Anatomy and Exercise Prescription
Anatomy and Exercise Prescription
This domain tests applied anatomy - planes, levers, muscle actions, innervation, dermatomes and myotomes - together with the principles used to prescribe safe, effective exercise.
Core rules
- Key myotomes: C5 deltoid, C6 biceps, C7 triceps, C8 finger flexors, L4 tibialis anterior, L5 extensor hallucis longus, S1 gastrocnemius. Matching dermatome and myotome findings localises the level.
- Exercise principles: specificity, progressive overload, reversibility, individuality and recovery. Apply FITT - frequency, intensity, time, type.
- Strength: roughly 60–70% of one-repetition maximum, 8–12 repetitions, 2–3 sets. Hypertrophy: 70–85%. Muscular endurance: below 60%, 15–20 or more repetitions. Balance training for older adults reduces falls.
- Eccentric work suits tendinopathy; isometric work can reduce early pain; plyometrics require adequate strength and control first.
- Avoid Valsalva manoeuvre in cardiac and hypertensive patients; avoid loaded spinal flexion and high-impact loading in significant osteoporosis.
Worked example
A 70-year-old woman with osteoporosis and knee osteoarthritis needs strengthening. Reasoning: compressive spinal loading and high impact raise fracture and pain risk, so choose supported hip abduction and extension with resistance bands, 2–3 sets of 10–15 at moderate effort, plus supervised balance work and walking. Progress resistance before adding impact, and monitor with a pain scale and sit-to-stand performance.
Traps
- Prescribing breath-holding during resistance work in cardiac patients.
- Forgetting specificity - cycling will not build grip strength.
- Adding impact before strength and balance are adequate in osteoporosis.
- Prescribing intensity without stating sets, repetitions or progression.