What we are talking about
Therapeutic exercise means movement prescribed with a clinical goal: a dose, a progression and a criterion for knowing whether it is working. It differs from general exercise the way a medicine differs from a supplement: what changes is that there is reasoning behind it.
It is also the intervention with the strongest research base in physiotherapy, for a long list of conditions: back pain, osteoarthritis, tendinopathy, post-operative recovery, fall prevention. And it has a property no passive therapy has: it keeps working when the physiotherapist is not there.
The place where things almost always go wrong is not choosing the exercise, it is everything else: how you perform it, how much load, how many times, and above all when to raise the bar. A programme that stays identical for three months stops producing effects after a few weeks.
When it makes sense to be followed
The situations where having someone watching genuinely changes the outcome:
- You have a sheet of exercises and a doubt that you are doing them wrong
- You have been doing them for weeks and nothing has changed
- You do not know when and by how much to increase the load
- Some exercises hurt and you do not know whether that is normal
- You found the exercises online and do not know whether they suit you
- You want a programme built around you and not a standard protocol
What can be done remotely, and what cannot
This is the area where distance weighs least of all, and where in one respect the format is even better: we see you performing in the place where you will actually train.
What can be done remotely
- Watching you perform and correcting in real time, which is the part that counts
- Building the programme around your situation, not around a generic protocol
- Progressing the load with criteria, session after session
- Teaching you to read your body's response, to make you independent
- Adapting the exercises to the equipment you actually have at home
What cannot
- Physical assistance during execution and hands-on correction
- Instrumented strength measurement and isokinetic assessment
- Very heavy loads where you need someone spotting you
If you have cardiovascular or respiratory conditions, or take medication that affects exertion, you tell us beforehand: it changes how the programme is set up.
Frequently asked questions
Can I do the exercises I find online?
You can, and some will do you good. The problem is not the exercise itself, it is that you do not know whether it is the right one for your phase, at what dose and for how long. It is the same difference there is between a list of medicines and a prescription.
How much should the exercises hurt?
Contained discomfort is often acceptable, especially in persistent problems. The real criterion is not how it feels during, it is how you feel the next day: if the reaction lasts and accumulates, the dose was wrong.
How many times a week?
It depends on the goal: strength wants few well-executed sessions, mobility likes frequency. What does not work is all-or-nothing, that is five full days and then two weeks off.
Is equipment needed?
Often no, and when it is, it is a resistance band and little else. The programme is built on what you actually have: a plan requiring a gym you do not go to is not a good plan.
