So you come to therapy. You're given a folder with exercise pictures, and bands to complete your resistance training when you're not at therapy; these exercises are a part of your "Home Exercise Program."
Here at Champion, we expect you to do your exercises for 30 minutes, twice per day throughout the duration of your treatment. On the days you come to therapy, it's only necessary to do them once more, as you'll do them with us, as well. We suggest using ice for 15 minutes after each exercise session (at home and in-clinic.)
What happens after you've had a few sessions and you can no longer fit all of your exercises in within 30 minutes?
Get through whatever you can in 30 minutes, and do everything you didn't have time for in the second session of 30 minutes. If you get through all of your exercises in 45 minutes worth of time, start them over.
What if I'm so sore from doing new exercises during a treatment session that I'm having problems doing them at home?
First thing you need to recognize is the type of pain you're having. If it's muscle soreness, do your best to push through it. If it's joint pain or localized pain right on an incision site or bony prominence associated with your diagnosis, either reduce the repetitions/sets, or reduce the weight you're performing the exercise with. The best way to describe the bad kind of pain is relating it to the symptoms you started therapy with; the pain you originally started therapy with. If the movement causes pain like that, anything above a 1-2/10, discontinue the exercise for the day. 1-2/10 may cause some discomfort at most, but this will be uncomfortable, at least slightly.
Second thing you need to do is understand that we are going to progress you, just slightly, each time you come into the clinic. You will have some residual soreness from the increased stress on the body, and this can make it difficult to wrap your mind around continuing with your HEP. Your soreness should be gone within a couple of days, but we have to force that hypertrophy in your muscles to improve your symptoms. It's not an easy process. If it's an exercise that causes lingering or sharp pains, stop. Our rule of thumb is no greater than a 4-5/10 on a pain scale. We want you around a 1-2, as far as pain goes. Please keep in mind, this does not include muscle soreness.
What if I forget how to do an exercise?
First suggestion would be to read the description under the photo - sometimes the description includes alternative options to performing the exercise that we used with you, and that version may not be the one depicted on your HEP sheets.
Second suggestion would be to do your best to do the exercise as you remember, and make a note to yourself to remind us to review it with you and make notes on your HEP sheets for next time.
Third suggestion, we're always just a phone call away. If you're really frustrated by an exercise, give us a call and we'll do our best to walk you through what we'd like for you to do.
What happens when my bands get too light, or weights get too light? Should I push myself without being told and increase?
If you've been doing an exercise that feels too easy for you, try to increase your resistance or weight for one set. Most of the time, you'll be required to do 2 sets of an exercise, or at least 20 repetitions of an exercise. Split your reps or sets in half, and try one at a higher resistance. If you don't have an increase in symptoms the next day, you're welcome to try to increase to doing all of your reps/sets at that higher level. If you do have some increased soreness, it's okay. Make sure to tell us that you tried, so we can make a note of it. This will not slow you down, as long as you performed the exercise with the correct form - you'll likely just have some muscle soreness for the next couple of days.
What happens when I'm finished with therapy, what do I do with my exercises?
It depends on what you were in therapy for.
Say you're an athlete who is post-surgical, you'll likely only be anywhere from 75-85% back by the time you're discharged. Why? Because legally, therapy is prescribed based on medical necessity, and medical necessity is equivalent to functionality. According to insurance policies, you're entitled to be able to perform all daily activities that are related to your functionality as a person. In other words, being able to cook, clean, bathe yourself, dress yourself, etc. As an athlete, being back to 100% means being able to return to play AND not feel limited by a prior injury; as if the injury never happened. You'll be discharged from therapy once you've met the functionality limitations, and can clear the specialized tests that are required to be cleared by a physician to return to play. However, there will still be aspects of your game that will be slacking, because you have to progress back up to higher level activity.
In this case, you'll want to keep up with your exercises for a couple months until you're more comfortable playing again. From that point on, doing your HEP 3x/week should be enough.
However, say you're in physical therapy for shoulder pain due to tendonitis, or impingement. By the time you're discharged, you'll likely already be rid of all your symptoms with most all activity. At your time of discharge, you'll be able to immediately switch to doing your HEP only 3x/week. If your symptoms return, even slightly, try to increase the number of times you perform your HEP before decreasing that activity that's causing the symptoms.
What if I just do my exercises in therapy, since I'm so busy or don't like to exercise?
Your symptoms will only have slight relief. Unfortunately, by the time you've had pain severe and for long enough that you've seen a physician and scheduled therapy, your injury, whatever it is, has caused modifications in your lifestyle. Your body will make changes that modify daily activities to protect that injured area from increased pain - examples can vary from secondary muscle group activations to compensate, all the way to using the other hand for activities that require overhead movement.
This requires completing your HEP religiously until at least some relief is felt. If you only do your exercises when you're here in the clinic, you'll likely see little to no progress. The interesting thing about physical therapy is it only works if you're willing to put the work in.