By Rebecca Gawler

PROMOTING INTUITIVE MOVEMENT

Physiotherapists play an important role in educating patients about exercise. Therefore, the way physiotherapists deliver this education will either promote a healthy or dysfunctional relationship with exercise. The following tips are beneficial to apply to all patients, not just those with diagnosed eating disorders: 

 DO:

  • Encourage patients to engage in exercise that they enjoy(1)

  • Educate patients on the health benefits of exercise such as increased strength, cardiovascular health, flexibility and mental health(2,3)

  • Educate patients on the importance of rest days and encourage moderation(1)

  • Be understanding of patient's social and work commitments and reinforce that these can be prioritised over exercise(4)

  • Encourage patients to listen to body signals before, during and after exercise, such as pain and fatigue, rather than having to comply to an exact number of repetitions, sets or distance(5).

DO NOT:

  • Make statements that encourage unlimited or excessive exercise such as 'more exercise is always better'(8)

  • Encourage patients to exercise for weight loss(1)

  • Comment on an individual's weight, shape or size in either a positive or negative way as both can be problematic, especially for individuals with eating disorders(9)

  • Talk about exercise in relation to counteracting food intake(8)

  • Encourage patients to complete an exact number of repetitions, sets or distance without listening to their body(5) 

References

  1. Reel J. J. The Right 'Dose' of Activity: Health Educators Should Promote Mindful and Intuitive Exercise. J Community Med Health Educ. 2012;2(9). doi:10.4172/2161-0711.1000e111

  2. Probst M, Majeweski M, Albertsen M et al. Physiotherapy for patients with anorexia nervosa. Advances in Eating Disorders: Theory, Research and Practice. 2013;1(3):224-238.

  3. Brown K. Physiotherapy In Eating Disorders. 1st ed. The Physiotherapy Eating Disorders Professional Network Group; 2018:1-5. https://cpmh.csp.org.uk/content/physiotherapy-eating-disorders. Accessed November 18, 2020.

  4. Lichtenstein M, Hinze C, Emborg B, Thomsen F, Hemmingsen S. Compulsive exercise: links, risks and challenges faced. Psychol Res Behav Manag. 2017;10:85-95. doi:10.2147/prbm.s113093

  5. Taranis L, Meyer C. Associations between specific components of compulsive exercise and eating-disordered cognitions and behaviors among young women. International Journal of Eating Disorders. 2011;44(5):452-458. doi:10.1002/eat.20838

  6. Van Cauwenbergh D, De Kooning M, Ickmans K, Nijs J. How to exercise people with chronic fatigue syndrome: evidence-based practice guidelines. Eur J Clin Invest. 2012;42(10):1136-1144. doi:10.1111/j.1365-2362.2012.02701.x

  7. Nijs J, Girbes E, Lundberg M, Malfiet A, Sterling M. Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories. Man Ther. 2015;20(1):216-220. doi:10.1016/j.math.2014.07.004

  8. Holland L, Brown T, Keel P. Defining features of unhealthy exercise associated with disordered eating and eating disorder diagnoses. Psychol Sport Exerc. 2014;15(1):116-123. doi:10.1016/j.psychsport.2013.10.005

  9. Mental Health First Aid Australia. Eating Disorders: Mental Health First Aid Guidelines. Mental Health First Aid Australia website. https://mhfa.com.au/sites/default/files/MHFA_eatdis_guidelines_A4_2013.pdf. Published April 2020. Accessed August 12, 2020. 

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