By Diego De Farias Diehl
I must confess. This is the one subject I was afraid to write about. No, I don’t mean publicly declaring if I prefer Vegemite or Marmite. Me, here is in this column needing to have a conversation with the hard-working population of the South Burnett area about something that is often neglected and hard to change. Hear me out.
A ‘Hard Yakka’ plumber recently came for an appointment with low back pain. During the appointment we also learned he had a history of cardiac disease in the family and was presenting high blood pressure, a reasonably, regular occurrence in my clinic. I asked him if he was doing any exercise/physical activity; he laughed, “Diego, I have one of those fancy watches that record your steps. I do about 15,000 steps starting from dawn and lift weights every day! Yes, I do exercise.’’ After talking with him further, he then gave the same look that I get from farmers, professional gardeners, tradies… you get the picture. That look was: ‘’Are you nuts!?’’
You see some of the hardest, but most important parts of my work as a physiotherapist consist of trying to help people to understand their condition; what the treatment options are; their risks and what the patients can do by themselves to help to improve their impairment, pain, or limitation. Some of the time, the clinician’s intervention is essential. This can be some sort of manual therapy, acupuncture, a specific technique/s to fix a problem or even meaningful advice. But for the rest of the time, the patient will have a significant role in their own recovery/management, often which demands lifestyle changes or squeezing 10-20 minutes of exercise into an already busy day.
This is not only my opinion or personal experience from 15+ years working with patients daily: this is a demonstrated phenomenon, called the physical activity paradox. While exercising regularly (walking, weightlifting, yoga, swimming, sports, etc.) can have many positive effects and help to manage/prevent pain, an occupational physical activity (i.e. repeated physical actions) often does not. For example, occupations demanding heavy lifting all day long lead to increased risk of high blood pressure and cardiac problems. There are a few reasons on why exercising is important and promotes health benefits and pain management. We also have studies to show why physical work all day long does not. Let’s take a closer look. We can measure different body responses in those two situations. In the case of Physical work, it often does not allow enough recovery time and exposes the worker to elevated blood pressure and heart rate for many hours a day. Also, physical occupations tend to expose us to repeated movement patterns over and over, without appropriate recovery time; the list goes on and on.
Regular physical activity can be an effective treatment option. Mind my words: can, not will! I can assure you, there is no magic recipe to all problems and that will suit everyone. But exercising is one treatment option that has shown (study-after-study) good chances of preventing and improving several health problems, as well as managing acute and chronic pain conditions for many patients. There is a time and place for it, and it is as option to be considered and discussed with your physiotherapist. Hopefully, my plumber patient, when asked if he is doing his exercises, will reply on a future appointment: “Bloody Oath, Diego!’’.