Rehabilitation exercises

The exercises you take home are the part of a treatment that works when you are not in the clinic. An appointment lasts under an hour, once or twice a week at most, the other hundred-odd waking hours are where a long-standing problem either changes or does not.

That is the honest case for them, and it is why they are prescribed here rather than handed out as a leaflet.

How the exercises get chosen

From the assessment, not from a template. Two people with the same complaint can need opposite things: one needs a stiff segment to move more, the other needs an over-mobile one to be better controlled, and giving either the wrong programme makes things worse rather than slower.

What the chiropractor is deciding between:

• Mobility work, where something has stopped moving through its range
• Strength and loading work, where a structure needs to tolerate more than it currently does, which is most tendon presentations
• Motor control work, where the range and the strength are both fine but the timing and coordination are not
• Postural endurance, where the problem is not capacity but how long it can be sustained before things fatigue

Why the list is deliberately short

Rehab programmes fail on volume, not on exercise choice. A list of ten exercises is abandoned in the second week; three that fit into an existing routine get done for months.

So a first programme is usually two or three things, tied to something you already do, after the shower, while the kettle boils, before you get in the car. It grows as things progress, and it changes when the presentation does.

What you get

• A demonstration in the appointment, and you doing it back so the chiropractor can correct it. Most exercises fail because they are performed slightly wrong rather than because they were the wrong choice
• How many, how often, and for how long, specifically, rather than “a few times a day”
• What it should feel like, and what would mean stop and mention it
• When it changes, so you are not doing week-one exercises in week eight

What it is used alongside

Rehabilitation exercise is rarely the whole of a plan. It usually sits with:

• Chiropractic adjustment, where restriction needs addressing before loading makes sense
• Massage therapy for the muscular guarding around an irritated area
• Posture correction, which is the same conversation applied to the positions you hold all day rather than the ones you train

Common presentations it forms part of include lower back pain, neck pain, sciatica and plantar fasciitis, the last of which is almost entirely a loading problem, and where the exercises do more of the work than anything done in the appointment.

If you have not been doing them

Say so. It is the most useful thing you can tell a chiropractor and the thing patients are most reluctant to admit, and it changes what happens next: a programme that is not being done is a programme that needs to be shorter, easier, or attached to a different moment in the day. Nobody here is going to be annoyed about it, and pretending otherwise wastes the appointment.