Going to physical therapy isn’t high on most people’s to-do lists. You’re there because of a nagging pain or injury, and will likely have to keep visiting your physical therapist over the next few weeks or longer to get the problem under control. That means you have to put in plenty of work to help put yourself on a path to feeling like yourself again ― and physical therapists are aware that it’s a big ask for many.
“Exercises in particular tend to take time to produce desired results,” said Kelly Short, a physical therapist and director of the Center for Restorative Therapies at Mercy Medical Center in Baltimore, Maryland. “We all can recognize that it takes time to build muscle strength, stretch out a tight group of muscles, or change our posture.”
More than 50 million Americans undergo physical therapy each year, which means you’re not the only one going through this form of rehab. But while physical therapists are consistently there to help coach you through recovery, there are a few missteps you may be making that unintentionally annoy them ― and that get in the way of your treatment.
We tapped three physical therapists to learn more about the biggest things patients do that frustrate them, plus why they should be fixed ASAP.
The biggest issue? Not doing your ‘homework.’
This is the No.1 complaint that physical therapists share. “Carry-over from the clinic setting to the home is vital,” Short said. “Practicing during the physical therapy visit and becoming proficient in technique is simply the start of building a habit of exercise to produce long-term results.”
Physical therapy is also a complicated process, said Dr. Andrew J Bach, a physiatrist at Cedars-Sinai Spine Center in Los Angeles.
“Rehabilitation is rarely as simple as ‘go to therapy twice a week for six weeks and you’ll be back to normal,’” he explained. “Many of these corrections require forming new movement habits, and habits aren’t built in just a couple of hours a week. That’s why doing your prescribed exercises at home ― your ‘homework’ ― is essential.”
Failure to do that homework, which is known as a Home Exercise Program (HEP), can interfere with your ability to get better quickly.
Consistency is also crucial with physical therapy homework, according to Kyle Smith, a clinical specialist in orthopedic physical therapy at The Ohio State University Wexner Medical Center.
“The one to three hours spent at your physical therapy appointments per week pales in comparison to the 168 total hours in a week,” he said. “Not performing exercises at home will limit your ability to keep the momentum between physical therapy sessions and build up toward your goals.”
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Physical therapists can tell if you haven’t been continuing your work at home.
Other behaviors that bother physical therapists
Aside from not doing your at-home exercises, there are additional choices and behaviors that can frustrate PTs during your healing journey. Here are a few:
You’re impatient.
Physical therapy is a long game, and that can feel frustrating when you want to feel better immediately.
“Avoid the desire for the ‘quick fix’ ― it can be very tempting,” Smith said. “Sometimes a quick resolution to an injury or chronic issue is realistic, and sometimes it’s going to take time.”
He stressed the importance of being willing to be patient, and to understand that the longer your issue has been with you, the longer it will likely take to completely go away.
Your form is off.
While doing your physical therapy homework is important, Smith said it’s especially crucial to use the proper form while you’re going through the motions.
“Don’t be afraid to ask your therapist questions or to review an exercise,” he explained. “Physical therapists prescribe these interventions every day, so they may take for granted your understanding of an exercise.”
Because you’ll be doing these exercises at home on your own without your therapist’s supervision, Smith said it’s important to understand the correct form before you go home. If you’re confused or uncertain, speak up.
You skip sessions.
It’s hard to schedule physical therapy around work and everything else you have going on in your life. But skipping sessions that you and your therapists arranged won’t help your recovery.
“Use the time outside of physical therapy wisely and you will be thankful when you see progress,” Smith said.
Don’t push yourself before you’re ready and cleared by your PT.
You try to do too much, too soon.
Some people see their exercise prescription as a “starting point” and feel that pushing things more will allow them to reach their goals sooner, Short said. But that approach can backfire.
“This can exacerbate their symptoms, creating a bigger problem than they started with,” Short explained.
Others may try to jump back into the same activity levels that they had before they started physical therapy, Bach noted.
“If you’ve just completed physical therapy for a back injury, it’s unrealistic ― and risky ― to jump right back into the weight room at full intensity,” he said. “Recovery is a gradual process, and your body needs time to adapt.”
Smith stressed the importance of being willing to modify your workouts and activity level in the short-term, noting that it can be vital to supporting your recovery efforts.
“Remember, the goal is to get back to your prior level of activity, but a short regression can ultimately be beneficial to achieving your end goal,” he explained.
You push through the pain.
It’s normal to feel a little discomfort during physical therapy, but you shouldn’t be in pain ― or ignore pain altogether.
In fact, Bach noted this is one of the most common mistakes he sees. “There’s a big difference between the ‘hurts-so-good’ discomfort of a productive workout and the pain that signals injury,” he added. “Some patients push themselves just to check off exercises, even when they’re in pain, and that can lead to setbacks or even re-injury.”
You’re not honest about how you’re doing.
Physical therapists will usually ask how you’re feeling at the start of every session ― this is not the time to say that you’re “fine” if you’re not. Instead, be upfront with your therapist about how you’re feeling, including any challenges and successes you’ve noticed.
“Working with your physical therapist to identify recent lifestyle changes that may be contributing to your pain can be beneficial,” Smith said.
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