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In physiotherapy, certain physiotherapy exercises are commonly prescribed because they are simple, effective at targeting specific muscles, and easy for patients to perform. However, these exercises often fall short in terms of functionality—they don’t always mimic the movements we use in daily life. This can limit their effectiveness in helping patients fully recover or improve their physical function. In this blog, we’ll discuss the top five exercises that are frequently prescribed in physiotherapy, why they may not be the best choice, and what alternatives could be more functional and beneficial.
1. The Bridge
What is it? The bridge is a fundamental exercise that involves lying on your back with your knees bent and feet flat on the floor. The goal is to lift your hips off the ground, creating a straight line from your shoulders to your knees. It’s often prescribed to strengthen the glutes and hamstrings, which are crucial for stabilizing the pelvis and supporting the lower back.
Why is it usually prescribed? Physiotherapists often prescribe the bridge because it effectively targets the glutes and hamstrings without placing stress on the lower back. It’s a low-impact exercise that’s easy to perform and can be done by people of all fitness levels.
Why it isn’t the best choice While the bridge does target important muscle groups, it’s not a functional exercise because it’s performed while lying on your back. In real life, we rarely find ourselves in positions where we’re lying down and lifting our hips. Functional movements are those that we use in daily activities—like standing, sitting, and lifting—and the bridge doesn’t mimic these movements.
A better alternative: The Hip Hinge or Squat The hip hinge or squat is a more functional alternative because these exercises mirror the movements we use when picking things up or sitting down. The hip hinge, in particular, is crucial for activities that involve bending forward, such as lifting objects. Squats are even more comprehensive, engaging the glutes, hamstrings, quadriceps, and core. These exercises help to build strength in the same muscle groups targeted by the bridge but in a way that translates more effectively to real-life activities.
2. Foam Rolling
What is it? Foam rolling is a technique that involves using a foam roller to massage and release tight muscles, particularly in the thoracic spine (upper back). It’s commonly used to relieve tension and improve mobility in the back, shoulders, and neck.
Why is it usually prescribed? Foam rolling the thoracic spine is often prescribed to relieve the strain on the muscles that connect to the back and to improve thoracic mobility. The idea is that by rolling out tight muscles, patients can reduce pain and improve their range of motion.
Why it isn’t the best choice While foam rolling can temporarily relieve muscle tightness, it doesn’t address the root cause of the problem, nor does it promote functional movement. Additionally, the effects of foam rolling are often short-lived, requiring frequent repetition without necessarily leading to long-term improvement.
A better alternative: Thoracic Rotation/Windmill Stretch The thoracic rotation or windmill stretch is a more functional approach to improving thoracic mobility. These stretches involve dynamic movement, which not only helps to release tight muscles but also improves the flexibility and rotation of the spine. This is important for activities that involve reaching, twisting, or turning, making the windmill stretch a more practical and effective exercise.
3. Scapular Setting
What is it? Scapular setting is an exercise that involves retracting and depressing the shoulder blades (scapulae) to stabilize the shoulders. This exercise is typically performed in a static position, focusing on isolating the muscles that control the scapulae.
Why is it usually prescribed? Physiotherapists often prescribe scapular setting to help patients develop a strong and stable base for shoulder movement. This exercise is particularly useful for individuals with shoulder pain or instability, as it reinforces proper shoulder mechanics.
Why it isn’t the best choice While scapular setting is a good starting point for shoulder rehabilitation, it’s not functional on its own because it doesn’t incorporate movement. In everyday life, our shoulders rarely operate in isolation; instead, they work in conjunction with other joints and muscles during complex, dynamic activities. Focusing solely on scapular setting without progressing to more functional physiotherapy exercises can limit the effectiveness of shoulder rehabilitation.
A better alternative: Multitasking with Scapular Setting To make scapular setting more functional, it’s important to combine it with other movements that mimic real-life activities. For example, incorporating arm movements or resistance exercises while maintaining scapular control can help patients develop strength and stability in a more practical context. Exercises like rows or push-ups with a focus on scapular control not only target the shoulder stabilizers but also engage other muscle groups, making the exercise more functional and comprehensive.
4. Standing External Rotation Shoulder
What is it? Standing external rotation is an exercise where you hold a resistance band or a small weight and rotate your arm outward, keeping your elbow close to your body. This exercise primarily targets the rotator cuff muscles, which are essential for stabilizing the shoulder joint.
Why is it usually prescribed? This exercise is commonly prescribed to strengthen the rotator cuff muscles, which are often weak or injured in individuals with shoulder pain or instability. Strengthening these muscles is crucial for maintaining shoulder stability and preventing injuries.
Why it isn’t the best choice While standing external rotation is effective for isolating the rotator cuff, it’s not a functional exercise because it doesn’t involve the full range of shoulder motion that’s used in daily activities. Traditional physiotherapy exercises like this often fall short because in real life, our shoulders don’t just rotate outward—they move in multiple directions, often in combination with other joints and muscles.
A better alternative: Functional Rotational Movements To make this exercise more functional, consider incorporating rotational movements that involve the whole body. For example, exercises like wood chops or cable rotations engage not only the rotator cuff but also the core, hips, and legs. These movements are more representative of the way we use our shoulders in real life, such as when we reach, twist, or lift objects.
5. Knee Extension Sitting
What is it? Knee extension sitting is an exercise where you sit on a chair or bench and extend your knee, straightening your leg. This exercise primarily targets the quadriceps muscles, which are important for knee stability and function.
Why is it usually prescribed? This exercise is often prescribed for individuals recovering from knee injuries or surgeries, as it helps to strengthen the quadriceps without placing too much stress on the knee joint. It’s a simple, controlled movement that can be easily performed by people of all fitness levels.
Why it isn’t the best choice While knee extension sitting is effective for isolating the quadriceps, it’s not functional because it doesn’t replicate the way we use our legs in daily life. In reality, our legs are rarely in a sitting position when we need to use our quadriceps; instead, we use these muscles when standing, walking, or climbing stairs.
A better alternative: Functional Leg Exercises Functional leg physiotherapy exercises, such as lunges or step-ups, are better alternatives because they mimic the movements we use in everyday activities. These exercises not only target the quadriceps but also engage other muscle groups, such as the glutes, hamstrings, and calves. This helps to build overall leg strength and stability in a way that translates more effectively to real-life situations.
Physiotherapy Exercises: Conclusion
While the top five physiotherapy exercises —like the bridge, foam rolling, scapular setting, standing external rotation, and knee extension sitting—are effective for targeting specific muscles, they often fall short in terms of functionality. To truly help patients recover and improve their physical function, it’s important to incorporate exercises that mimic the movements we use in daily life. By focusing on functional exercises like hip hinges, thoracic rotations, multitasking with scapular setting, functional rotational movements, and functional leg exercises, physiotherapists can help patients build strength and stability in a way that’s more practical and beneficial for their everyday activities.
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