Specialising in musculoskeletal, orthopaedic, spinal and sports rehabilitation

Love of Exercise

Love of Exercise?

It is February and this month is dominated by Valentines day and so this is the month of love and we want to share the love of exercise with you.

If you have started a new fitness regime in January, then by February hopefully you have fallen in love with exercise. Meaning that you should now find some sort of joy for performing this type of physical activity. Whether it is the feeling of achievement afterwards or the physical challenge of completion there should be some enjoyment for participation in this type of behaviour.

The love of exercise can be polarising. Say “Exercise” to people and there are two common responses:

Great! I love exercise

Oh NO! I hate exercise

If you remember from out last post, exercise is Physical activity that is repeated, planned, purposeful and structured.

Exercise is a relatively new concept in terms of biology, because we are now performing physical activity for health reasons rather than working the land or hunting.

Love of our physical form comes from understanding our bodies from an evolutionary point of view. Because exercise is actually not a natural phenomena and is relatively new in terms of the human experience on Earth.

So, why do most people hate exercise when it is so good for us?

The key is in our biology and more particular viewed through the lens of evolutionary biology.

Where saving energy when we were hunter gatherers was the name of the game. This is also why we have evolved to be so energy efficient at walking and why you can’t walk your way to weight loss.

Here we would have been active most of the day with physical tasks. This is the same with the agricultural revolution, physical tasks were required for the farming of crops and livestock.

The use of Technology has been a game changer in terms of human physical exertion. We now work by sitting down all day which is a direct paradox to how our physical biology has evolved.

The other concept is the abundance of food, particularly very tasty high calorie food that we don’t have to hunt or forage for.

These days in order to be healthy we have to choose to move. However, this goes directly against your primeval drive to rest, relax and conserve energy. Or indeed take the route of least resistance. Increasing your Physical Activity might look like taking the lift/escalator rather than the stairs in a modern day environment.

To counter our natural instincts to conserve energy, “Smart” new buildings have deliberately changed their layouts so that stairs are at the front of a building and the lifts are at the back. Thus encouraging stair use and physical activity by making our environment more “physically friendly”

Moreover, we need to apply this logic to our entire lives in order to simply get more activity into our lives. Strategies such as active transport, which means walking or cycling to work, or at least getting off one stop earlier on the bus for example.

Most health advisors agree that 150 mins of moderate physical activity per week is the minimum investment of time for health purposes. Despite this recommendation, most adults struggle to achieve this, bearing in mind this is only 22 minutes per day.

Strangely, we have known about this in the UK since the 1950’s. But 80 years later we continue to repeat our learning of the old information.

Physical activity for health benefits is best explained by the London Buses study by Morris et al in the 1950’s. In this revolutionary study comparing the health of Bus Drivers against Bus conductors clear evidence can be seen that walking around the bus and climbing stairs is better for your health than sitting down for the same hours of work (See reference).

Physical activity has multiple benefits to both physical and mental health. It’s so good for you it should be prescribed to everyone. However, the medicine is not necessarily to everyone’ s taste.

So, this concept that we should “love exercise” perhaps needs a rethink.

We should be encouraged to exercise, but ultimately, this should be our decision based on what is good for our health, the health of our families, our nations and our world.

At Marylebone Physio and Sports Medicine we understand the importance of exercise. Whether you love it or not we can prescribe you the right exercise at the right time to get you back to loving whatever exercise is your preference.

Because, the best exercise for you is the one you love doing.

Thanks to Daniel Lieberman and his book “Exercised” as the inspiration behind this post.

Exercised: Why something We never evolved to do is healthy and rewarding By Daniel E. Lieberman, New York, NY: Knopf Doubleday Publishing Group, 2021. ISBN-13: 9781524746995

MORRIS JN, CRAWFORD MD. Coronary heart disease and physical activity of work; evidence of a national necropsy survey. Br Med J. 1958 Dec 20;2(5111):1485-96. doi: 10.1136/bmj.2.5111.1485. PMID: 13608027; PMCID: PMC2027542.

New Year, New You

The 5 most common Gym mistakes in January

It’s January and the new year brings about the reflection of new year’s resolutions.
This will no doubt involve some sort of new fitness regime
We all know the benefits of regular exercise, but what are the 5 most common mistakes that new comers and those returning to the gym make?

  1. The correct dose of exercise – The Goldilocks principle
  2. Consistency is key – You can’t get fit in one workout
  3. Dynamic Warm up – Save static stretching until the end
  4. Train Movements NOT Muscles – Train the brain
  5. Having a plan to your training – Let your plan be your guide

The correct dose of exercise – The Goldilocks principle

Exercise Prescribers here at Marylebone Physiotherapy, we are experts at getting the dosage of exercise correct for each client. Not too easy as to be ineffective and not too hard as to not be able to walk the next day. Not too cold, not too hot, but just right, is also known as the Goldilocks principle. Exercise can be defined as physical movement that is:



Purposeful and


We can use the acronym RePPS to help us remember this

Repeating a movement is the very definition of exercise. You learn to master a particular movement, then you load it up with heavier weights or speed up the movement. You can also perform the movement under fatigue.

