The Importance of Being Compliant: PT works best as prescribed

December 11, 2009

General Information

This is a statue of Oscar Wilde, in Dublin.  The Importance of Being Earnest is a funny, funny play, by this witty playwright.  Photo credit: boocal on Flickr“You want me to do how many repetitions?!”  “How many times a day?!”  “Will I have time to eat?”  “I’m really busy at work.”  “I completely forgot about that one.”

As someone who has had to rehab injuries in the past, I really understand how difficult staying vigilant and compliant with a home exercise program can be.  Life is fast-paced and no one has time for rehab.  Work demands, family, chores, kids, practices, school… the list of responsibilities goes on.  As the holiday season peaks, you’ll only be getting busier and busier.  However, following your therapist’s recommendations including avoiding certain activities and performing your home exercises is just as important to your recovery as geauxing to physical therapy.  In most physical therapy sessions, I use my hands to stretch a joint,  give your body feedback on what posture it needs to maintain, or demonstrate exercises to show proper technique.  These activities in the treatment sessions are vital to laying down the foundation for your recovery.  Building strength takes repetition and reinforcement everyday.  Your body needs practice to learn to move correctly and this is best achieved through your home exercises.  If I had to use a metaphor, attending your physical therapy appointment is the ship and your home exercises are the crew.  Without the two working together, you won’t be sailing anywhere.   So, I’m going to offer a few tips I’ve learned from experience, my patients, and my Psychosocial Aspects of Sport course in college.  Hopefully, this will help you remember to perform your home exercises, stay on track, and run a tight ship.

  • Be committed and write it down. Vow to yourself that you will do what it takes and then write down what it will take.  People who write things down are more likely to commit ideas to memory and action.
  • Stay consistent. I use this one all the time: Whenever you go to the bathroom you do 3 of your exercises.  Yes, your bathroom trips will take longer, but your exercises are now built into your day and are broken down into manageable chunks.  Or when you take a shower, before dinner, first thing when you wake up, before leaving work, etc… Make it something that can be part of your routine, like brushing your teeth.
  • Schedule it. Your time is valuable.  Pencil in time during the day to take care of yourself and honor your own appointment.  You’ll feel better throughout the day, knowing you’ve done your share.
  • Have a buddy! Remember the buddy system in school?  It works well for therapy too!  You are more apt to exercise if you have an exercise partner.  Know someone who is also going through therapy or needs to stay physically active (ahem, that’s everyone)?  Voila!  You have a PT buddy.  You will count on each other to stay physically active and compliant with exercise.
  • Bribe yourself. I’m thinking back to those days when I couldn’t watch The Wonder Years until all of my homework was done.  This can work well for you too!  “I can’t ______ until I have done my home exercises.”  Put your own bribes in the blank: watch the game, read a book, go out for the night, watch missed Glee episodes…. whatever it is for you, start bribing!
  • Give yourself plenty of reminders. Write yourself notes EVERYWHERE.  Dry erase marker on your mirror in the bathroom, notes in the planner, voicemails to yourself, emails to yourself, put it in the iCal, note in your car visor, note on your nightstand, and a BIG one on the fridge.
  • Stop thinking about it and do it. Your PT is the little voice in your ear asking you why you haven’t done your exercises for the day.  Stop the voice by just being done with them, already!
  • Set a goal and look back at it frequently. If you are highly motivated to be better and healthier then you will really look forward to your home exercises.  Keep your motivation up by writing down an important goal to be achieved with therapy. Look back at it frequently to remember why the exercises you are doing are so important to you.
  • Make a list and check it twice. Make a grid or list of all of your exercises in rows with columns for each day of the week.  Check them off each day as you do them so you won’t forget whether you have done them today or not.
  • Involve others to motivate and push you. Tell family and friends about your rehab and the exercises you have to do everyday.  Then give those same family and friends the right to nag you about doing them.
  • Multitask. One of my patients said he does his exercises while he is on conference calls.  Brilliant!  Do two things at one time!  Talk on the phone, watch TV, listen to the radio while doing your exercises.  For most of the exercises I prescribe, I want my patients to be paying attention to what they are doing and concentrate, but if you can do two things at one time to stay compliant, by all means do so!
  • Reflect back on how far you have come. When you find it hard to do your exercises for the day, think back to a time when you couldn’t do ______, or when your pain was ______, or when you used a ______ to walk.  Build on your successes.

Many times my patients really want to stay compliant and do their part at home, but they just don’t know how to stay on track.  I hope these tips have given you a few ideas.  Remember, rehab is a process.  It may take a long time to build up the right amount of strength or change a habit, particularly if you have a chronic condition or one that has developed over several months or years.  You’ve already acknowledged that you need to make a change by seeing your therapist.  Put your recovery plan in motion with your therapist’s recommendations, and set sail to better health.

MoniqueSerpasPT

MoniqueSerpasPT

Physical Therapy Orthopaedic Specialist at Southeast Louisiana Veterans Health Care System

My name is Monique Serpas, PT, DPT, OCS. I am a physical therapist and board-certified Orthopaedic Clinical Specialist practicing at the Southeast Louisiana Healthcare System in New Orleans, LA. I realize how difficult it can be to overcome an injury or manage a chronic condition and am focused on helping my clients achieve wellness through a physically active lifestyle. I treat orthopaedic, balance, and vestibular disorders and practice using a combination of hands-on manual therapy, therapeutic exercise, and education. This enables my patients to assist in their own recovery and injury prevention. I also have developed fall prevention and golf-related rehab programs in the past. I hold a Doctor of Physical Therapy from Concordia University Wisconsin (2008) and a Bachelor of Science in Kinesiology from Louisiana State University (2004). I am a member of the American Physical Therapy Association (APTA), Louisiana Physical Therapy Association (LPTA), and the Orthopaedic and Neurology sections of the APTA.

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