Explain

Explain purpose of exercises 

It is important to explain to the person the reason they are doing the exercises and how the exercises will help them to achieve their goals.


Explain the steps involved in the muscle strengthening program 

Explain to the person that the muscle strengthening exercises provided initially may just be the first step towards helping them to achieve their goals. 

Exercises need to be progressed until they become more functional and replicate the movements they want to perform as part of their goals.


Question

Nguyen sitting

Remember Nguyen? 

Nguyen wants to be able to be able to return to her duties as president of her local community group, which involves her being able to mobilise around a kitchen, assist making meals and being able to lift light weight. 

As Nguyen’s clinician you have provided Nguyen with some exercises for shoulder strength as part of a larger muscle strengthening program. Nguyen is not yet ready to perform functional exercises. 

Nguyen asks why she needs to do shoulder exercises when she doesn’t use her shoulders when walking, when in the kitchen or when lifting.

What would be an appropriate response to Nguyen in this scenario?

  •  a. Because although it may not seem like it, she needs shoulder strength to be able to prepare meals in the kitchen and lift things
  •  b. Demonstrate to Nguyen how shoulder movements are part of the activities that she would like to be able to do
  •  c. Explain how the shoulder exercises may be a step towards doing more functional exercises similar to the activities she wants to be able to perform
  •  d. All of the above

If you selected d, you are correct.

Either explaining or demonstrating how shoulder exercises contribute to a movement and then also explaining that the exercises are just one step towards achieving her goals.


Explain how to perform the exercises correctly and safely 

It is not possible for the clinician to be present at every session, therefore, it is important to explain to the person and caregiver how to perform the muscle strengthening exercises correctly. 


It is important to tell the person: 

  • Where they should feel the muscles working during the exercise 
  • Any common errors that can be made when performing the exercises 
  • Cues and tips to help the person and caregiver to remember the exercises and correct techniques (drawing exercises can be a good way to explain this) 
  • Ways to get immediate feedback about whether they are performing the exercises correctly, i.e. by using a mirror or window reflection 
  • To remember their safety first; exercises should be performed in a safe environment where there is no risk of falls or injury 
  • Explain to the person and caregiver when it is appropriate to seek emergency care according to the contraindications


Explain common misconceptions when performing muscle strengthening exercises 

These are some common misconceptions people may have when performing muscle strengthening exercises: 


1. That muscles need to be ‘hard’ and contracted when performing muscle strengthening exercises 

  • Muscles should be relaxed when performing exercises, encourage the person to be relaxed when performing exercises 


2. That doing more muscle strengthening exercises will make you stronger more quickly 

  • Muscles need time to recover so that they can become bigger and stronger. It is important that you do not overload muscles. Overloading muscles can lead to injury or re-injury. It is important to stick to the exercise plan when performing muscle strengthening exercises. 


3. Thinking that if you miss an exercise session, you should do double next time 

  • By doing twice as many exercises as planned, you are overloading the muscles, it is important not to overload muscles as this can lead to injury or re-injury. 


4. It is okay to push through pain 

  • Whilst it is normal to feel the muscle ‘working’ or feel fatigued when performing muscle strengthening exercises and it is also okay to experience muscle soreness afterwards, the person should not be in any pain during or after performing muscle strengthening exercises.


Explain how to adapt exercises for the home environment 

It is important to remember that the equipment you have in your clinic may not be available in the person’s home. 


Many household objects can be used to perform muscle strengthening exercises, including: 

  • Water bottles filled with water or sand 
  • Towels or sheets 
  • Kitchen bench or table top 
  • Walls 
  • Fallen branches from trees and plants