Rehabilitation for Disc Herniation and Osteoarthritis - Rehabilitation

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Regarding rehabilitation issues related to intervertebral disc herniation, degenerative arthritis, and patellar valgus?


Hello Doctor: I have been experiencing physical discomfort and in March of this year, I was diagnosed by a physician with stage 1 approaching stage 2 lumbar disc herniation at the L4-L5 levels, patellar malalignment, and early-stage degenerative arthritis.
I have been attending outpatient rehabilitation at a hospital and have been following the rehabilitation program since then.
My condition has improved after rehabilitation, and I currently do not need to return to the hospital for follow-up visits, but I need to continue doing strength training exercises at home.
Recently, I saw reports on television and the internet regarding exercise that stated, "When the body performs the same movement for an extended period, it can develop a memory that leads to exercise fatigue, resulting in diminished effectiveness.
It is recommended to change the exercise movements periodically to allow the body to reset its memory." Since I no longer have outpatient visits, I cannot ask my rehabilitation therapist about this issue.
I would like to ask you, Doctor, does this phenomenon also occur with rehabilitation exercises? Can the effectiveness of rehabilitation decrease due to exercise memory fatigue? If this memory fatigue does occur, how should I change my exercise movements in the absence of outpatient consultations? I am currently following the movements prescribed by my rehabilitation therapist while doing strength training exercises at home.
Should I consider these exercises as part of my daily routine and do them every day? Under what circumstances can I take occasional breaks? Thank you, Doctor, for taking the time to provide me with your advice.

Ms. Chen, 50~59 year old female. Ask Date: 2023/11/20

Dr. Lin Ruixiang reply Rehabilitation


Hello: First of all, congratulations on the improvement of your pain due to rehabilitation.
To get to the point, your concerns are valid.
Any exercise (including resistance training) can become less effective over time due to the familiarity with the movement technique (what you refer to as muscle memory).
As your skill level improves, the same amount of exercise may yield diminished results.
There are two solutions to this: one is to increase the exercise volume, and the other is to change the mode of exercise, such as alternating between using your left and right hands in sports.
Additionally, you can alternate between exercises that engage different muscle groups (such as cycling and swimming).
I hope this helps address your concerns.
The Hualien Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2023/11/20

More Info


Understanding rehabilitation for conditions such as disc herniation and osteoarthritis is crucial for managing symptoms and improving quality of life. Based on your description, it seems you have been diagnosed with a combination of disc herniation and early-stage osteoarthritis, which can lead to significant discomfort and functional limitations. Rehabilitation plays a vital role in your recovery process, and it is great to hear that you have already seen improvements through your rehabilitation program.

Rehabilitation for disc herniation typically focuses on pain relief, restoring mobility, and strengthening the muscles that support the spine. This often includes physical therapy exercises, which may involve stretching, strengthening, and aerobic conditioning. For osteoarthritis, the goals are similar, but the focus is also on maintaining joint function and reducing stiffness.
Regarding your question about the concept of "exercise fatigue" or "motor memory fatigue," it is indeed possible for the body to adapt to repetitive movements over time. This phenomenon can lead to diminished returns from the same exercise routine, as the body becomes more efficient at performing those movements, which may not challenge the muscles sufficiently anymore. To counteract this, it is beneficial to vary your exercise routine periodically. This can involve changing the types of exercises you do, the intensity, the duration, or even the equipment used. For example, if you have been doing a lot of resistance training for your lower back, you might incorporate some aerobic exercises like walking or swimming, or even try different strength training exercises that target the same muscle groups in different ways.

In terms of how often you should perform your rehabilitation exercises, consistency is key. It is generally recommended to engage in your prescribed exercises several times a week, ideally every day, especially if you are not experiencing significant pain. However, it is also important to listen to your body. If you feel fatigued or are experiencing increased pain, it is perfectly acceptable to take a rest day or to modify your routine to include lighter activities such as stretching or gentle yoga.
If you are uncertain about how to modify your exercises or if you feel that your current routine is no longer effective, consider seeking guidance from a physical therapist or a qualified fitness professional when you have the opportunity. They can provide personalized advice based on your specific condition and progress.

In summary, rehabilitation for disc herniation and osteoarthritis is an ongoing process that requires attention to both exercise variety and consistency. By incorporating a range of movements and listening to your body, you can optimize your rehabilitation efforts and continue to improve your strength and mobility. Remember, the goal is not just to alleviate pain but to enhance your overall functional capacity and quality of life. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider when possible.

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