Monday, August 13, 2012

Is Your Home Exercise Program Really Necessary?

 I asked my Dentist years ago if I really had to floss my teeth regularly. His reply simply was, “only the ones you want to keep.” Ever since I’m a flosser! When a physical therapist gives you an exercise, activity or stretch it’s a lot like flossing… It’s in your best interest to do them and to do them every day unless your PT states otherwise. Your home exercise program (HEP) and your postural corrections are as important to the success of your therapy as is the massage, ultrasound or joint mobilization. The HEP is not only designed to correct muscle imbalances but in the long run, and sometimes short-run, helps reduce your pain and keep it from coming back. 

     I used to be a massage therapist and I would get a lot of  “PT drop-outs.”  My clients/patients would say things like, “PT didn’t help me at all. I still have pain, that’s why I’m here to see you.”  I would ask if they did their HEP. Often I would hear, “No, was that really so important? It was so boring and I didn’t have time.” I think from the patients’ point of view it’s easy to feel that way. Your PT gives you these exercises and some of them may indeed feel really boring and inconvenient to do. However, what is more inconvenient, the pain that can keep you up at night or the exercises?

     It is important to remember that a therapy program is usually not an overnight process. Typically patients come to us with groups of muscles that are weak or dysfunctional (Even athletes! Especially athletes!), and in order to help stop the pain, we need to improve the strength/performance of those muscles. Improving strength typically takes 4-6 weeks when the exercises are done regularly. So, we ask you to please hang in there and be patient with your exercises. The results are not over-night.  This is true particularly when we are trying to break poor postural habits and inspire new ones.

     On the other hand, we need to know if the HEP is increasing your pain as you perform it and if so how much. It should not increase your pain significantly so if the next day you wake-up after your exercises and the pain has shot up a lot, you need to tell us. As it relates to your HEP and your symptoms, it’s good to ask yourself: “When does the pain come on? …… When I’m sitting, laying down, running, washing my hair or right after my HEP.” Being clear about what aggravates your symptoms really helps us identify the culprit. 

     Lastly, look at the exercises this way, you will not only be proud of yourself when you stick to it, but you’ll look better and feel stronger. Also some of you ask if you’ll have to do these exercises for the rest of your life. The answer is not necessarily, but you should want to keep strong for the rest of your life anyway; look at the exercises like a tool that’s helping you keep healthy and away from pain. It’s a win, win situation!

John Howard (Johann), DPT, LMT
Duffy & Bracken Physical Therapy

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