Physiotherapy plays a vital role in helping people regain freedom of movement and prevent the onset of chronic pain. Regular consultations with a physiotherapist can be an effective way to improve your body's functional abilities, avoid injuries and maintain a healthy lifestyle. Physiotherapist Sandis Kristaps Lagzdins explains when to see a physiotherapist and what role physical activities play.
What are the observations in practice regarding the patient profile who most frequently visits a physiotherapist?
Most of my patients present with musculoskeletal problems – back pain, joint pain, and headaches. On a daily basis, I work with patients who need gentle range of motion improvement and pain relief, as well as those preparing to return to 30 km hikes or professional sports after injuries, using plyometric (jumping), strength and power exercises.
Although relatively few patients come to me for consultations with the goal of improving posture or exercising purely for preventive purposes, many willingly continue exercising for future injury prevention after overcoming their initial problem.
When should you see a physiotherapist and when a certified fitness trainer?
People often think that you should see a physiotherapist only when pain has appeared or after an injury, and a fitness trainer when everything is fine. However, this is a misconception. You can visit both a physiotherapist and a sports physician at any stage of rehabilitation where the goal is to improve functional status – whether right after an injury or surgery, for prevention, or when returning to professional sports.
You can visit an experienced and knowledgeable fitness trainer with the goal of improving functional status, but only if the person has no injuries or other complaints. However, before visiting a fitness trainer, a physiotherapy consultation is recommended so that the physiotherapist can assess injury risks and provide recommendations if any exercises need to be individually adapted.
What are the most commonly observed barriers that prevent people from engaging in physical activities?
In my opinion, it is the inability to prioritise one's health as one of the main priorities. I have noticed that people often start taking care of their health only when problems arise. Lack of time is usually cited as the main reason why people do not devote enough attention to physical activities. In reality, with minimal equipment and good physiotherapist support, it is possible to create a meaningful home workout that takes only 20 minutes, including the warm-up.
The second significant factor is lack of determination. However, it is not as complicated as it may seem. Even a simple walk is a good start. To help maintain motivation, it is worth finding someone to exercise with or choosing a sport that truly inspires you. Moreover, setting goals can be a very effective approach – committing to exercising several times a week and moving towards this goal with small but well-considered steps.
Some people also avoid exercising because they worry about what others will think of them or feel insecure about whether they are performing exercises correctly. However, a good physiotherapist can help alleviate these concerns by providing clear instructions on how to perform exercises correctly, what sensations to expect, and how much fatigue should be felt at the end of each exercise.
Of course, upbringing also significantly influences attitudes towards physical activity. If parents lead a sedentary lifestyle, there is a high probability that the child will too. Genetic factors and injuries also play a significant role – in such cases, it is especially important to find suitable activities that match the specific health condition. This is exactly why it is very important to consult a physiotherapist.
However, the most significant barrier among people is lack of awareness about the positive impact of regular physical activities on health, including how to start exercising and where to seek help.
How often is therapeutic exercise used as the primary method for treating or reducing pain?
Therapeutic exercise is very frequently used as the primary method for treating and reducing pain. However, it is important to understand what functional limitation caused the pain and, based on that, choose a way to reduce it. Therapeutic exercise is a broad concept – it encompasses many different types of exercises that can improve strength, power and endurance, balance, aerobic capacity, joint range of motion, and local metabolism, which secondarily also reduces pain.
In cases where pain reduction cannot be achieved through exercise alone, massage and manual therapy techniques, as well as physical therapy procedures, come to the rescue.
What to expect from a physiotherapy consultation and therapeutic exercise?
During the consultation, it is essential to inform the patient about the nature of their problem and explain with which methods and in what timeframe we can expect positive results. To ensure therapy effectiveness, data collection is necessary – using assessment questionnaires, pain scales, strength and range of motion measurements. This allows providing an objective assessment of how the patient's functional status is changing throughout the course of therapy.
Therapeutic exercise can have different goals depending on the patient's condition. If pain is significant and the injury is acute, I focus more on ergonomic advice and exercises that improve joint metabolism or mobility. Conversely, if the pain and functional level are stable, I choose strength or endurance exercises.
Patients are different. Some are ready to purchase equipment and exercise regularly on their own. However, there are also patients who openly say that they have other priorities at home and are willing to exercise only under physiotherapist supervision. As a physiotherapist, I need to be able to create a plan for each patient – whether with sessions under my supervision or independently.
What is riskier – complete physical inactivity or incorrectly performed exercises?
Neither option is optimal. Performing exercises without knowing whether they are being done correctly creates a significant injury risk, while abandoning physical activities creates an increased injury risk due to inactivity, as well as additional obesity and cardiovascular disease risk.
The ideal option would be to increase the level of physical activity in daily life and visit a physiotherapist to determine what load is optimal for your age and personal fitness level.
What are the greatest risks associated with a sedentary lifestyle?
The risks caused by a sedentary lifestyle creep up unnoticed, and their consequences affect absolutely everyone. The greatest risk is injuries. Muscles maintain their strength for only 14 to 21 days without training, after which they slowly begin to lose mass and strength. If physical activities become irregular, muscles become weaker, reducing our ability to resist unexpected loads in daily activities.
