Discover a proven approach to tailoring exercise prescriptions for each patient, enhancing outcomes with the Institute of Physical Art’s expert framework.
Every effective exercise prescription begins with a thorough understanding of each patient's unique needs, goals, and challenges. At Revolutions in Fitness, our approach starts with a deep-dive assessment—reviewing injury history, physical limitations, lifestyle factors, and activity preferences. This ensures every plan is rooted in the individual’s current state and aspirations.
For example, a cyclist with lower back pain will require a different strategy than an active adult recovering from surgery. Through one-on-one sessions and attentive listening, we identify both the overt and subtle movement restrictions that may impact recovery and performance. This patient-centered evaluation forms the foundation for selecting the right exercise at the right time.
Our patient (we’ll call her B) had a herniated L5–S1 disc and couldn’t sit or hike comfortably. Mechanically, her right innominate was not flexing well, so we started with mobility — contract–relax with a sacral wedge to work for 'hip flexion' (HISLE) over a sacral wedge and self soft tissue mobilization of her deep hip rotators with a ball.
If something’s stiff, that’s where we start. When that gets mobile the next restriction becomes the new home exercise target. The 'mechanical'/hard end feel always sets the stage.
Once things move, we have to ask: what’s still napping?
For B, her multifidi were on a coffee break. Cue the ballerina prone hip extension and push–push–pull–push sequence — tiny, precise, gravity-resisted isometric contractions that “make the muscle an offer it can’t refuse.”
These drills are small but mighty. Isometric, specific, and often held — because endurance builds awareness. Usually the patient not only has more tone in the muscles we are facilitating after the exercise (core) but also decreased high tone muscles as well that have been trying to do the work of the core
After reawakening the stabilizers, we zoom out. Now the goal is coordination — all the muscles playing together.
For a hiker like B, a wall climber is gold — it’s global, load-bearing, and mirrors the real movement. Step-ups? Even better. They train the posterior chain for posterior depression and uphill stability without triggering flexion sensitivity.
Motor control exercises should “train what to do.” If they hike, climb. If they ride, pedal. If they dance, sway. "You get what you train for"
As Greg Johnson says, our job in the clinic is to find and facilitate neuromuscular and motor control not to strengthen the client in the clinic. But if we stop there, our patients will not have the abilities to maintain good form (motor control) as the functional demand for force or repetitions meets life (a 3 mile uphill hike for patient B.
Adding resistance, weight, or longer holds cements the pattern. For example, progressing a step-up by holding a kettlebell on the same or opposite side — or adding a resistance band pulling down and back — turns a motor control exercise into a strength builder.
At its best, exercise selection isn’t random. It’s elegant.
We start where the body’s stuck, wake up what’s asleep, teach the system to dance together again, and then build it strong enough to last.
And yes, we laugh a lot while doing it. Because good movement — like good mentorship — should feel alive.