Management of a Patient Continuing Stretching Exercises
The patient should continue with the current stretching regimen while progressively adding resistance training and aerobic exercise to their routine to maximize long-term outcomes. 1
Assessment of Current Status
- The patient reports feeling okay and has been doing stretching exercises since being seen by another OPC provider on 9/17/2025 1
- Stretching exercises alone provide a foundation for joint mobility but should be complemented with additional exercise modalities for optimal outcomes 1
Recommended Exercise Progression Plan
Continue Current Stretching Program
- Maintain daily stretching when pain and stiffness are minimal (ideally before bedtime) 1
- Hold each stretch for 10-30 seconds before slowly returning to resting position 1
- Perform stretching exercises 2-3 days per week at minimum, with daily stretching providing optimal benefits 1
- Precede stretching with a warm shower or application of superficial moist heat to enhance effectiveness 1
Add Resistance Training
- Begin incorporating resistance exercises 2-3 days per week targeting major muscle groups 1
- Start with low-intensity resistance (40-50% of maximum capacity) if new to strength training 1
- Perform 10-15 repetitions per set for beginners, with 1-2 sets per exercise initially 1
- Allow 48 hours between resistance training sessions for the same muscle group 1
Incorporate Aerobic Exercise
- Add 30 minutes of moderate-intensity aerobic activity most days of the week 1
- Choose activities based on patient preference and accessibility (walking, cycling, swimming) 1
- Ensure intensity allows speaking but not singing comfortably during exercise 1
Structure Each Exercise Session
- Begin with a 5-10 minute warm-up of low-intensity range-of-motion exercises 1
- Follow with the main training period (stretching, resistance, and/or aerobic components) 1
- End with a 5-minute cool-down period involving static stretching 1
Monitoring Progress and Adjustments
- Gradually increase exercise intensity over time to maintain moderate intensity criteria 1
- For resistance training, increase weight when 15 repetitions become somewhat easy (Borg RPE 12-14) 1
- Modify stretching exercises if pain occurs or joint inflammation is present by decreasing range of motion or duration 1
Important Considerations
- Supervised exercise programs (by physical therapists) are generally more effective than unsupervised home programs 1
- Individual preferences, access, and affordability play important roles in exercise adherence 1
- The combination of different exercise types (stretching, strengthening, aerobic) provides more comprehensive benefits than stretching alone 1