Everyone knows that you send a claimant with a musculoskeletal injury to an Exercise Physiologist when they’re ready for a focused work and life conditioning program.
So as you can imagine a large proportion of our work is with musculoskeletal injuries: rotator cuff tears, frozen shoulder, whiplash, carpel tunnel, lower back strains, disc bulges, ACL repairs, various broken bones, and joint replacements.
It’s also becoming standard practice for EPs to provide conditioning programs for people with cancer and mental illness. And its not uncommon for EPs to see cardiac and pulmonary cases.
But these just skim the top of the types of conditions we see.
We flicked through our files to find the most surprising conditions that our EPs are working with to give you a sneak peek of a day in the life of a Specialised Health Exercise Physiologist.
Ok, if you’ve worked with us for a while you know that we specialise in Fatigue Management, so this one isn’t all that surprising.
What was interesting though, was the various underlying causes of the fatigued state: Mental Illness and cancer as well as benign tumours in the wrong place. It can also be a result of diseases like Lyme disease, Cushing’s disease, Bowel diseases and Hepatitis, or Viruses such as Influenza, viral encephalitis and glandular fever. Fatigue is also a common symptom with Fibromyalgia and of course Chronic Pain.
No matter what the cause, Fatigue is the main barrier to having a normal life.
Our programs for Fatigue are more than just “Graded Exercise Therapy.” It’s also essential to include pacing education and support for other lifestyle factors such as nutrition, stress management and sleep hygiene. We are also one of the only companies in Australia and NZ utilising Heart Rate Variability in this space.
That said, it is important to know the underlying disease, any contraindications, interplay with medications, and of course the individual’s comorbidities, other barriers, and goals.
Migraines and Headaches
Migraines and headaches are also a common barrier to work and life. Sometimes they’re a result of whiplash, and sometimes we receive referrals specifically for migraines.
Some migraines are related to a condition called Vestibula Disorder and may not include the experience of a headache, but the sufferer may endure dizziness, vertigo, imbalance and nausea.
In this case, we liaise with any other treating health professionals and explore relevant referrals, for example to an Optometrist or Dietician. We guide the use of a symptom diary, discuss lifestyle factors such as stress management, review their confidence in activity pacing and of course assess their ergonomic set up. Pain education may also be of benefit here.
Particular exercises can assist in balance, and of course overall deconditioning. Appropriate neck mobility and strengthening exercises are beneficial in supporting against any neuromuscular factors causing the symptoms.
People who have suffered severe burns often experience decreased mobility due to tightening of the skin. Understandably they also experience a significant amount of pain. Some also experience numbness and fatigue.
With difficulty moving some joints and with pain, you can therefore conclude correctly, like with most health conditions, there may be a significant loss of strength and fitness. So, we provide mobility techniques as well as exercises to improve physical capacity towards their individual goals, and of course, fatigue management strategies if needed.
We get a lot of referrals for brain injuries as well. The injuries themselves occurred in various ways: Traumatic Brain Injuries (motor vehicle accidents, assault, falls), hypoxia, and even melioidosis (a tropical bacteria). The result of a Stroke is also considered to be a brain injury.
Exercise programs in these populations, other than focusing on the goals, often benefit from exercises that stimulate neuroplasticity, particularly if re-learning movements is needed.
We get a few complicated conditions. This could mean exact diagnosis isn’t clear, the cause isn’t clear, there’s numerous diagnoses or something’s gone wrong!
For example, one of our EP’s at the moment has a client who had an unfortunate gastric bypass failure, which resulted in frequent hospitalisations and regressing to a state of being unable to walk due to the amount of weight lost. He lost a lot of strength and experiences a significant amount of pain, so our EP is working to address the barriers and improve function!
There’s heaps more, but you probably don’t want to read all day.
Some other conditions that might surprise you are insomnia, agoraphobia, narcolepsy, necrotising fasciitis, gall bladder attacks and pancreatitis.
If you think about it though, when you know that Exercise Physiologists studied exercise and its’ impact on health and disease, plus our main role is to get people fit enough so they can get involved in life… it makes sense that we see all walks of life.
Exercise Physiologist and Writer/Content Manager, Specialised Health
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