This problem becomes particularly relevant after the age of 50, when bone density, muscle mass, and overall physical capacity begin to decrease even more rapidly. Interestingly, in older adults, fall risk more often increases not due to lack of balance, but due to insufficient strength .
When movement is limited, the body cannot expend enough calories, which increases the risk of obesity and excess weight. Excessive weight, in turn, significantly increases the risk of diabetes and cardiovascular disease. In Latvia, the most common cause of death is cardiovascular disease. Regular physical activities improve aerobic capacity and heart function, thereby reducing this risk.
What is the importance of deep muscles and joint mobility?
Strong deep muscles and optimal joint mobility will certainly help avoid injuries. Joint mobility can be affected by various factors – shortened muscles, ligaments surrounding the joint, and swelling. If one joint has a limited range of motion, there is a high probability that compensation and overload will develop in another joint.
Deep muscles have a special function – while the "superficial" muscles perform the obvious work (for example, raising the arm above the head), the "deep" muscles ensure that during this movement, the humeral head stays in place. If active muscle stabilisation is lacking, passive structures (such as the labrum and surrounding ligaments) can become overloaded over time, causing pain.
What are the main signs that a person has weak deep muscles or poor joint mobility?
In everyday situations, it is nearly impossible to identify deep muscle weakness on your own. In practice, I identify it using two main methods: deep muscle strength tests and joint movement observation – for example, analysing scapular movement when raising the arms above the head, or assessing lumbar and hip function.
Even minimal, imperceptible range of motion limitations can significantly affect movement biomechanics. It should be noted that some people are genetically more flexible and others are genetically stiffer – therefore, the optimal range of motion will differ slightly for each person. However, some limitations can be noticed on your own, for example – that when sitting with one leg crossed over the other, the top leg is usually always the same one.
What should a beginner keep in mind to avoid injury at the gym?
Ideally, it would be advisable to first visit a physiotherapist who could help develop a training plan, determining training duration, load, frequency, and other important nuances. Work experience shows that people in the gym most often perform exercises without fully knowing what the exercise is intended for, and simply try to replicate movements seen in a video – this creates an increased risk of overload and injury.
When exercising individually after a specialist visit, I recommend following these principles:
- Warm-up is mandatory – both generally and specifically for each exercise. The warm-up should take 5–15 minutes to prepare the body for activity, deliver oxygen to the joints, and activate the nervous system.
- Start with a lower load – perform the first training sessions at a lower intensity, gradually increasing the load over several weeks regardless of whether it is a strength or cardio workout.
- Vary your training type – perform both aerobic and strength training sessions. Any cardio workout (running, cycling) is insufficient for improving muscle strength and will eventually create muscle imbalances.
- Listen to your body – always consider how you feel and stop physical activities if your condition worsens.
How to recognise early signs of injury?
Experiencing mild pain during or shortly after training is completely normal. Physical training causes micro-injuries in muscles and tendons. Over time and with experience, it becomes easier to distinguish normal training soreness from pain that indicates something more serious.
What is considered normal:
- Regional muscle soreness during or after training that usually resolves within 1–3 days;
- Mild general fatigue and joint fatigue that disappears within 1–2 days;
- Mild joint discomfort that disappears within 1–2 weeks after starting regular training.
Symptoms that require stopping activities and consulting a specialist:
- Sharp pain that reaches at least 5 out of 10 on the pain scale;
- Muscle pain that does not resolve within a week;
- Joint discomfort that does not resolve within 1–2 weeks;
- Any neurological symptoms – tingling, numbness, or sudden loss of strength;
- Haematomas (bruises) and visible or palpable swelling.
What are the recommendations regarding training frequency and rest periods?
- Quality sleep – the most important factor for optimal results. Adults need regular 7–9 hours of sleep that include all appropriate sleep phases. This can be measured with a smartwatch or smart ring.
- Balanced nutrition – if the body is not provided with sufficient nutrients and vitamins, it will not be able to effectively build muscles and recover after training. Consult a nutrition specialist.
- Training frequency – if a long training session (1.5–2 hours) covering many muscle groups is planned, perform it no more than 2–3 times per week. If three different programmes for specific muscle groups have been developed and each session lasts less than an hour, with good sleep and healthy nutrition you may train 4–6 times per week.
How to motivate people to work on their health regularly?
For any practical advice to be effective, the desire to start taking action is needed first. It is very important for all of us to be able to spend quality time with family, devote time to favourite hobbies, and work effectively. Injuries and illnesses can negatively affect these abilities. Therefore, no matter how selfless we may be, it is very important to primarily take care of our health – it is an essential prerequisite for everything else.
Five tips from physiotherapist Sandis Kristaps Lagzdins
- Visit a physiotherapist – to understand how to most effectively and safely achieve your goals.
- Remember that even a simple walk is physical activity. Additional physical exercise in daily life is not that hard to achieve – choose stairs instead of the lift or a bicycle in good weather.
- Find a sport that brings you joy. If you find company to exercise with, it will not only be more fun but will also provide additional motivation.
- Use habit tracking apps. Share your activity progress with friends – it creates a greater sense of accountability.
- Plan your time! This will help you understand how to most effectively incorporate exercises into your daily routine.
Although we cannot always fully control life circumstances and challenges, we can certainly influence our lifestyle. A healthy lifestyle is an investment that we can control and improve.