When you’re attending physical therapy sessions, your therapist may do some passive activities where you get to relax. That’s everyone’s favorite part–the soft tissue manipulation, the muscle release–it’s magic.
But the real magic happens when you work! The most effective parts of physical therapy are guided by the therapist, but performed by you. You’ll feel real progress when you’re sweating, “feeling the burn,” and going home tired after a challenging session that didn’t seem possible a few weeks (or months) ago.
It never stops there. You only attend physical therapy one to two days per week for an hour each visit. Let’s put that into perspective.
You’re only spending 2 out of 168 hours per week rehabbing from your injury with a physical therapist.
Therapists never expect you to actively rehab every waking hour–rest is important too. But two hours of rehab per week doesn’t seem like enough.
So what should you do on days that you don’t attend physical therapy?
Do Your Home Exercise Program
To get the most out of physical therapy, you need to do your home exercise program (HEP). An HEP is a short list of prescribed exercises, just like prescribed medication, that you should perform per physical therapist recommendation. An HEP usually consists of:
- About three exercises to practice with pictures or descriptions
- Sets and repetitions to follow
- Performance frequency per day or per week
- Special instructions for your unique situation
Your HEP evolves as you go through physical therapy. The first week may consist of simpler movements and pain relief, while later weeks may consist of more complex movements that you’ve learned in the clinic.
The main rule is to stick with the HEP. Don’t do more, and don’t do less (unless otherwise instructed). If something seems unclear, email your therapist to get clarification.
Reasons You Should Perform Your HEP
We get it. There are days where you just don’t have time to do your HEP, or you just totally forget. If you’re having trouble fitting your HEP into your routine, you need to discuss this with your physical therapist. They will have ideas of ways to incorporate your HEP into your daily routine to make sure you’re staying ahead.
We also understand that there are days where you may feel discouraged, and an HEP seems like such a useless task. But it’s quite the opposite. If you’re feeling discouraged and unmotivated, performing your HEP may be the most useful task you can do for your rehab journey.
1. You can make gains on your own.
A physical therapist is certainly helpful in gaining more joint motion or guiding your strengthening regimen, but these gains are ultimately yours to make.
For example, your physical therapist may have tips and tricks on how to gain more range of motion for your post-operative shoulder. They might facilitate a ton of movement in the clinic, but unless you reinforce these motions at home with mobility exercises in your HEP, you may miss out on additional mobility gains that you could have made on your own. You can really impress your therapist if you return to therapy with more motion than you had before!
2. You keep the momentum going.
Like the example above, your therapist helps facilitate mobility or strength gains, but your HEP is incredibly important in moving your rehab forward.
Most of the time, if you don’t perform your HEP as prescribed, the physical therapist can tell. Your measurements and movement patterns will look exactly as they did the previous session, indicating that none of your previous gains were maintained.
This doesn’t always mean that you’re going backwards, but it can be a dangerous pattern to follow as it slows down your progress. Remember that insurance will only pay for a certain amount of physical therapy sessions, so slower-than-necessary progress can limit your success.
3. You establish habits.
By performing your HEP regularly, you’re establishing healthy habits of taking care of your body. You’re becoming more aware of your joints, muscles, and movements. You’re learning how to appreciate your body for its resilience as you see improvements in the little things, like pain-free running or effortless stair climbing.
Even after rehabilitation, you’ll be inspired to continue stretching, strengthening, and moving in ways your body needs to feel bulletproof.
What Happens If I Don’t Do My HEP?
We could answer with a scary statement here, like, “You’ll go backwards and end up having surgery!” But that’s not always the case. Sometimes, nothing happens. Some patients get better anyway.
Yes, it’s true.
The better question is, “What Will I Miss If I Don’t Do My HEP?” The answer depends on the person, but the general consensus is that you won’t meet your maximum potential. You may get better, but you might not reach your goals.
For example, if your knee had an operation and you don’t do your HEP, you’ll probably go back to walking and stair climbing without any problems. But, you’ll have trouble finding your stride when you go back to soccer practice. Or maybe you’re left with an underlying fear of reinjury, since you don’t feel as strong as you could be. If you’re a college athlete, this could be a huge hindrance that could have been avoided with more practice at home. Remember that physical therapy is only approved by insurance for a limited timeframe, so you need to make the most of it.
Let’s consider a different example. If you tore your shoulder’s rotator cuff while lifting your grandchild, you may be facing surgery. First, your doctor wants you to try physical therapy because the tear is small. You’re an excellent patient in the clinic, but you always forget to do your HEP at home. You get better anyways and discharge from physical therapy after six visits. But as time goes on and you lift your grandchild, do home DIY projects, or swim in the ocean, you can feel that your shoulder is vulnerable.
Physical therapy, combined with an HEP, gives you the flexibility, strength, and confidence to continue living your life to your full potential. Don’t limit yourself.
Just like you need to finish your prescribed antibiotics during an infection so it doesn’t return, you need to complete your HEP.
JACO Rehab’s physical therapists want you to reach your full potential. We want to help you get back to the activities you love. Then, we want you to tell us all about it!
Reach out to JACO Rehab to schedule an appointment at any of our four O’ahu locations: Honolulu, Waikele, Kapolei, and Mililani.
Written by Nicole Hernandez, DPT