Home Exercise Programs - Why are Physical Therapists so obsessed with giving "homework"?

Your doctor will prescribe you medication, say, for high blood pressure or cholesterol, or any other number of conditions. If you no longer test as having “high blood pressure” at your next doctor’s visit, will they take you off of the medicine? Generally no! They will say that the medication is effective, and to continue taking it so that your body doesn’t regress to its previous hypertensive state (high blood pressures return). As physical therapists, we are not trained to prescribe medication. Our prescription comes in the form of exercise. While exercises do take longer to complete than swallowing a pill, we hope that the feelings after completion of the exercises have the effects of decreased pain, improved range of motion, or, if nothing else, a sense of accomplishment that you are actively working toward your goals. I always encourage my patients to continue doing their exercises daily or at least every other day after discharge from therapy in order to maintain their level of success. Keep strengthening, keep stretching, keep focusing on how you were taught to walk, sit, stand, etc and it will hopefully, overtime, become more of an unconscious habit. In reality, we know that most people will fall off of their exercise program. It’s human nature - life happens. So, my best piece of advise is to keep all of the exercises you were given from therapy. If you find that your pain starts to return, or if you’re no longer able to do the exercises to the same quality as before, grab out those handouts and start working through them. Ideally, you will find yourself able to heal yourself through movements you already know! And, if you’re just not regaining that prior level of success, call up that physical therapist for a refresher. We are always happy to reteach and reestablish consistency with you in order to prevent you from a total regression in pain and function. In Physical Therapy, exercise is medicine - remember to take it daily!

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Treatment techniques in general

In physical therapy, we use a variety of techniques to elicit healing. These include:

• Massage to help loosen muscles, bring blood supply, inhibit (turn off overactive) muscles that are bound up too tight, provide relaxation. Touch can be a powerful component of healing and I often feel that I cannot understand what is going on with someone's body without touching the tissues

• Stretching to elongate muscles - not all tight muscles need to be lengthened, but as we get older, the need to stretch our muscles becomes even greater.

When we combine massage and stretching, we can help your body gain mobility - or - the ability to move a joint through a larger range of motion which helps provide nutrients to joints and helps to decrease pain.

• Ultrasound to shake up tissue and bring heat blood and healing materials to the hurt area

• Electrical stimulation to either teach muscles how to contract, or to help put a road closed sign on nerves that are sending pain signals to the brain (similar to TENS).

• Movement - simply moving your body at joints through their largest range of motions correctly. Often times we learn ways to compensate (or alter) the normal pattern of movement in order to decrease pain, or use muscles that are stronger. Compensations will often work for a long time, but place the body into more vulnerable positions causing unnecessary wear and tear. Teaching movement in how the body is supposed to move can help decrease pain by eliminating compensations that hurt more than help.

• Exercise for Strength - not push ups or sit ups, but specific movements that use specific muscles that may be underactive, uncoordinated, or just lazy because other muscles (compensations) have taken over their role and work load.

• Exercises for Stability - these are the least "sexy" of all of the activities we generally do because, they are boring! However, they are so very important. Our stability muscles are like the quarterback on the football team - not the biggest player on the field, but one that is pivotal in keeping the ball moving down the field. A football team with only line backers is like a body driven only by the big beefy muscles that control compensations - it might be a powerful strong team of brute force, but it will probably never make the playoffs. Stability is the balance for our system, and stability is required for good posture, balance, walking, running, lifting, pushing, pulling, and all other "ings" that come with living everyday life.

I've missed some things, but covered the basics, and this post is getting too long as it is. Tell me if you can think of anything I missed, questions regarding the information given, or for examples of what an activity might look like in the clinical setting.

What is Physical Therapy?

Physical therapy is a practice of medicine geared toward patient’s achievement of highest level of function and quality of life. I see it as empowering patient's healing through movement. It is the role of the physical therapist to help coach, guide, and educate our patient in how to use their body to heal their body. The therapist is only a tiny portion of the overall puzzle that is physical therapy.

We assess how your body moves - both where you hurt, and the areas above and below your pain location. We use hands on techniques, called Manual Therapy, to massage tissues, mobilize joints, restore alignment and body symmetry. We use exercise to help stretch or strengthen muscles necessary to overcome your specific pain or limitation. We will look at your balance, both while standing still and with walking, lifting and completion of everyday activities (getting in and out of the car, loading the dishwasher, carrying laundry, navigate stairs, etc.) We can also use machines such as ultrasound and electrical stimulation to add energy to your system with the goal to make pain better in order to allow improved tolerance to therapy session and day to day function.

When you have pain, lost range of motion, weakness, or just general difficulty with living your life to the fullest physically, I hope you will think of seeking the assistance of a physical therapy.