The best physical therapist knows one thing: a home program that is simple and easy to follow is the best medicine.
Often, the Physical therapists with the best intentions will give out pages and pages of exercises that interfere with the life of the person in pain, that had surgery or has loss of strength or mobility. They mean well but are making the cardinal mistake of over-dosing the exercise program with a kitchen sink approach. Like in most situations, a specific, skilled intervention based on what the patient needs that week is best and there is always one or two exercises that can specifically improve the problem.
The best Physical Therapists in the world also know when to rest their patients in order to recover from them. Let’s face it, the exercises and movements are new and a lot for the body to deal with in a healthy situation, never-mind injured. If you, as a patient started to feel better or make gains in mobility and strength with certain exercises and start to lose the gains you made, it is time to rest from them. Your body is not able to keep up with the constant request to make a change. A few days to rest and recover will make all the difference and even more gains will be made without the exercises.
How many are enough? How many repetitions and sets should you be doing and how often per day? In therapy and rehab, there is really good scientific exercise that the best Physical Therapists know: one set is enough! Unfortunately, all too often Physical therapist are overwhelmed with up to 6 patients in an hour! While this practice is the “normal”, it is not skilled and it is not ethical. Due to the lack of time to work with the patient and develop the exercise program, the PT might just give out 10 or 15 or 20 and 2-3 sets of all the exercises. This is the hallmark of bad physical therapy that can not only not help, but can actually injure the patient further as it is an over-dose of exercise and new movements.
So, in closing, if your exercise program is a book of black and white pictures, stick figures, sketches and all the repetitions and sets are the same or similar and do not change, that is not physical therapy. You deserve one to one, skilled care that is specific to you and your own goals. In these cases, search out the best physical therapy that works with you without distraction and is based on the best science, your outcome goals and most importantly, creates significant improvement in just 2-3 sessions.
Adam Iannazzo, PT