PT versus at home exercises

hi all,

i have a script for physical therapy to improve my core strength and other issues that i have with my back, however my personal life is crazy right now so i was wondering if anyone has found that they were able to successfully get stronger by just doing exercises at home and not going to PT… just don’t know if i could fit that into my schedule right now but could do it at home
thanks

There is a LOT you can do at home for core strength, but if there are other considerations it might be safest to start out with PT.

If you Google “Yoga with Adriene Core”, she has a lot of free videos that could be a good place to start. Even in non core specific videos, there is a core component to almost every move. She’s great whether you are just starting out or have some experience.

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I have found traditional PT limited in what they really tell people to do at home - it’s always a series of appointments. Which is fine if it’s an injury and recovery needs close monitoring. But I’ve had much more satisfaction from a form of occupational therapy called myofascial release. My provider equips me, purposefully, to do things at home. I think if you have referral to PT, as others have said, maybe go initially and ask for exercises at home and then periodically check in if needed to course correct.

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What I’ve done is go to PT a couple of times, learn the routine and then do the exercises at home. I also don’t the time to run to an appointment 3x’s a week and the co-pays get spendy. The one time I stayed consistent with it was when my lower back went on the fritz and the therapist did some type of passive traction that was miraculous and something I couldn’t do for myself by myself :slight_smile:

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Ask your doctor or PT about this.
I had shoulder surgery and before it talked with the surgeon about therapy, being out of town and hard to have someone drive me for therapy.

He then changed his instructions to getting me up to speed to do the therapy by myself at home.
The plan was doing certain therapy, exercises that took some 5+ minutes every hour, ten times a day, with bands and without,
Oh, my, that was a whole day’s worth of hard work for the first two weeks!
Then I saw him, he changed the exercises and now were three times a day.
Two more weeks he was very happy with my progress and I could do them twice a day.

Before surgery he had warned I may not get 100% use of that arm, but afterwards he was very happy that I did and said that he rarely lets a patient do their own therapy, but he knew I would and that I did great.

So, do talk to your doctor and then be sure to do what you agreed to do, if you are given a plan where you do the therapy yourself, is that important.

If you are too busy to go to therapy, be sure you won’t be too busy to do it properly at home.

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I’ve always liked PT; sure it’s a pain, but they give you targeted exercises and can assess your improvement (or lack of) and switch it up if needed. I’ve always learned a lot about how best to target my issue. Also, they usually find a weakness/problem you didn’t know you had. Bear in mind, too, whatever your other back issues are, if you need follow up treatment, insurance companies often make you finish PT before authorizing something else.

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In my current experience (recovering from a knee injury, working with a wrecked meniscus and bone on bone osteoarthritis in one knee), I’d recommend both-and: see a PT and also work at home. I have very much valued the informed and targeted advice of the PT during visits. And also her always changing recommendations about which exercises to focus on at home, and how I am doing them. She has been great at explaining which muscle systems can best support the knee (and they are all over the body!), and how to make/keep them strong.

Best wishes to you in your path to optimal motion!

PT has its place in the beginning to tell you not just what to do, but also HOW to do it, which is as if not more important than simply what to do. It also tells you what NOT to, at least for now.

Keep in mind that “core strength” is way way beyond sit-ups and crunches or oblique work, whether standing up or lying down

Core is armpits to hips, 360*. If you don’t have hip mobility and flexibility, your core suffers. If your shoulders have limited ROM, your core suffers. If your foot or ankle stability is weak, your core suffers.

I have been getting stronger, more mobility in my hips, more stability in everything, for 20 years, at home, than I ever did in the previous 15 years at a gym, and with less equipment but with way better programs actually designed to improve all those things.

So yes, you can do it.

What prompted the “you need a stronger core” Rx? That matters the most, in terms of where you should start.

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Go to PT, even if it is just once a week or every other week. I had to go for a hand injury and I would do the work there and then make sure I did the exercises at home as directed. I finished PT in half the time and only went every other week as the facility was an hour away.

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Granted I have only had PT once in my life ( after I had my shoulder replaced ) . I just did the same exercises at home that they had me do at my appointments. On ones that were more complex I just had them print them off for me and add notes/ instructions so I made sure I was doing it correctly.

At the end of 6 weeks I had a lot of exercises to do 2x a day but it really made a difference in my recovery . One thing about PT is they push you through the pain. Something we can be reluctant to do when going solo.

Depending on what your back issues are, I might at least try PT for a while so you are doing exercises that won’t add to your back problems?

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I’ve just been discharged from once a week PT with at-home exercises for a badly strained rotator cuff. I was going once a week for the first 6 weeks or so, then we spaced the visits out a bit.

The value of going in was that the exercises were progressive (in fact, he started out a bit too aggressive and we had to dial them back,) he could make sure I was doing them right, and guage my progress, and he could recommend and perform other therapies in addition to the straight exercises (some massage and manipulation to start with, and later a session of dry needling, which really hit the spot.)

