Exercise Prescription & Rehabilitation

Exercise Prescription & Rehabilitation is a structured, medically guided program in which a sports medicine doctor designs specific physical exercises to help a patient recover from injury, manage a chronic condition, or restore normal movement and strength.

Rather than simply recommending 'rest' or 'go to the gym', the doctor analyses exactly how the body is moving, where strength or flexibility is lost, and which tissues — muscles, tendons, ligaments, or joints — need targeted work. Each exercise is chosen for a reason: to rebuild stability, reduce pain, retrain movement patterns, or prevent the same injury from happening again. The program is adjusted as the patient improves, so the workload grows with the body's capacity.

This program is used whenever injury, illness, surgery, or a long period of inactivity has affected a person's ability to move, work, or play sport comfortably. A sports medicine doctor may also use it proactively — to correct movement problems before they lead to injury.

• Muscle strains (tears in muscle fibres) and ligament sprains (stretching or tearing of joint-stabilising bands)
• Tendinopathy (chronic pain and degeneration in a tendon, such as the Achilles or rotator cuff)
• Recovery after orthopaedic surgery, such as ACL reconstruction (repair of the main knee-stabilising ligament) or joint replacement
• Osteoarthritis (wear-and-tear joint disease) of the knee, hip, or shoulder
• Chronic lower back or neck pain linked to weak core or postural muscles
• Stress fractures (tiny cracks in bone caused by repeated load) during the return-to-sport phase
• Patellofemoral syndrome (pain behind or around the kneecap)
• Sports-related concussion (a brain injury from impact) during graduated return-to-play
• General deconditioning (loss of fitness and strength) after prolonged illness or hospitalisation

Exercise prescription is not always suitable as a standalone treatment. A doctor will usually refer the patient elsewhere first, or combine it with other care, in the following situations.

• Acute, unstabilised fractures that still need surgical fixation or immobilisation
• Severe cardiovascular (heart and blood vessel) disease where exertion carries significant risk without specialist cardiac clearance
• Active infection or inflammation in a joint or surgical wound that has not yet been treated
• Conditions where exercise itself is contraindicated until another problem is controlled, such as unmanaged severe anaemia (very low red blood cell count)

A well-designed exercise rehabilitation program is generally considered low-risk when supervised by a qualified sports medicine team, but some unwanted effects are possible, especially early in the program or if the load is increased too quickly.

• Temporary increase in muscle soreness or joint pain in the first few sessions, particularly if the body has been inactive for a long time
• Delayed onset muscle soreness (DOMS) — deep aching in the muscle that typically peaks one to two days after a new exercise
• Aggravation of an existing injury if exercises are performed incorrectly or progressed too fast
• Minor strains or sprains during the rehabilitation exercises themselves, especially in patients who are deconditioned
• Fatigue or dizziness during exercise in patients who have cardiovascular conditions or are returning from serious illness
• In rare cases, a fall or balance-related accident during exercises that challenge stability

Unlike many medical procedures, exercise rehabilitation usually requires no fasting and no general anaesthesia (medication that puts you fully to sleep). However, a thorough assessment before the program starts is essential so the doctor can build a program that is safe and appropriate for the patient's current condition.

Before the program begins, patients are usually asked to do the following.

• Bring any previous imaging results — X-rays, MRI, or ultrasound (USG) scans — related to the injury or condition being treated
• List all current medications, including blood thinners or anti-inflammatory medicines, so the doctor can note any that affect exercise safety
• Avoid smoking and limit alcohol in the lead-up to the program, as both slow tissue healing and reduce the effectiveness of exercise
• Wear comfortable, appropriate clothing and footwear on assessment day
• Be honest about current pain levels, previous injuries, and the physical demands of work or sport

The doctor will usually run one or more of the following assessments before designing the program.

• A physical examination measuring range of motion (how far a joint can move), muscle strength, and balance
• Functional movement screening — observing how the patient performs basic movements like squatting, stepping, or lifting
• Cardiovascular screening (a check of heart and blood vessel health) if the patient is older, has a known heart condition, or has been sedentary for a long time
• Review of imaging such as MRI or X-ray to confirm tissue status before loading it with exercise
• Pain assessment using a standardised scale to set a baseline

The first session typically follows a predictable sequence, though the exact steps and duration vary between patients and clinics.

• 1. The doctor or physiotherapist (a movement and exercise specialist) reviews findings from the assessment and explains the goals of the program.
• 2. A warm-up phase prepares the specific muscles and joints that will be worked.
• 3. The prescribed exercises are introduced one at a time, with correct technique demonstrated and then practiced under supervision.
• 4. The patient's response — pain, fatigue, form breakdown — is monitored throughout.
• 5. A cool-down phase reduces heart rate and eases muscle tension.
• 6. The clinician reviews what was observed, adjusts any exercises if needed, and explains what to expect before the next session.

Because this is a therapy program rather than a single procedure, 'aftercare' refers to what happens between sessions and after the full course of rehabilitation is complete. Recovery from the condition being treated unfolds gradually over weeks or months, so ongoing communication with the treating team is important throughout.

• Rest between sessions: the body repairs and adapts during rest, so the prescribed recovery period between sessions should be respected — training every day is usually not advised, especially early in the program
• Pain monitoring: mild muscle soreness after sessions is normal; sharp, joint-located, or worsening pain between sessions should be reported to the doctor before the next session
• Home exercise program: in most cases the doctor or physiotherapist will assign specific exercises to do at home between clinic sessions — these are a core part of the program, not optional extras
• Activity restrictions: high-impact sport or heavy lifting is usually limited until the treating team gives clearance, to avoid re-injury
• Sleep and nutrition: adequate sleep and a protein-sufficient diet support the muscle repair that makes rehabilitation work; the treating team may give general guidance on this
• Smoking and alcohol: both slow tissue repair and are usually discouraged throughout the rehabilitation period
• Progress reviews: the doctor will schedule regular reassessments — using the same movement and strength tests done at the start — to measure improvement and adjust the program
• Discharge and long-term maintenance: when the rehabilitation goals are met, the doctor will usually provide a long-term maintenance exercise plan to prevent recurrence