Patient Interview

November 11, 2020

Patient Interview: Phulpreet was referred to us following a lower back injury he had obtained at work. Given Phulpreet’s pre-injury job role was quite heavy and labour intensive, I recommended he commence a gym-based program to ensure we had adequate equipment so he was able to demonstrate lifting capacity in order to return to full pre-injury duties. Phulpreet, however, was not 100% confident with attending the gym on his own given he had no previous gym experience. Fast forward to now, just five short weeks into his program, Phulpreet is averaging 4 weekly visits to the gym (one of these being supervised) and has gone from being certified fit to complete supervisory duties, to close to full capacity whilst also reporting a significant improvement in lower back symptoms.

I asked Phulpreet a few questions at our most recent consultation to understand how he (and I assume quite a few others) feel when we recommend a gym membership and they have not stepped foot in a gym before. I also wanted to address how he has gone from feeling quite anxious in a gym environment, to attending 4 times per week and more importantly how he feels as a result.

Prior to your injury, what is your exercise history?

“Absolutely nothing, it was all just work-related. I felt because I lifted heavy things at work, I did not really need to attend the gym because I was doing enough”.

What was your view around the gym prior to starting this program?

“I was nervous about what other people thought of me. Was I doing exercises with the right technique? What if I was doing it wrong?”

What did you expect when getting referred to us at Absolute Balance?

“I thought you were going to push me too hard I was going to be so sore and wouldn’t want to come back.”

2-3 sessions in, how did this change?

“Was such a big improvement, I started with mat work which was good to start and once you had taught me to breathe properly and release the tightness throughout my back my pain improved almost immediately. Because you taught me the technique, I didn’t even think about other people watching me at the gym. Because I felt so much better it made me want to come to the gym to get better.”

How has your perception around pain changed?

“Significantly, I don’t have to rely on other people for my daily activities and I’m no longer in pain throughout the day. It also helped me get my health back on track, I feel a lot better after coming here.”

What advice would you give to someone else who has been recommended to attend the gym but has no previous experience like yourself?

“Do not compare yourself and do not look at others for comparison, pay really good attention to your instructor as they are there for you to help you.”

  At our initial assessment, Phulpreet was able to lift 5kg from floor to waist and waist to shoulder, he struggled to complete full range squats or multiple cable rotations due to on-going pain throughout his back. Phulpreet’s average pain score was 6/10 following prolonged sitting or standing and was very guarded when asked to move into lumbar flexion and extension. The photos below were taken just five weeks into his program and his average pain score has decreased to an intermittent 1/10 pain.

Given Phulpreet was quite reluctant to attend the gym given the minimal prior experience, I spent additional time throughout our sessions on teaching him correct technique, how to adjust machines, gave him a few key points on what to focus on throughout each movement and tried to limit the exercises I prescribed to one area of the gym. From speaking with Phulpreet, it was these little changes that reportedly made him feel much more confident with attending the gym as he felt no one was staring at him for doing something with wrong technique or not being able to adjust the machines.

By identifying these barriers early, it ensured that I could address these and make sure there was not going to be any push back when it came to Phulpreet’s progress and compliance to the program. This has helped immensely when proving functional capacity within the gym and making sure he was comfortable within the gym environment. Phulpreet also mentioned to me at our last meeting that he was planning on continuing his gym membership even after our supervised sessions have ceased.

Please feel free to contact our team at info@absolutebalance.com.au if you have any queries regarding how best we can help.

Channai Graham (B.Sc-Ex.Sp.Sci,Post.Grad.Dip.(Clin.Ex.Phys))

Senior Accredited Exercise Physiologist (AEP) (AES) (ESSAM)

Prehabilitation in Workers Compensation: Enhancing Function, Reducing Downtime

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As the global population ages and the prevalence of musculoskeletal conditions continues to rise, the demand for orthopaedic surgeries has surged dramatically. With this increase comes a growing emphasis on not just the surgical intervention itself, but also on the preoperative phase as a critical window of opportunity to enhance patient outcomes. One of the most promising strategies emerging in this space is prehabilitation—a proactive, personalized approach to preparing patients physically and mentally for surgery. Prehabilitation can be broadly defined as a personalized exercise program designed to improve physical function and optimize recovery outcomes for any upcoming surgical intervention. In the context of workers compensation, prehabilitation offers additional value. By maintaining or even improving a patient’s physical function prior to surgery, individuals are often able to remain engaged in modified or light-duty work roles. This not only supports their psychological well-being and financial stability but also contributes to faster and more sustainable return-to-work outcomes post-surgery. A recent meta-analysis by Punnoose et al. 2023, found that a targeted prehabilitation program increased muscle strength, improved joint function and led to a higher health-related quality of life (HRQOL) scores. These findings were consistent with patients undergoing Total Knee Replacements (TKR), Total Hip Replacements (THR) and lumbar spine surgery. Some clinical applications are listed below: Targeted approach of 4-6 weeks, with 2 sessions per week. This aligns with physiological evidence suggesting that a minimum of 4–6 weeks of strength training is needed for neuromuscular adaptations. Mixture of supervised and unsupervised intervention Multimodal programs (e.g. combining exercise with education or psychological support) may enhance outcomes By improving outcomes and reducing recovery timeframes, prehabilitation stands out as a cost-effective, proactive approach to treatment.  James Chandler Workers Compensation Specialist ‑ Team Leader South (AEP, ESSAM) Exercise Rehabilitation Services – WA

