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)

June 19, 2025
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
June 13, 2025
When it comes to exercise, most people focus on warming up or pushing through the workout itself, but what often gets overlooked is the warm-down which is a period of gentle movement and stretching after your main workout. Though it may feel tempting to skip it, a proper warm-down is crucial for both your physical health and your mental well-being. Here is why this final phase of your workout deserves just as much attention as everything that comes before it: 1. Helps Prevent Injury One of the most important physical benefits of a warm-down is injury prevention (Witvrouw, et al., 2004). After intense activity, your muscles are warm, flexible, and more prone to strain if you suddenly stop moving (Witvrouw, et al., 2004). Gradually slowing down your heart rate and stretching your muscles helps release tension and reduce muscle stiffness, which can significantly lower the risk of cramps, strains, and post-workout soreness (Witvrouw, et al., 2004). 2. Promotes Better Circulation During exercise, your heart rate and blood pressure increases to support your body’s physical demands (Alter, 1998). If you stop abruptly, blood can pool in your limbs, leading to dizziness or even fainting. A warm-down helps maintain healthy blood flow by gradually lowering your heart rate and allowing your body to transition smoothly back to a resting state (Alter, 1998). This improves circulation and helps the body clear out metabolic waste products like lactic acid (Alter, 1998). 3. Supports Mental Clarity and Stress Relief Exercise is a proven mood booster, and warming down can enhance these benefits. Taking time to breathe deeply and reflect during your warm-down allows your nervous system to shift from the high-energy "fight or flight" mode into the calmer "rest and digest" state (Van Hooren & Peake, 2018). This shift reduces stress hormones like cortisol and helps improve mental clarity, calmness, and emotional balance (Van Hooren & Peake, 2018). 4. Enhances Flexibility and Recovery Including dynamic and static stretches during your warm-down helps maintain or even improve flexibility over time (Alter, 1998; Witvrouw, et al., 2004). Muscles are more pliable after a workout, making this the perfect time to gently lengthen and release them (Alter, 1998; Witvrouw, et al., 2004). This not only reduces soreness in the days following exercise but also supports quicker recovery and better performance in future workouts (Alter, 1998; Witvrouw, et al., 2004). 5. Reinforces Healthy Mind-Body Connection Warming down creates a moment of mindfulness—a chance to tune into how your body feels after movement (Van Hooren & Peake, 2018). This reinforces a healthy relationship with exercise that is about more than burning calories or hitting performance goals (Van Hooren & Peake, 2018). It is a time to appreciate what your body can do and to give it the care it deserves (Van Hooren & Peake, 2018). This shift in perspective can be especially helpful in maintaining long-term motivation and preventing burnout (Van Hooren & Peake, 2018). Conclusion A warm-down might seem like a small part of your workout, but its benefits for your physical and mental well-being are significant. From preventing injury and aiding recovery to promoting mental clarity and deepening your connection with your body, those extra 5–10 minutes are well worth your time. So next time you finish a run, gym session, or yoga class, do not rush off, take a couple minutes to wind down. Your body and mind will thank you for it. References: Witvrouw, E., Mahieu, N., Danneels, L., & McNair, P. (2004). Stretching and injury prevention: an obscure relationship. Sports medicine, 34, 443-449. Alter, M. J. (1998). Sport stretch. Human Kinetics. Van Hooren, B., & Peake, J. M. (2018). Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries, and the long-term adaptive response. Sports Medicine, 48(7), 1575-1595.
May 23, 2025
Each year, more than 53,000 knee replacements are performed in Australia, with that number steadily increasing. It's predicted that by the year 2030, this number will rise to over 150,000. Unfortunately, genetics play a significant role in whether you will develop osteoarthritis and require a knee replacement. However, there are several proactive steps you can take to reduce your risk. Weight Management Maintaining a healthy weight is important for reducing the risk of knee osteoarthritis. Excess weight puts additional stress on your knees, increasing the risk of developing osteoarthritis. Live an Active Lifestyle Engaging in a variety of exercises, including both strength training and aerobic activities, is essential for maintaining healthy knees. Strength training helps build muscle around the knee, providing better support and reducing the strain on the joint. Aerobic exercises, such as walking, swimming, and cycling, improve cardiovascular health and promote overall physical fitness. A well-rounded exercise routine can help reduce the risk of injury and osteoarthritis. Avoid Repetitive Knee Injuries Preventing knee injuries is another key factor in reducing the risk of needing a knee replacement. It’s been shown that people who have had multiple knee injuries and or surgeries are more likely to develop knee osteoarthritis later in life.  Brody Kilbey Workers Compensation Specialist (AEP, ESSAM) Exercise Rehabilitation Services – WA
More Posts