Exercise prescription – are we looking at it all wrong?

Adi Goldstein 339915 UnsplashNot a week goes by without some reference to how much exercise we should be doing. Government directives, TV information pieces, reality TV boot camps… we’re sinking in information. Parish noticeboards are awash with posters hoping to entice new participants to join classes. There are campaigns to encourage participation (This Girl Can). GP’s endorse exercise prescription and never miss the opportunity to tell us we should be exercising more. However, as a nation, we are still failing to achieve the recommended 150 minutes of moderate exercise/week.


So my question is – Exercise prescription – are we looking at it all wrong?

Having attended a brilliant seminar by Dr Tim Anstiss at Elevate 2018, I think we might be. Tim is Medical Director at the Academy of Health Coaching and suggests that behavioural change techniques play a key role in encouraging physical activity.

There are many reasons why peoples physical activity varies, so a one size fits all solution won’t help. The sport and fitness sector play a key role in helping people to improve their fitness. It can be scary to pitch up at the gym for a training programme because the GP has told you to. In fact, it feels like a punishment. Everyone works individually. There is limited social interaction unless it is with your trainer and there is a feeling of being judged. Consequently, your adherence rate may reduce and the only outcome is a fear of gyms. On the other hand, the gym might be absolutely the right place for you and you may find it extremely motivating.

However, research has revealed that the majority of doctors in England are unfamiliar with recommended levels of physical activity. With fewer than two-thirds confident about discussing the topic with their patients.

So how can we help a client get the best from their exercise?


Joshua Ness 225844 UnsplashConsider a person centred approach? Empathetic listening, motivational interviewing, realistic goal setting, and most importantly, a supportive social structure in which to exercise. Congratulate them on making the first step to improved fitness. Listen to their fears and needs. You will get a better outcome if your client feels they are really being listened to. Regularly check on targets and remember, sometimes not improving is better than getting worse.


Let’s celebrate people’s success

Sofiya Levchenko 165628 UnsplashWe should also be celebrating success, however small that may be. To be able to celebrate success, the goal setting has to be realistic, positive and motivational. Celebration can take many forms. You could regard a reward system as bribery but if it works then happy days! Just make sure it is something the person really wants or values. Coffee vouchers, online e-reader vouchers or a lottery ticket may be a better sweetener than a free gym membership or snazzy trainers



The seminar reminded me that FLexercise teachers are trained in so many behavioural change techniques. Planning, scheduling, prompting, cueing, using visualisation, demonstrating, supporting, encouraging, developing a social structure in class. The list is endless. We really do have a person-centred approach to exercise and one size doesn’t fit all. We listen empathetically and positively motivate our class participants.


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Our classes are places of fun, laughter, friendship and support. Everyone works at their own level. Participants are self-monitoring. They tell us they are feeling fitter, more flexible etc. They are also self-regulating, returning week after week. And finally, they tell their friends about us and there is no better advertising than word of mouth.

Exercise prescription? No thanks. Give me social prescription any day.