By Rob Stanborough ~PT, DPT, MHSc, MTC, CMTPT, FAAOMPT ~ First Coast Rehabilitation
One of the interventions we use at First Coast Rehabilitation is functional exercise.
We use functional exercise because of the way the body learns, which is in patterns, patterns that can develop your whole life.
There are lots of different ways to exercise. You can exercise for endurance, strength, to promote healing, or even increase mobility or flexibility. Each type includes specific guidelines and parameters used to achieve optional performance and maximum benefit. But if your goal is to improve your function, i.e. ability to perform a specific activity such as running, standing from a chair, picking something up from the floor, walking for half a day while sight seeing or carrying your child, you should work toward doing that task. It sounds simple enough, but it may not.
Functional exercise is built on a neurological and physiological principle called training specificity. If you want to be a good golfer – play golf, not tennis (you can play tennis too, but you should golf). If you want to be able to play pickleball, then play pickleball.
Again, it sounds simple enough but sometimes executing the activity or a portion thereof may be hindered due to injury, poor conditioning, or some other factor.
At First Coast Rehabilitation, we often will break the function, or activity down to its most basic components in order to initiate extremely specific and isolated exercises with the goal of putting it all back together again into a functional exercise.
Again, it seems like common sense and simple enough, but dissecting the function into isolated movements before putting it back together again can be done in many different ways. Nevertheless, the goal should be to ultimately perform the function.
A high level activity example could be surfing, which requires core stabilization, and balance, as well as lower and upper body strength. The activity could be broken down in many ways, but core stabilization would most likely be a good place to start. Exercises may include rotation or diagonal strengthening, progressing to multidirectional perturbations (challenging forces from outside the body) to standing on a mobile surface mimicking surfing.
A lower level, everyday activity example could be reaching to pick something up from the floor. This also includes core stability, ankle, knee and hip mobility and strength, as well as balance. Like the example above, this could be broken down in many ways, but hip and core strength would be a good place to start. Exercises may include reaching forward from a chair and then from a Swiss ball. Lunges could be used to also strengthen the lower extremities and back. Eventually, reaching for objects outside the base of support could be used to challenge balance, gradually moving lower and lower toward the floor.
Although these are extremely brief and incomplete examples, it is what 500 words or less will allow. The take home message is, don’t just exercise, exercise with purpose and intent. Exercise with function in mind, utilizing training specificity. If you are going to exercise, make sure you’re exercising or training in a manner consistent with your goals. Break it down to build it back up. Much can be done on your own but if you need help, we can get you started.
Rob Stanborough was one of the first PT’s to be permitted to use DN in FL and doing so since 2017. He has trained others in DN since 2010 both nationally and internationally as a Senior Instructor for Myopain Seminars (www.myopainseminars.com). He is a co-owner of First Coast Rehabilitation, est 2006 (www.firstcoastrehab.com), has presented and published regarding DN and co-authored Myofascial Manipulation: Theory & Application, 3rd ed by Proed Inc.