How and Why do We Prescribe Exercises?

Most people exercise with an objective in mind, whether it’s being more physically capable, losing weight or looking better. It’s possible to make progress towards these fitness-related or aesthetic goals with little guidance, but when using exercise to relieve back pain or recover from an injury or surgical procedure, you may need to be far more precise.

Every body has a unique set of strengths and weaknesses across its muscles, so treating pain, injury or any other physical condition requires a precise prescription of exercise for the individual’s unique physical make up, not simply X exercise for Y condition.

Here are some examples of common physical complaints and how we might prescribe exercises to treat them.

Muscle weakness or imbalance

A common mistake people make when strengthening is to start too heavy with their exercises. You might think you’ll make faster progress by using heavier weights, but what’s more likely to happen is the muscle you want to work out becomes overloaded and offloads the force into surrounding muscles that you weren’t targeting.

It is also important to consider the function of each muscle in movement; that is, whether they are a prime mover to drive the movement or a stabiliser that provides a strong base to let other muscles do the work. The latter don’t require heavy resistances to be trained, and many simply “turn off” if they become overloaded.

Let’s say that you can feel your legs struggle when you run up the stairs. Such an action requires both strong and powerful quadriceps to push you up and along, and also high levels of endurance in your gluteus medius to keep your legs stable. Both are vital, but require very different types of exercise to train them.

Your quadriceps and similar prime movers should respond well to training under progressive heavy loads as that is what they are designed to handle. Stabilising or postural muscles like gluteus medius work at low levels repetitiously or for prolonged periods, and so you need to train them similarly: lower resistance and high repetitions.


Sitting at a desk all day, intense exercise sessions and some health conditions can all leave your joints feeling stiff or muscles tight. When dealing with stiffness, the objective is to restore as much movement as possible to the affected area rather than strengthening.

A prescription for prolonged sitting-induced lower back pain might be to stand up for five minutes every hour or to perform 20 repetitions of a single, low intensity movement to ensure the affected muscles aren’t locked in place for too long. If your ankle is stiff after a big sprain, you might be advised to work at pushing your knee over your toes every hour.

In both cases, the exercises aren’t difficult, they simply try to get you moving. The more you move, the more likely you are to ease the restrictions caused by stiffness, which enables you to take on further exercises we prescribe and reduce feelings of fatigue.


Rehabilitation from muscle or ligament injury and surgery requires a broad and complex approach.

Say that you’re in rehabilitation for a knee injury and you want to return to running, cycling or sports. A knee that’s been out of action will have lost a significant amount of strength and mobility, and if this isn’t restored, there’s a high risk that the knee will be easily overloaded and injured again.

Getting your strength and movement back will therefore start with very simple, monotonous tasks (like bending your knee or squeezing your thigh) to make sure you move perfectly and use the right muscles before you progress to heavy or explosive exercises (like squatting with weight or jumping) that are required to get you back to 100%.

Time off can effect muscles and joints far away from the site of injury too, such as your hip and ankle when you have hurt your knee. This means your rehabilitation is likely to include exercises which don’t seem to train the knee, but these are often paramount in making sure you recover well and don’t get injured again.

This very gradual pace can be frustrating but diligence to our specific exercises and instructions pays dividends. So, when recovering from injury, please remember every task is important no matter how simple or unrelated it seems, and you can always ask your physiotherapist why you need it if you are unsure.


If you’re finding it painful to move, it may be because you’re not moving ‘correctly’. Even if you manage to achieve the desired objective – from grabbing something out of the top cupboard to serving in a tennis game – it may be the wrong muscles or tendons doing most of the work.

With our knowledge of how muscles function and interact to achieve movement, we can prescribe exercises that encourage your body to recruit or fire the right muscles to keep you moving and achieving your goals while relieving or entirely eliminating your pain.

A physiotherapist will be able to show you how to move correctly through the repetition and provide prompts to keep moving well on your own. They will also give you advice on how much load is appropriate for the specific strength of the muscles you’re targeting, which we determine through various tests and watching how your body moves. It’s near enough impossible to be able to self-assess your body in such detail, even for us physios.

If you’ve been experiencing niggles big or small, don’t just live with them. With the right exercise prescription, we can rid you of your physical annoyances and help you make the most of your body. Get in touch with us via or by calling 0207 937 1628.


Liam McCloskey – Musculoskeletal Physiotherapist