For exercise physiologist Nisanth Nandakumar, specific exercises with medication can go a long way in rehabilitation

Want to get rid of that paunch? The gym prescribes abdominal crunches. Strength training? Not for the elderly. Swimming is the perfect exercise. “Not if you have uncontrolled hypertension,” cautions Nisanth Nandakumar, physiotherapist and exercise physiologist. In the same breath he adds that abdominal crunches cannot be ‘prescribed' for everybody and the elderly will do well with age-appropriate strength training.

An exercise physiologist specialises in the changes that take place in the body with movement or exercise. This information lets us know ‘how and why' an exercise works and helps choose what is suitable for an individual's needs. It is the ‘science of exercise'. A professional like Nisanth becomes relevant at a time when there is a gym in every nook and corner. There are personal trainers, but “in a situation like that exercise is prescribed to suit the services the gym offers and not so much the person's requirements. Each person's body is different and its needs are different, something which is rarely considered,” he says.

You work out in the gym daily. Is the equipment adjusted according to your needs? Does it suit you? Is your technique right? Or are you overtraining? Aerobics is another fad. Do people know how it impacts the knees? Or that the knees need strengthening because they bear the brunt of aerobics? How CAN people refer to magazines and books and exercise? Do you know it can cause injury? This is when the realisation dawns that the whole notion of exercise and physical activity is flawed.

And these are just some of the uncomfortable questions Nisanth bombards one with.

Medicine, diet and exercise

A passion for sports led Nisanth to his occupation. He is a physiotherapist with a Masters in Exercise Physiology (an Applied Masters in Clinical Exercise Practice from Victoria University, Melbourne) which makes him, in lay terms, something of a ‘specialist physiotherapist'. As an exercise physiologist his area of expertise is preventive and rehabilitative exercise. He believes most medical conditions can be ‘managed better' with a combination of medicine, diet and exercise rather than solely depending on medication. The best part is that there are no side effects with such an approach.

He tells the story of a person with a spinal cord injury (neck) with control over only one of his shoulders, in Melbourne, who learnt to swim. “It took two years but eventually he swam. There, the expectations are high; they want to achieve their functional peak after an injury or a stroke, for instance. There, after a stroke, the aim is to be able to run. As opposed to here, where there is no hunger to do more. After a stroke, either people are confined to the bed or the expectation is to be able to walk up to the bathroom.”

Lack of awareness is a contributory factor, he agrees. Certain types of injuries (even spinal), strokes etc. can be rehabilitated with exercise, he says. Same goes for certain types of conditions such as high cholesterol and hypertension. Exercise is often seen as a remedy but rarely is its preventive aspect considered, he says. It is not just rehabilitation that he is interested in. If you want an exercise regimen that suits you, (not necessarily gym or equipment based) he can help.

According to him, there is plenty that a physio can do in the rehabilitation of a patient, which does not or cannot happen very often. In the conventional hospital scenario, treatment to be administered by the physio is decided by the doctor.

His own space

He speaks from the experience of having worked in a city hospital. “Sometimes there are 20-30 patients in a day, and you can spend only 10-15 minutes with each patient.” Nisanth, therefore, offers consultation and works with those who need his service. He has, what he calls, a ‘space' in Tripunithura (Nisanth Wellness Consulting) where he works with his clients on a consultation basis.

Committed as he is to the cause of exercise, he does not want people to get carried away with the idea that exercise is some sort of magic cure. It is something that has to go hand-in-hand with a healthy lifestyle, if required, a lifestyle change. Sounding a note of caution, he says, “Exercise is a powerful tool in improving health but it is not a miracle cure and has to be used intelligently.”