For some people, working out can be a pain in the neck. Literally. Or maybe a pain in the lower back. And for that reason, they put a kibosh on kickbox class and skip soccer practice. Assuming there is no acute injury – such as a fracture or strain – pain of the ongoing, nagging variety can present one of the biggest obstacles to maintaining physical fitness.
But a recently launched multimedia program proposes that the only way to reduce – and even prevent – chronic pain and injury is by moving the body more, not less.
Developed in Toronto by a team of medical, health and fitness professionals, Functional Progressive Rehabilitation is aimed at those who suffer from aches and pains, introducing exercises that will get them on track to Feeling Pretty Remarkable (the program's in-house nickname).
Currently, FPR consists of a recommended 12-week lower-back series that's available in a mobile application for iPhone and iPad or on DVD. Three more programs – focusing on knees, shoulders and motherhood – will be available this fall.
Chiropractor Kevin Jardine, the co-owner and president of Collaborans, the health care and fitness education company behind FPR, is adamant that certain exercises – based on evidence-based research – allow the body to combat chronic pain. The alternative – avoiding activity – can be self-destructive, he says.
"I equate physical inactivity with a disease entity in and of itself, called the deconditioning disease," he explains. "Basically, our bodies are rotting and rusting to a point that they cannot function well and they start to deteriorate."
FPR trains both body and brain to reverse the internal signals that contribute to chronic pain, which he describes as "an echo left on the nervous system, even though there's often no tissue damage occurring."
FPR is no-nonsense and refreshing in its set-up, and eschews the splashy, sexy, annoying visuals that are ubiquitous in home-workout DVDs.
There is no faux warehouse backdrop, no perma-smiling entourage and no celebrity trainer yelling peppy feedback into a headset.
Instead, physical therapist Chris Nentarz explains each exercise (demonstrated by a man or a woman) as if he's right beside you, reminding you each time to bring your belly button to the floor.
The DVD also comes with a travel-friendly compact manual that contains a log sheet for self-monitoring.
Both formats use post-production graphics (arrows and lines denote correct angles for body alignment) to support Mr. Nentarz's concise cues.
The exercises are challenging and require a mental checklist to achieve proper form.
A large portion of the program, divided into Limber, Load and Lengthen sections, draws from Pilates; core stability, or "abdominal bracing" as it's called in FPR, is integral to the program.
Dr. Jardine points out that the goal is to engage and control the small muscles – microactivation – to help the spine move properly. He says these motor-control exercises are the equivalent to developing a skill versus simply performing a range of movements.
Each of the four phases (users advance one level every three weeks, hence the "progressive") can be completed in 20 minutes.
Gregory Heath, a professor of health and human performance at the University of Tennessee at Chattanooga, commends FPR's rehabilitative approach.
"The point they make – that inactivity by itself has a disabling effect – is a good one, there's no question about that," he says by phone.
But he does express some concern over the 20-minutes-per-day claim: "It's a little bit more complicated than that."
Prof. Heath, who co-authored a paper on physical activity as part of an ongoing series in the medical journal The Lancet, points out that people should not ignore the importance of cardio endurance for protection against diabetes, obesity and heart disease.
"Only 35 per cent of the world's population meets that recommendation," he says.
Dr. Jardine says that healthier people, including some of the athletes he treats at his Toronto practice, can still derive benefits from FPR, using it as an adjunct to regular activity, particularly as a means of preventing injury.
(Full disclosure: Dr. Jardine treated me for a stress fracture last summer.)
Of course, the most obvious issue with exercise outside a structured setting is whether people have the necessary discipline.
"Compliance or adherence is always a big challenge for exercise therapists or health professionals. When someone is supervised, it is always more guaranteed they will do it," says Lucie Brosseau, a rehabilitation epidemiologist at the University of Ottawa who, with funding from The Arthritis Society, has created short instructional videos called People Getting a Grip on Arthritis.
Ultimately, Dr. Jardine hopes that FPR is disseminated in workplaces and also by family doctors so that, at minimum, people have a first-response option for reducing aches and pains.
"I would love people to be able to make the choice to get their body strong and get back to what they love to do," he says, adding, "I would also love to see the medical community – the everyday general practitioner – say to patients, 'I have a solution for you that you can try, you just have to follow it,' rather than what they're currently doing, which is 'Take this,' or 'Don't be so active.'"