We all understand exercising is backed by evidence and that we should educate our patients to exercise. Unfortunately, in some patient population, simply talking about exercises will halt the entire conversation at once. A patient in a care facility once said, "I have been working for my entire life, why do I still have to work out?" She just turned around and refused to do anything afterwards.

Is it possible that one can limit patient's autonomy by providing less treatment options? We know some modalities have no evidence, but clinicians seem to be aware of the positive effect of the modalities.