There are a number of concerns regarding strength training in a rehab setting. Finding the right studio and the right person to understand you can be a frustrating proposition. At our clinics, we make sure that we speak to all our clients individually first. Before we even consider charging them.

Inflammation in joints and surrounding soft tissues

Inflammation is an indicator of the body’s attempt to clean the injury site for tissue healing. I am constantly contacted with clients with conditions ending in the suffix “-is”. So, in a nutshell, anything ending in -is like arthritis, bursitis, plantar-fasciitis, spondylitis, bronchitis, the list goes on, is all inflammation. Care must be taken when using resistance training not to overload tissues during the inflammatory process. Hence our Pilates multi-apparatus is all low-load springs. In the initial stages of rehabilitation, high reps and low resistance exercise provide an effective counter-stimulus to the inflammatory process.


With repetition schemes of > 30 reps, there is a local aerobic response in the working tissues. The high volume / low resistance creates an increased oxygen requirement in the injured tissues. This is then addressed by the bodies super-compensation. The increased oxygen is very important where protracted inflammatory states are concerned, because oxygen is an antagonist to proteolytic enzymes. “Proteolytic enzymes digest protein by aiding in the digestion process, breaking it down into amino acids”. This type of exercise promotes capilliarisation in the working tissues.


Ishcemia of Muscles

Too many therapists attempt to exercise people who are suffering from soft tissue ischemia. This only leads to increased pain and frequently discourages the patient from participating in an exercise programme. When a muscle is ishchemic, it is getting less and optimal blood supply to maintain homeostasis in the working tissues (even at rest). The following are common sources of muscular icshemia.

  • Poor posture
  • Protective muscle spasm (stress fracture, joint injury (Hilton’s law))
  • Overload of tonic muscles (faulty movement patterns and sport or specific overload)
  • Trigger point development
  • Response to referred pain
  • Psychological stress and limbic overflow



Advanced programme design – Paul Chek