Throughout engagement in the process of physical therapy, many individuals struggle with parameters of their home program. How often should I do the exercises? How many sets and reps should I do? Should I feel pain or stay away from pain completely?
Notice what all of these questions have in common: “Should”
Traditional physical therapy tends to be very prescriptive. Pre-filled templates with “3 sets of 10” of this, “2 sets of 20” of that. For many individuals, this cut and dry prescription makes sense, and creates a clear structure for engagement with the exercises at home. However, consider what this rigid structure deprives you of.
By the therapist deciding on the exact parameters of your home program, agency may be removed from the individual. The performance of the home program becomes less about facilitating a positive engagement with one’s body, and more about what you should be doing- a task to check off the to-do list.
Okay, so… there shouldn’t be any structure to my home program?
Our lives are a constant dance between rigidity and chaos. Too much structure, we have rigidity, close-mindedness, decreased spontaneity, and limited options. Not enough structure, we have chaos, confusion, and a loss of direction. How do we find a healthy balance?
The structure of one’s home program is highly individualized based on person, environment, and goals. What works for one person may not work for another. What works for you today may not work for you tomorrow.
Sometimes life is busy. Sometimes our environment is not conducive to completing our home program. Sometimes we don’t feel good. Rather than seeing the completion of your home program as all or nothing, how can you modify it to fit into your day regardless of what is going on in your life?
Consider creating a loose structure, with room for adding and subtracting
Perhaps practicing the whole series of movements in your routine can only happen three times this week. However, what about five minutes here and five minutes there to engage with the movements in a way that fits in with the rhythms of your day?
You find yourself lying in bed for a few extra minutes and you try bringing your knees to your chest, or rotating from side to side.
You are standing in the kitchen waiting for the water to boil, and you find your hips gliding.
You are getting up and down from a chair, and you decide to practice three additional sit to stands with awareness of your body mechanics.
Questions to ask yourself
Learning how to direct your own care is ultimately what we aim to teach you at the Wellness Station. Consider asking yourself the following questions to enhance this ability-
If I were my therapist, what might I want to know more information about?
Consider a situation in which you are engaging with physical therapy, but you feel that you “aren’t getting better”, or the exercises aren’t “working”. If you were your own therapist, what would you want to know more about?
How often do I spend time with the movements?
When our home program is a to-do list item, it can be very easy to rush through it and let it slip through the cracks. If you are spending no more than 10 minutes total each day engaging with yourself through mindful movement, and wonder why the therapy is not more effective, then the answer may be that you are not spending enough time with it. If you want to learn the language of your body more fluently, you have to practice.
It may be helpful to have a goal of how long you would like to engage in the movements, perhaps at a specific time each day. For example, 20 minutes in the morning before breakfast.
To further enhance the therapeutic effects, take 10 minutes here, five minutes there, two minutes here, five minutes there, to re-engage with the movements throughout the day.
Am I working “on” my body, or working “with” my body?
We could spend all the time in the world on our home programs, but if we are not doing the movements as intended, they will have little therapeutic benefit. If the way you are engaging in your movements is to accomplish a task, push through pain, or to just do what you think you’re supposed to be doing, then the intention is missed. The completion of the movements is less important than the manner in which they are performed.
The intention of the movements are to be able to pick up on the signals from your body with greater sensitivity, bring stimulation and change into your tissues, and grant agency to know how to respond to pain and discomfort. Keep asking yourself as you perform the movements… “Am I working on my body, or learning how to work with my body?”
In addition to a designated time for my home program, how am I implementing what I’ve learned into what I’m already doing throughout the day?
We live in our bodies 24/7, and we are already moving our bodies throughout the day, whether we are mindful about that or not. This grants us the ability to be engaging mindfully with our bodies pretty much all the time.
Getting out of bed or out of a chair- think about your body mechanics.
Standing in the kitchen- turn it into a dance.
Walking to and from rooms- what is that light from your chest doing?
Picking up a box from the floor- send your bottom back and tuck your pelvis when you come up.
By considering these concepts, your home program will likely become more rewarding, enjoyable, and instrumental in moving towards success in your therapeutic journey.
At the Wellness Station, we will guide you to creating an adaptable structuring that empowers you to direct your care and enhance your wellness, fitness and beyond.
Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team