns you need help with, whilst balancing your programme with other exercises that do not increase your symptoms, to ensure targeted gradual loading without significant exacerbation of your symptoms.

Stage 4: What is your preference?

Probably the least considered in regard to evidence but most important for long term successful self-management. By this stage, you might be down to an exercise selection of about ten or so exercises. If you can provide your patient with options they enjoy and are comfortable with, your programme will be significantly more effective in the long term.

Remember, there is no one cookie-cutter programme for a condition. To make your programme as effective as possible, make sure it suits your patient’s needs, they are able to tolerate it and they enjoy it enough to continue independently long term.

Tayla O’Halloran (B.Sc. – Exercise Physiology)

Workers Compensation Specialist