1.
Physiotherapy
Patient
Information on Exercise

2.
Objectives
• Effects and benefits of physical
activity
• Muscular types
• Effects of exercise
• Effects of pain on muscles
• Types of exercise
• Exercise prescription (How often,
how much to exercise, how to
structure)

3.
PHYSICAL ACTIVITY

4.
What do we mean by physical
activity?
• Physical activity is any
activity that is above your
normal daily activities
• I.E. taking the longer route
when walking from A to B,
gardening, walking the
dog, riding a bike, taking
the stairs instead of using
the lift.

5.
Lack of physical activity
• The lack of physical activity is costing the NHS £7.4
billion per year (Public Health England).
• 1 in 4 women & 1 in 5 men do less than 30 mins of
exercise a week
• Physical inactivity is the fourth largest cause of
disease and disability in the UK.
• > 40% women & 35% men are sitting more than 6
hours a day.

6.
Physical Activity Prevents
or Helps Manage
(World Health
Organisation, Public
Health England)
Respiratory System:
Asthma, COPD, Cystic
Fibrosis
Musculoskeletal System:
Rheumatoid Arthritis,
Osteoarthritis, Hip Fracture
(↓36-68%), Low Back Pain
(↓25%), fibromyalgia.
Endocrine System:
Diabetes (↓ 30-40%)
Mental Health: Depression,
Dementia, Schizophrenia,
Parkinson’s Disease (All ↓<30%)
Cancer: Breast (↓35%),
Colon (↓25%),
Endometrial (↓30%)
Cardiovascular System :
Stroke, Heart Attack,
Peripheral Vascular Disease,
Coronary Heart Disease, Heart
Failure (All ↓20-35%)

7.
Public Health England Guidelines
Physical
Activity
Guidelines
5-18 Years:
60 minutes of
moderate to
vigorous activity
daily.
19-64 years:
More than 150
minutes of
moderate exercise
or 75 minutes of
vigorous exercise &
2 strength training
sessions per week
64+ years:
Less than 150
minutes of
moderate exercise
or 75 minutes of
vigorous exercise &
2 strength training
sessions per week

8.
BENEFITS OF EXERCISE

9.
Different Fibre Types
• These fibres are in every muscle in the body. When a muscle contracts it
uses 2 energy sources; Adenosine triphosphate (ATP) & Oxygen
• Type 1/Slow Twitch: Use primarily oxygen, they are the smallest in size,
are slow to fatigue & slowest to contract. Individuals like long distance
runners have a high proportion of these fibres.
• Type 2a/Fast Twitch Oxidative: Use ATP & Oxygen, are medium sized
fibres and contract faster than Type 1. 400-800m & rowing athletes have a
higher proportion of these.
• Type 2b/Fast Twitch: Use ATP only, are the largest fibre types, fastest to
contract and fatigue. Athletes that run the 100m or weightlifters have a
high proportion of these.

10.
What happens when we get injured or
pain
Pain
•Impacts our proprioception
(self awareness of joint
position)
•Reduces Muscle activity
•Increases cortisol
Injury
•Stiffness
•Weakness
•Increase cortisol and
local inflammation, which
causes pain.

11.
HOW DOES EXERCISE HELP AND
WHY DO HEALTH PROFESSIONALS
GO ON ABOUT IT ?

12.
Strengthening
• Unfortunately with pain and
reduced movement you get
weaker and stiffer which can
also cause pain.
• Exercise not only improves
strength but also helps stretch
tight tissues.
• Research shows a structured
exercise program is far better
than a surgical intervention
(80% of the time) in people
with painful musculoskeletal
conditions.

13.
Mechanotransduction
• Strengthening stimulates the
muscle tissue to repair
damaged tissue (through
stimulation of fibroblasts).
• Have you heard of Wolff’s Law,
this is the stimulation of new
bone tissue when it is exposed
to increased. E.g. boxers have
up to 20% increase in bone
density in their hands.

14.
Reduces muscle pain (Myalgia)
• Certain bio-chemicals are produced as a result of
pain, swelling and reduced tissue mobility which can
irritate nerves causing pain.
• Exercising the muscle allows your body to disperse
and remove these from the muscle tissue thus
reducing pain.
• Exercise also causes the release of Endorphins (an
endogenous opiates mechanism), Endocannabinoid
(non-opiate mechanism) and Serotonin (a type of
neurotransmitters) which all reduce pain.

15.
EXERCISE PRESCRIPTION

16.
Types of Exercise
Aerobic / Cardiovascular
• This is exercise such as
running, cycling and
rowing and improve
periods of exercise that
are more than 120
seconds and require
oxygen as an energy
source.
Anaerobic / Strength
• Exercises such as weight
training, powerlifting,
weightlifting. This is
exercise that takes less
than 120 seconds and
mostly utilise an Energy
source called ATP.

17.
Basics
Endurance Hypertrophy Strength
Sets 3-4 3-4 5-8
Reps 15+ 8-12 or 20RM 3-6
Load <60% >65% >85
Rest (seconds) 60 90 120+
Rate of Perceived
Exertion
(0-10)
5/10 6-7/10 8-9/10
Days Per Week 5+ 3-5 3

18.
Additional Information
• The rest period between each set of exercise is as
important as the repetitions, so make sure you rest
for at least 1 minute.
• You need to do 2-3 sets of repetitions per exercise.
• You need to feel the exercise is causing around 5-7
out of 10 effort at the end of each set.
• Don’t feel you have to carry out the whole
movement of the exercise. Partial repetitions also
build strength.

19.
What type of exercise is best?
IT DOESN’T MATTER
Just make sure you enjoy it!

20.
How Often & How Long & How Much
• Minimum of 2 weeks
• Minimum time to take effect in the muscular
tissue is 3 months. To get long term effects of
exercise ideally need to maintain it for 18
months.
• The order that you do exercise doesn’t matter
but try to do exercises that use the most
muscles first.

21.
Conclusion
• There’s no right exercise. Do what you enjoy!
• Make sure you maintain it for at least 3
months.
• The more physically active you are the faster
you heal and recover.
• Being active helps reduce pain
• Physiotherapy is the best profession to guide
you back to being physically fit from injury
and/or long term conditions
• Think of goals you want to achieve and let
your physio know