Why we are not a fan of bans

Prohibitions in physiotherapy and training - why this is not good

In the field of physiotherapy and training, there are numerous recommendations that can often be equated with prohibitions. Such statements about what you should do to achieve goals such as building strength, increasing endurance or reducing body fat create a lot of uncertainty, anxiety and even failure. Whether it's avoiding certain exercises or training methods, bans can do more harm than good.

It's not uncommon that patients come to us and mention: ‘He said I'll never be able to ski again and I should accept it!’ or ‘I was told I can't lift weights during pregnancy?’ or ‘Jogging is bad for your knees, isn't it?’

Let's take a look at a concrete example. Lisa* comes to us. She has been suffering from knee pain for two years and has not yet had a satisfactory treatment result, in fact there is not even a proper diagnosis. She was told ‘Don't do squats because they hurt and provoke crepitations. Don't do these exercises for a while and then you'll feel better’. No sooner said than done. Lisa is actually feeling better. The swelling has gone down and the pain has virtually disappeared. She starts strength training again. One day later, the swelling is back and the pain is even more intense than before. What did the ban achieve? Nothing. On the contrary, Lisa is now very frustrated and, above all, confused. What would be the better course of action?

Let's go back to what happens when bans are imposed on patients and customers. And then think about what can be done instead.

1.individual needs are ignored

Every person is unique, and this also applies to the body's needs and response to different treatment and training methods. A ban on not performing an exercise could be unnecessary and even counterproductive. Prohibitions neglect the individuality of the exerciser and often lead to important aspects of the training not being utilised. Besides, how can we ban someone who is passionate about jogging and needs it as a mental balance just because someone once claimed it leads to osteoarthritis? (The fact that this is not the case is another matter). Or how realistic is it to forbid a 80 year old from using extra weights when exercising if she lives alone at home and has to carry the washing down to the cellar? Instead: Take a closer look at the patient, enquire about their environment, consider the overall picture. Offer modifications to make a certain exercise easier for the time being until mobility is better or the pain is less.

2.Psychological effects

Prohibitions can significantly impair motivation and enjoyment of training. If someone is told that he or she is not allowed to do a certain exercise, anxiety arises. And this leads to a negative attitude towards exercise and worse health. If training goals are linked to prohibitions, a feeling of fear and frustration can spread, which leads to avoidance of training in the long term. Anxiety increases further, which often leads to a deterioration in general health. A vicious circle. Instead: Define goals, find compromises that don't harm the body or the mind.

3. lack of flexibility and adaptability

A ‘forbidden’ training regime can lead to important aspects of training not being tried out. This limits the versatility that is often necessary to overcome plateaus or make new progress. If you only ever follow the same routes, you won't see the progress in the long term. Prohibitions prevent people from functioning in everyday life. Instead: Treatments and training should be a dynamic process that adapts to the development and needs of the individual.

4. promotion of extreme positions

Another problem with bans is the tendency to take extreme views. Instead of taking a balanced approach, some tend to think in black and white categorisations: ‘This exercise is bad and should never be done’, ‘Fat should be completely eliminated from the diet’ or ‘Only very high weight training is effective’. Instead: Be open to new ideas. Always ask questions, listen and discuss, look for a solution together. Keeping up to date with the latest research findings.

5. risk of injury and chronic complaints due to incorrect alternatives

When certain exercises are banned, a good and well thought-out alternative is often forgotten. Instead of providing a safe and effective alternative to a banned exercise, this could lead to false compromises that even increase the risk of injury. If only a limited number of exercises are allowed, the body could be loaded one-sidedly. Instead: Modify treatments and exercises. Do not omit. Try to do fewer repetitions, incorporate more breaks, find other positions.

6. avoidance behaviour and leaving the comfort zone

Physiotherapy and training should encourage you to challenge your body and push it to its limits (with precaution). If you avoid certain techniques or exercises as a matter of principle, you prevent yourself from developing and learning new skills. Of course, some exercises are challenging and not everyone has the necessary strength or technique when they start. However, the very exercises that cause problems may be the ones that are the cause of our condition. Instead: Pushing the limits, stepping out of your comfort zone, always with your health condition in mind.

Conclusion: Treattments and trainings should be based on knowledge, not on prohibitions

Instead of creating a rigid set of rules with prohibitions, the focus should be on understanding and customising training techniques and making recommendations. A flexible approach based on goals, abilities and health conditions is the key to sustainable success. Ultimately, training is about learning and development - and this is best achieved without restrictions that hinder the natural development process.

Best, Anneke & Oliver