how long should I do home exercises after finishing pt?

One of the common questions a physical therapist will answer is: “how long should I do home exercises after finishing PT?” This is a great question and is generally specific to an individual patient’s needs. For example, a 19-year-old athlete with a rotator cuff surgery will have drastically different limitations and needs than a 69-year-old with a rotator cuff surgery. That being said there are some general guidelines a physical therapist will consider when answering this question

The answer to this question largely depends on what a person was in physical therapy to address.  If a patient is rehabilitating from lumbar fusion surgery it is important to maintain core strength around the fusion to protect the hardware for years or decades to come; in this case a therapist may suggest “forever exercises” to be done at a minimum of one day per week indefinitely. Contrast this to a flare up of elbow tendonitis due to swinging a hammer excessively while doing a home improvement project. This isolated event may require only one or two months of exercises to resolve and fully rehab the elbow back to baseline strength.

General Guidelines

​A general rule of thumb is that complete post-surgical exercise routines typically will last at least six months, and often significantly longer. The older an individual having surgery, the more likely they will need to do upwards of 12+ months of rehabilitation exercises. Take the example of the 19-year-old and 69-year-old rotator cuff repairs above. The 19-year-old may be back to playing baseball within ten months post-op, having achieved full range-of-motion and strength.  At ten months the 69-year-old may still be 15% shy of their full overhead motion with notable weakness when reaching overhead. The 69-year-old may need to continue their shoulder exercises for 18 to 24 months in total to achieve their full potential.

Realistic and Achievable

​One of the most important factors to consider when making a long-term exercise plan--whether PT related or not--is that it needs to be realistic and achievable. I know I can’t tell a patient they will need to do seven-day-a-week exercises for the rest of their lives; it’ll never happen!  I tend to explain to patients that muscle strengthening happens effectively with as little as two resistance workouts per week and that strength maintenance can occur with only one workout a week.  Based on these guidelines, I help the patient to determine what is a reasonable home exercise program moving out of PT. For the 69-year-old rotator cuff repair patient, they could continue one-day-a-week exercises for 15 minutes or they may opt to continue a five-day-a-week program, depending on their goals and motivation. 

​Like most questions a PT gets asked, this question does not have a one-size-fits-all answer. Certain injuries will heal and a patient will be 100% better within a few months requiring no further exercise regimen. Some surgeries or large injuries will require six plus months of rehab exercises. Other injuries--my own low back pain included--can be nagging and need addressing weekly or as needed during a flare up. Speak to your physical therapist if you need clarity on your home exercise program and how long to continue it after discharge from PT. 

Author

Eric Hanyak, PT, DPT