by Erin Looney, DPT
One of the most frequent questions I am asked by both new and established patients is: “Do I need to continue my home exercises?” or “How long do I need to continue my home exercises?” My hope is to shed a little light as to why we give our patients exercises to do at home.
Let me start off by saying that it is difficult to categorize the variety of complaints/problems our patients seek care for, however, I’m going to attempt to simplify things by creating 2 broad categories – Acute Pain and Chronic Pain. By no means do all patient complaints fit into one of these categories, however most do.
Acute Pain generally comes from new injuries. For example, this might be pain from a recent surgery, ankle sprain, broken bone, etc. Patients with these concerns often experience more temporary problems such as: decreased strength, range of motion/flexibility restrictions, swelling, scar tissue restrictions, and tenderness. Mobility and functional movement concerns are usually also temporarily present. This may include, difficulty with walking/limping, trouble reaching overhead, inability to put full weight through one of their legs, inability to perform work tasks, pain with walking up and down the stairs, or trouble sitting for prolonged period of time. In short, most of these patients were functioning well – maybe playing sports or enjoying a walk on a nice summer day – prior to their injury occurring. Our goal through treatment during the PT sessions and more importantly with the home exercise program is to bring these patients back to the level they were at prior to injury/surgery. For these patients, the home exercise program is most often used while attending PT sessions. Realistically, our patients are only with us for 45-60 minutes 1-3 times per week. This isn’t much time, if you think of all the hours in a week. For this reason, we try to use the time we have during our sessions to do the things you can’t do on your own and we use the home exercise program as “homework.” Patients in this category generally “graduate” PT and resume their previous activities (sports, walking, etc.) and either need to continue their home exercise programs for a short amount of time, or do not need to continue.
Chronic Pain generally comes from old injuries, medical conditions, or repetitive “flare-ups.” For example, these patients might have chronic pain, postural dysfunction, reoccurring back pain, etc. Patients with these concerns often experience more reoccurring problems that are constant or come and go such as: decreased strength, range of motion/flexibility restrictions, scar tissue restrictions, and tenderness. Mobility and functional movement concerns are usually also constant or come and go. This may include, difficulty with walking/limping, trouble reaching overhead, inability to put full weight through one of their legs, inability to perform work tasks, pain with walking up and down the stairs, or trouble sitting for prolonged period of time. In short, most of these patients have good and bad days/weeks/months. Our goal with most of these patients is to teach them ways to modify their lifestyle, posture or daily activities to help ease some of their chronic discomfort. For these patients, the home exercise program is used while attending PT sessions and after to maintain positive changes. Realistically, our goal is to give our patients the tools to make positive lifestyle changes to help minimize the chronic nature of their complaint(s). Patients in this category generally “graduate” PT with a home exercise program that they will continue indefinitely.
Regardless of a patient’s complaint(s)/pain, our goal as physical therapists is to restore/optimize function and to support an active and healthy lifestyle. We strive to assist patients with return to activity that is appropriate and that peaks their interests. For many, this also includes making new, positive lifestyle changes.
Dr. Looney is a Physical Therapist at Boston Sports Medicine
