February 2, 2017 by ACE Physical Therapy and Sports Medicine Institute  
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Commonly Asked Questions In Out-Patient Physical Therapy
by ACE Physical Therapy and Sports Medicine Institute

Tid Bits of Info.

  • Max heart rate is approximately 220 – your age.
  • Lifting > 70 % of your 1 rep max will enhance your chances of stimulating the muscle chemistry to develop more muscle size/strength.
  • Target fat burn with a cardio workout that maintains your heart rate between 60 – 70% of your max heart rate.
  • Putting heat on an inflamed area feels good but can make the condition significantly worse.
  • Seek the advice and treatment of a Physical Therapist that specializes in orthopaedics if you get injured.

Every day patients asks questions during physical therapy. While many of the same questions commonly arise, the answers depend on the specific patient and situation. Most healthcare professionals will rely on evidence based research to provide their guidance to the answers that they provide to these questions. They will offer patients both general guidelines and specific application based on the patient needs. Here are some common questions that arise daily in the out-patient orthopaedic and gym/fitness center setting.

How often should I exercise?

This question is tricky because the answer can range from one time per week to several times per day.   The type of exercises that are to be performed and the exercise goals that the individual has will help the healthcare professional determine the proper answer.  If someone wants to be more active and does not have any specific exercise goals, it would be safe to say that any amount of exercise is sufficient.  On the other hand, to lose weight and increase muscle strength and cardiovascular endurance requires exercise almost every day.  Exercise routines can vary on a daily basis, but to accomplish specific fitness goals entails performing some type of exercise nearly every day of the week.

What is tendinitis?

The tendon attaches the muscle to the bone and enables the muscle to pull on the bones of the body and move them.  In some instances the muscle helps to stabilize the bones and controls movement. The tendon is made up of literally thousands and thousands of tiny little strands of material that resemble little leather belts.   When the tendon is used repeatedly or too aggressively, it can develop micro-tears (seen under magnification) that cause pain.  The tendon that is injured transitions from a pain-free, smooth and lubricated structure to a painful, rough and less lubricated structure.  When it is actively used or stretched the pain is worse.  Surprisingly, many times tendinitis hurts less after the injured tendon is put through an exercise routine.  Unfortunately, the excess rise in tissue temperature and increased blood flow and lubrication all recede once the routine comes to an end and many times the pain is worse than when it started.  

Do I use hot or cold?

When dealing trying help an injury heal, the question if hot or cold?  The rule used by most Physical Therapists, Athletic trainers and other fitness healthcare professionals is to apply heat “before” activity and ice “after” the activity.  If in doubt, apply ice.  The human body gets inflamed when the musculoskeletal system is injured and one by-product of inflammation is heat.  Therefore if more heat is applied the inflamed tissue the inflammation process increases and there will more pain.  On the other hand if ice is applied to the injury site, the tissue temperature will slowly decrease and the inflammation process can be managed.  The result will be less pain secondary to the analgesic effects that ice has on the sensory nerves.  The inflammation process will slowly come under control.

How long do I need to be on a cardio machine?

This question has many answers that depend upon the individual’s exercise goals.  Each exercise session has two main factors: time and intensity.  The longer the duration and the higher the intensity will equal a more aggressive and beneficial routine but this might not be the best for everyone.  To burn calories someone should exercise for a prolonged time.  If burning fat is the goal, then a prolonged session (>30 min) several times per week at a moderate intensity is usually the best.  Performing cardio exercises at approximately 60 – 70% of your maximum heart rate can target fat burning.  If endurance is your goal then working out at for a prolonged time period will be needed, also.  The higher the intensity for a longer time will develop a greater amount of endurance.  Lastly, if you want to develop the ability to increase your power or speed and don’t care about longevity then you can perform short bursts of cardio exercises.  These bursts will need to be extreme and push your heart rate above 80% of the maximum.  This type of conditioning will “burn” stored sugars and not rely on oxygen as a fuel source.

How can I lift weights and not get too big?

This is a very common question and concern with many people especially with women.  The ability to develop muscle is reliant on several key factors including age, hormone levels, diet, exercise type, and intensity.  To develop muscle strength, a person has to strength train and “over-load” the muscles.

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The amount of resistance and number of repetitions plays a major role in the end results.  A high amount of resistance and a low number of repetitions will target strength gain and enhanced muscle size.   By adjusting workout to consist of less resistance and high repetitions, the muscle chemistry will change but the endurance will increase and not the size.  In most cases, women do not have the proper hormone levels that are needed to develop “big” muscles.  They can get very strong without developing the “bulky” muscular appearance.

Who do I go and see if I get injured while working out?

Seek the advice and treatment of a Physical Therapist that specializes in treating orthopaedic injuries.   These licensed healthcare professionals are specialists in treating these injuries and can help you modify your exercise routine which will enable you to avoid injuries in the future.  They can be seen without a doctor’s prescription, but your individual insurance plan might require that you have a referral from your primary care doctor.

There are a lot of questions that arise on a daily basis in the out-patient Physical Therapy setting.  These questions don’t always have a specific answer, but there are common answers that can apply to nearly everyone that steps through the door.

Read more articles on our main website blog at: ACE-pt.org/blog

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