So I would say try to go in if at all possible. I think if I had not, I would have ended up needing surgery, which I was strenuously trying to avoid.

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Yes, please tell us this first.

Of course you can do PT exercises at home but your therapist may not want you to do certain things until they watch you and see what causes pain/discomfort and/or how you feel afterwards, etc. Especially depending on the issue.

Most of us should improve core strength by 100% or even more - but it can be dangerous to try this at home without supervision with many issues/injuries – especially back and hips.

I would definitely go to PT first and discuss with the therapist.

The other issue is that most people don’t do them at home. Which is another reason they may want you in the clinic at first.

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Go to PT

I second the poster above-if you don’t have time/inclination for an appointment, you don’t have time/inclination to do it at home. End of story-either you’re serious about getting better or you’re not.

One other thing I will say is to be as picky as possible about choosing a therapist. Look at the type of patients they normally treat and their own interests. When I went to PT for herniated disc related pain, I chose a PT who was an active athlete herself (BJJ I think) and who treated NFL/NHL players all the time. The treatment plan I got there was much different than what I would have gotten from someone who only treated “old people” looking to be able to sit on the toilet after surgery…She costs the same co-pay as any other PT for me, but she understood the semi-insane athlete mindset we have as equestrians-yep it hurts but I’ll still be riding and I want to get back to full functionality in the saddle ASAP.

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this^^. I just finished round 2 of PT for my lower back. I have multiple problems down there. First place was good, but not great. I did get some exercises that pretty much fixed my initial problem, however some months later developed leg weakness/tightness. Long story but went to another PT place, recommended by a number of people. Coincidently my therapist does barrel racing, and the head guy understands riding and the mindset of people who have an athletic passion of some sort. They identified some specific issues and gave me a list to do for stretching/strengthening a bunch of leg/hip muscles. And then we worked on CORE. Consistently I’ve heard that a strong core is essential when you have back issues. I have a bunch of those exercises to do, have invested (a whopping $25 or so) in some bands and a ball. Also - my PT gave me a print out with pictures of each exercise; also have it online, where you can look at videos to be sure you are doing it correctly.
None of this will totally fix my problems, but I can see a difference in how I feel and have a “go to” if something particular feels weird.

I would start with PT and ask them to prescribe a regimen of at home exercises for you to do. It’s important to start under the eye of a professional to make sure you are doing the exercises correctly at first. Even a small change in alignment can mean they don’t work as I rented, or worse that they aggravate your injury.

At home alone we often push to fast or not fast enough which can also delay healing.

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I would at least start with PT to make sure you get the proper kind of exercises for your issue. I went for a similar problem I had unsuccessfully been trying to take care of myself. I just didn’t have the level of knowledge to choose the right stretches and exercises. The big deal for me was finding a place that had appointments early enough in the morning for me to attend before work. In the beginning I went 2x a week and they gave me homework that I had to do 3x/day. Over time the appointments became 1x a week and then every other week. I was religious about doing the home exercises even though it took about 1.5 hours total every day.

Another thing to consider might be virtual PT. I have a friend who did it and my insurance also started offering it. It’s called Sword Health, pairs you with a PT online, and comes with a tablet and sensors that you use to run through the assigned exercises at home.

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I recommend going. I’ve been through a lot of pt between two hip replacements, a messed-up neck, and problems with a knee, ankle and hands. It’s true I can (and did!) do the exercises, but the therapist also added some other modality to help speed recovery. I wouldn’t have known what to do, or been able to do it.

Finding a good therapist is key. In the early days I wasn’t so picky and ended up with younger, less experienced therapists. Now I’m much pickier and gravitate toward older more experienced therapists who have lots more tools in their toolbelt.

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I recommend going at least for a while. I wouldn’t be near as far in my ankle recovery without my PT. Even though a lot of the exercises are familiar to me, and I also swim/aqua jog to add strength. But I don’t think I would push myself as hard, especially on bad/painful days, without the PT telling me to push through it. There are some exercises I darn well know I would avoid because they f*****ing hurt to the point of tears. It’s not fun, and sometimes seems like what you might do at home, but a good PT is priceless

I’m still here to find out what prompted this Rx, as that really impacts what can/can’t/shouldn’t be done at home :slight_smile:

I recommend going. I’ve been to PT for various issues several times (a few different lower limb problems, hand, shoulder, then the other shoulder, hip/SI, back). For me, I am not great about doing the regimen at home for most of these (hand exercises were the easiest). It helps me to figure out a way to schedule the appointments once or twice a week. If you feel too busy to go, you’ll feel too busy to get it done right at home. I also really appreciate some of the tools, equipment, and modalities at the PT’s office that can be hard or impossible to replicate at home. And as mentioned, I’d you are getting manual therapy, needles, therapeutic ultrasound, or something like that, you really need to go. You will also have someone monitoring your changes in strength and range of motion as well as assessing pain—when is it ok and when does it mean you need to make a change to the program.

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