How to Fit Exercise into Your Lifestyle

September 1, 2025
As Exercise Physiologists, a large part of our role is to empower an injured worker to integrate exercise into their lifestyle – something that is easier said than done for everyone! A common misconception about exercise, is that, for an effective workout, it must be a gruelling 1-hour session in a gym or a 10km stomach churning run, however this is not the case! Here are some alternatives and strategies to gradually make positive changes to your life: One easy way is to add movement to tasks you already do. Walking or biking instead of driving short distances, taking the stairs instead of the elevator, holding your newborn as you perform a few quick (and safe!) squats or completing short exercises during TV commercials are simple ways to stay active without setting aside extra time. Another is to schedule ‘mini’ workouts like any other appointment. Set aside just 20 to 30 minutes a few times a week—whether in the morning, during lunch, or in the evening. Utilising exercise equipment that we give you during our initial assessment and picking a handful of exercises that you may particularly enjoy, is a great shorter alternative. Treating these moments as important and ‘you’ time can help build a consistent habit. Exercising with others can make it more fun. Invite a friend for a walk, join a fitness class, or play a sport with family. When you combine social time with physical activity, it feels less like a task and more like enjoyment. The same goes for a sport or hobby that you may like, whether it’s swimming, yoga, hiking or dancing! Experimenting with the introduction of one of these strategies can be an easier first step to making a positive lifestyle change. With a little planning and creativity, exercise can become a natural part of your lifestyle, helping you stay healthy and energized without adding stress to your day. Alexander Gerry Workers Compensation Specialist (AEP, ESSAM) Exercise Rehabilitation Services – WA

The Beauty of a program: Couch to 5k

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If you have doom scrolled through Instagram/Facebook or YouTube recently you may have been bombarded with advertisements for a slew of different exercise programs. These all usually have something to do with what you value and target you with a preamble on how to get it, how did I shrink my waist size, how do I build muscle or how I rehabbed my knee pain. As an exercise physiologist it's my job to write these programs! Now although I don’t always enjoy interruptions to my news feed of cat videos and rugby highlights, I do actually think a lot of these programmes have merit! I love anything with a bit of structure that can help you progress yourself towards what you care about so today I wanted to write about one of my favourite programs of all time and that is the “Couch to 5km Running Programme” Why Running? I love running as an exercise choice, it gets you outdoors, it has increasing social connections via run clubs/park runs and is completely free! However, it’s hard to jump in to, I see a lot of people getting tripped up by some of the barriers that come with it. A lot of the people I see starting running don’t know about the many choices that come with exercise and in the exercise physiology business we call this the FITT principle! - Frequency – How often are you doing your running? - Intensity – How fast or slow are you running? - Time – How long should I run for? - Type – Why run over biking or rowing? A dedicated programme takes care of these for you, and I think the Couch to 5k programme does a fantastic job of introducing you to all these different ideas. Language! The first thing I love about the “Couch to 5k” is its language. The use of simple and direct language leaves a bit of room for interpretation. You can see clear above on your first Tuesday run you will run for 1 minute and walk for 1 minute. In this small interval that speed is utterly and entirely up to you. Go as slow as you like or as fast as you like however I want you to run for the entire minute! Keeping things simple is so important and this guidance is exactly where I would want you to start off as a beginner runner, have some fun and run! Progression! From week to week the running times can be seen to get bigger and bigger! Slowly but surely these intervals only increase by 1 or 2 minutes at a time. Between each session you will be able to notice small increases, but your fitness catches up with that! The whole point of a programme is that it starts small and works up, no single day itself should feel like an insurmountable workout but by the end you’re able to run a whole 5k! Rest! This program builds in rest days and rest periods so well. Each day is spaced out giving some time for you two recovers but not so much so you can get some fitness in! Within the workouts as well these intervals leave you working for the right amount of time each workout. Goals Too often when working out our goals are too big and lofty. Being able to make big changes start with small actions and goals. You can’t change yourself image in one day so I like the time frame of 6 weeks (in some programmes 6-12 weeks) because by the end we have a set definable goal of what we want to achieve, and we can really feel thar progression of fitness! Mathew Walker Exercise Physiologist Exercise Rehabilitation Services ‑ WA
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