Exercise physiology: Clinical Application

Understanding exercise physiology on a microscopic level allows the practitioner to make clinical decisions macroscopically. This knowledge can be used in a number of different clinical settings. The knowledge has led to the use of muscle energy techniques such as Hold-Relax, Contract-Relax, and Hold-Relax with agonist contraction. The chiropractic school (University of Western States) teaches and recommends this treatment in their curriculum. Knowing that calcium is key to muscle function and that CoQ10 is a crucial component of the electron transport chain for aerobic energy (ATP) production may lead us to make diet or supplemental recommendations based on the patients needs. We can tailor our rehabilitation programs based on which muscle fiber types our patient needs to focus on. The 60 year old with low back pain may benefit more from slower concentric, eccentric and isometric contractions of core stabilizers than ballistic exercises that increase type II fibers. (As a side note it’s important to know that eccentric muscle contractions place the most amount of stress on the muscle. This can be used for training purposes or in the clinic for orthopedic evaluation of muscles.) It may be useful to tell the 60 year old that reduced pain or incidence of low back pain episodes doesn’t mean exercise can be stopped. Educating the patient on continually working these muscle groups to allow long-term stabilization is important in the clinical setting. The more ballistic activity would benefit the sprinter more than it would the marathon runner. This knowledge allows us to select specific types of programs to optimize the patient’s health and performance.

In summary, understanding exercise physiology can allow us to make specific physical activity recommendations based on our patient’s specific needs. The understanding of the body’s energy systems and biochemical needs allow us to aid the patient in their dietary needs. The marathon runner may need to supply his/her body with the proper nutrition’s to optimize their physiological potential before and after an event. Finally, the information can allow the practitioner to make clinical treatment decisions. This is evident with the muscle energy techniques utilized by many health professionals. In a sense, knowing exercise physiology boils down to making physical activity, diet and treatment recommendations in the clinical setting. Exercise physiology is a rapidly evolving field that is becoming increasingly important in the delivery of health care especially for the sports chiropractor.