Exercise Referrals

Mactaggart Leisure Centre is community owned and is, therefore, available for the whole community to use. We have trained an exercise by referral instructor, who was previously a personal trainer, to be able to take on clients who would ordinarily either be very nervous about beginning to exercise or would not be able to exercise alone at all.

We have now set up a GP referral project that has all of the island’s GPs, nurses and physiotherapists able to refer their patients to the leisure centre for individualised, managed exercise regimes. We use both our pool and gym for this.

Aquacare is our pool based exercise referral session and has been a successful project run by Mactaggart Leisure Centre since 2001. The pool is heated to over 30 degrees and the project is designed to help adults with both long and short term musculoskeletal injuries and long-term physical or mental health conditions through individualised exercises in a warm, zero gravity swim pool environment. The session runs every week for 60 minutes with time before and after for socialising and refreshments. Aquacare has been instrumental in providing a safe environment for some of the most disadvantaged members of the community to be able to rebuild/maintain their physical and mental health.

Each client is provided with an exercise card and given initial instructions on how to perform each exercise. Once they are confident, the instructor will leave them to it a bit more but will always be on hand for questions. This means that each client has a completely different set of exercises within a group exercise session. This ensures that each session is specific to each client and also maintains the psychosocial benefits of group exercise sessions. Referrals are generally 12 weeks long but a lot of the clients stay for much longer than that, using the session as a form of therapy

We can also use of gym for exercise referral. The gym is ideal for patients suffering with bone and joint disorders such as osteoporosis, which water based exercise can do little to mitigate. We can also take on clients suffering with advanced cardiac and pulmonary issues and chronic lower back pain. When referring to the gym, all clients are given one to one sessions with the exercise by referral instructor. Sessions run for one hour and referrals are 12 weeks in length. It is hoped that after the 12 weeks, the client will be in a routine and will be happy and confident to run their own gym sessions and continue attending the gym. An exercise card detailing what was done within the referral is given to the client to act as an aide memoire.

Aquacare Case Study

I have always been hypermobile which lead to a couple of shoulder dislocations in university. This issue had not bothered me for the last twenty years and I have had an active lifestyle, for example swimming and performing CPR as a health care professional. During a procedure at work, an action required pulling and twisting which tore tissue and disabled the shoulder. I was left with shoulder apprehension and then later on heard an unstable “clunk” noise which followed the shoulder falling out of it’s socket. My shoulder was put back in on Islay without x-ray. Islay does not have an x-ray machine so I was flown out and correct position was checked the next day. After this some further scans were planned. After this time I had an MRI arthroscopy. Unfortunately this did not give good results and medical professionals couldn’t agree on a diagnosis or treatment. I spent 6 weeks in a sling and six weeks doing very gentle physio to avoid further injury. Eventually (three months after the initial injury) a treatment was decided upon and I underwent a posterior labral tear repair and stabilization. After this operation my arm was put in a sling for four weeks. By the time I started physiotherapy I had had over three months of muscle wasting leading to complete immobility. The first physiotherapist started by doing very limited exercises and the same exercises every day. Up until this point I was being managed by a physio on the mainland so hadn’t actually had an in person appointment. This did not help that much and it is only when I saw a physio on Islay that I started to make improvements. She suggested a range of exercises to increase strength and mobility. She also suggested water based activity.

I tried to go into the Mactaggart Leisure Centre pool during a public session and felt very insecure in the water. That session had strong swimmers making waves and the water was quite cold. I was also aware that, to all intents and purposes, I looked like a healthy individual. That obviously was not the case and I knew I wouldn’t be able to quickly get out of the way of anyone and the lifeguards wouldn’t necessarily know I was injured.  I found this a little frustrating as I was once a competitive swimmer myself. My physiotherapist suggested attending Aquacare, which I thought was just a form of therapy for old people. Having found out it can also be used for injury recovery I went along. This session is a lot quieter, the water is a lot calmer and warmer and the instructor and lifeguards are aware that everyone there is potentially vulnerable. It took some time to get personalized exercises from the Aquacare instructor so I ended up using exercises my physio had suggested instead. It made a huge difference and by the time I got those exercises from Aquacare, I had already regained some of my swimming ability. In the water my arm can float in all directions. There is resistance in all directions with much smoother movement. I was finding I have a much greater range of movement in water compared to on land. Now the instructor has left me to it a bit more, knowing I am motivated and supported by a physio. It is the most tiring of all my exercises but has made a huge difference.

Gym Referral Case Study

I was referred to the gym by my GP. I have multiple health conditions including pulmonary embolisms, a heart murmur, anemia, hypertension and arthritis. I had also had my gall bladder removed last year. I was feeling down and was struggling with my weight. It was difficult to exercise as I got out of breath easily. It felt like I wasn’t going to achieve anything.

I started in the gym with a one to one exercise by referral instructor. He took me through various exercises and told me what I could do at home safely and also had a few ideas for healthy eating. I feel these sessions went really well. By about half way through I felt I was confident to go into the gym by myself. I could start to see and feel a difference and this boosted my confidence. At first, I couldn’t manage that much. I only went on the cross trainer for about a minute at a time whereas now I can manage 20 minutes!

I have completed the 12 week programme and I feel much better and much more confident. I use the gym 2-3 times per week. I’m also in the pool once per week and the same instructor holds a healthy eating lunch just after that pool session. I am out and about more, meeting new people and generally feeling good in myself. I have lost about a kilo in body weight. The instructor says this is because I have focused on the weights and am now building muscle, so the weight loss won’t be so noticeable but I can feel I am getting fitter and stronger. I now have a feeling of achievement, know I am on the right track and have overcome that feeling of despondency. I have reduced a little bit on cardio work, and I know I need to continue with that to continue my weight loss journey.

Overall I am chuffed to bits! I never really went into the leisure centre before as I was apprehensive of water. There is now a group of us friends that go every week and I am also in the gym a couple of times as well. I quite often see the instructor with new patients as I kept the routine of going at the same time each week. It turns out that is one of the instructors permanent slots for referrals so it’s good to catch up. He usually asks what I’ve been up to and that helps to keep motivated. I have also bought a bit of kit to exercise at home and try to get on my bike once per week.