Planning your exercise is covered later on in this Blog.

Purposeful relates to your specific fitness goals. Remember that weight loss is a side effect of fitness training and not the desired goal.

Structured refers to the way your training session is broken down into its component parts

Below is an example of a typical gym session:

Dynamic Warm up
Metabolic conditioning
Cool Down
Use the RePPS principle for your next session.

Consistency is key – You can’t get fit in one workout

“You can’t drink the Ocean in one gulp!”

It is the same with exercise, you can’t get fit in one workout, just like you can’t live your life in one day.

The first six weeks of training you are unlikely to see any results. However, you are likely to feel better and have more energy. The best things come to those who wait, but in a society that wants instant gratification the wait can be frustrating.

Around 8 weeks the physical transformation becomes visible. We tend to lose body fat and gain lean muscle. Look forward to 12 weeks and things are looking even better

However, you will eventually plateau with your fitness gains and this is where you need to maintain it. Make time for exercise and be consistent.

Dynamic Warm up – save static stretching to the end

If you have not trained since your School, College or University days then things have changed. Wear warm layers and slowly strip them off as your body warms naturally with the heat generated from the movement.

We tend to favour a dynamic warm up in preference to static stretching. We can save that until the end of the workout. Because performing static stretches slows down your heart rate, lowers injury risk and helps reduce DOMS (Delayed Onset Muscle Soreness) we tend to leave it for after the workout. The other reason for this relates to studies where over stretching muscles in the warm up loses the protective effect of the tendon reflex that is designed to stop over stretching.

Dynamic as the name suggests means we are moving through a movement rather than holding a static posture. This could look like Squats and lunges or Press ups and toe touches. Starting with partial movements and building into full range, listening to the body and not pushing into pain or restriction.

Movement sequences that open the hips and rotate the body and examples of dynamic stretching.

Train Movements NOT Muscles – Train the Brain

Unless you are body building or focusing on particular muscles, then we at Marylebone Physiotherapy would encourage you to train movements not muscles. That’s why we have our own Movement Specialist, Katia.

Movement is a skill, and as such it needs to be practiced and challenged in order to not just make it better, but optimise the movement. The brain knows nothing of individual muscles, it knows only movement.

There are seven level 1 functional movements that you should be familiar with, these are:
Hinge or bend
Walking (Gait)

These seven movements form the basis of all functional movements the body has to perform.

Examples of Level 2 functional movements are running jumping and throwing.

Level 3 functional movements are the highest level and these require proficiency at levels 1 and 2 before attempting. Level 3 includes multi-directional movements or combinations of movements linked together.

An example of this is a Burpee.
This is a hip hinge into a press up, back into standing and then performing a jump at the top of the movement. The Burpee is normally completed at speed to add to the challenge of the movement.

Having a plan to your training – Let your plan be your guide

How do you get there if you don’t know where you’re going?

The answer is to have a plan. This will be based on your Fitness goals.

Are you doing a Couch to 5 km or Running a Marathon? Are you starting your first Boot-camp or competing at CrossFit?

Most Gym goers start with a “Push, Pull, Legs” Plan of three times a week

You could train one of the functional movements every day of the week. Or you could break the functional movements up into training each once during the week.

An example might be:

Monday – Push, Twist

Tuesday – Walk

Wednesday – Pull, Lunge

Thursday – Walk

Friday – Hinge, Squat

So, there you have it. The five most common Gym mistakes and how to avoid them happening to you.

Now it’s your turn to implement this new knowledge and have an injury free return to training.

This is your year to get fit, stay injury free and enjoy being healthy.


Rehab Matters, CSP Physiotherapy, Marylebone Physiotherapy, Health Consultants Inc, Acupuncture

Rehab Matters

The CSP is currently promoting a campaign ‘Rehab Matters’ which is aimed at improving access to rehabilitation services across the UK. This is an idea that is shared by Marylebone Physiotherapy & Sports Medicine and we thought we would share the CSP’s provoking film about two fictional characters who have very different experiences after leaving hospital as one receives physiotherapy and the other does not. Enjoy.


Marylebone Physiotherapist, Alexia Critien, Health Consultants Inc, London, Best Physiotherapist, Musculoskeletal treatment, Acupuncture, Massage, Clinical Pilates, Anti-gravity physiotherapy, Baker Street, Gloucester Place, BNP Paribas, Costa Coffee, Pret a Manger, The Dorset Cafe, Oxford Street, Marylebone train station,

No Pain No Gain!


Is the old saying ‘no pain no gain’ true? Is it OK to feel pain after exercise, and how much is too much?

DOMS, or Delayed Onset Muscle Soreness can be an uncomfortable reminder that we are not as strong as we thought we were. However, contrary to popular opinion, it can affect anyone regardless of fitness levels. From a couch potato running for the bus, to elite sportsman Andy Murray competing in the grueling heat of the Australian Open, there is no hiding from the beast that is DOMS.

Read More