What the heck is exercise physiology?
When I worked as a writer, people understood that I wrote stuff. Now I work as a clinical exercise physiologist and sometimes people have little-to-no idea what I do!
Admittedly, it’s not simple, and the profession hasn’t been around long. One of the first to prescribe exercise and connect it to health benefits was Hippocrates in Greece circa 600 B.C. (from which we get the term ‘hippocrisy’, since Hippocrates kept skipping leg day). The profession of using exercise to treat health conditions then cropped up in Sweden, Denmark, Germany, and USA during the 19th century, but the practise of exercise physiology only really took off in Australia with the establishment of its professional body in 1991. The profession officially became part of the Australian healthcare system in 2005, when Medicare included accredited exercise physiologists for the management of chronic disease.
Since 2008, a clinical exercise physiologist (commonly referred to as an EP) has required at least 4 years study in exercise science and physiology at university, including 500 hours of clinical placements. They are classed as an allied health professional (i.e. same level as a physio, psychologist, or clinical dietitian). EPs work with Federal and State health and insurance schemes such as Medicare, state workers’ health, safety and compensation schemes, NDIS, DVA and My Aged Care, as well as private health insurance.
In short, an EP uses behavioural change strategies and evidence-based interventions to improve patients’ health and wellbeing by treating, managing, or preventing chronic health conditions. These interventions are usually based around exercise, but also involve health education, and help with lifestyle change. This ‘Exercise is Medicine’ philosophy supports the World Health Organization’s Global Action Plan on Physical Activity. It also looks at how physical activity interacts with aging, menopause, physical and cognitive function, and how to maximise human performance in extreme conditions.
EPs need an understanding of how the body works, major diseases, neurological conditions, and medications in order to collaborate with medical professionals, effectively use exercise for better health outcomes, and look out for patient safety. EPs also treat 9 of the 10 most prevalent chronic conditions in Australia. On that list, conditions like back pain, arthritis, osteoporosis, neurological conditions, lung disease such as COPD and asthma, heart, stroke, and vascular disease may come as no surprise. What is less known is that EPs also treat mental and behavioural conditions such as depression, anxiety, PTSD, and autism spectrum disorder. Another big one – huge, in fact – is treatment for all types of diabetes. In cancer, an EP plays helps treat the symptoms such as fatigue, depression, and lymph node swelling, while also helping to improve the effectiveness of treatment therapies, as well as recovery from these therapies.
While the very nature of a chronic disease or injury is that it may never heal, an EP helps improve quality of life and can provide workarounds that allow a patient to do the activities they love more often and for longer. As an example, a 79-year-old triple bypass patient began training with me and was soon able to return to singlehanded sailing. A year later, however, a sailing accident caused multiple breaks in his ring finger, just two months before a World Masters Laser Championship. My role then focused on training his brain and body to change how he performed grasping activities such as pulling on ropes and steering a tiller while protecting his broken finger.
Today, exercise physiology is also used both before and after surgery to help patients reduce the risk of complications and improve recovery and function. This is used for both musculoskeletal procedures, such as knee, hip and shoulder reconstructions, and disease related procedures such as cardiac and cancer surgeries.
EPs also help improve workplace safety and efficiency. The safety aspect can include assessments of the physical requirements and standards needed for a role, rehabilitation of injuries and graded return to appropriate work activities. An EP service such as Your Best Performance can help productivity by educating workers in better movement patterns for speed, safety, and energy conservation, and provide strategies to help workers reduce injury, pain and other stress that can affect their ability to do a job well and reduce absenteeism. We have a special interest in entertainment performers and emergency service workers who want to maintain high standards or prepare for new roles and helping them develop ways to work with chronic diseases or physical issues.
In practice, an EP does not simply implement and supervise a program. The EP must assess and adapt to the person at every session, since people with chronic health conditions or pain may present very differently from one session to the next. Similarly, an EP has an understanding of medicines and how they impact on exercise, movement ability and safety, and recovery.
The EP tends to take a whole-health view of the patient. They are frequently in contact with referring GPs, physiotherapists, neurologists, cardiologists, and other medical practitioners. They may also recommend or refer patients to dietitians, occupational therapists, speech therapists, psychologists, and other health professionals in order to seek the best outcomes for the patient’s whole health.
While the potential for the population to benefit from exercise physiology is vast, the network of exercise physiologists is small, as is the proportion of the medical profession’s understanding and appreciation of the profession. This means that, so far, much of the work done by EPs in Australia is directed to the elderly and those with well-established disabilities and chronic conditions. This is a crucial and urgent necessity. However, a primary goal Your Best Performance is to work on preventing chronic conditions or ameliorating them while they are still in early stages. The aim is to help people do the things they need, want and love to do, and to do them longer into their life.
Your Best Performance uses the slogan “do better, know better” because we believe people will be more motivated to make better choices with their exercise, activities, and lifestyle in general if they understand why these choices are beneficial in the longer term. This is an essential step in assuring you can do the activities you want or need to do for your work, your family, and a more fulfilling life deeper into older age. ‘Doing’ what you’re told to do is temporary. ‘Knowing’ and understanding why you should do something is for life.
