With the proliferation of information available over the internet in both written and video format, one of the things we’ve increasingly seen in our field over the last 10-15 years is the number of patients who have engaged in some form of DIY physical therapy before they seek out professional help.
While there are certainly merits to doing your own research and trying some things at home, there are some clear downsides as well:
DIY physical therapy can be beneficial for minor injuries and rehabilitation under proper guidance, but individuals should exercise caution to avoid exacerbating conditions or causing harm. Consulting with a professional is advisable to ensure a safe and effective approach to self-administered physical therapy.
In this article, we’ll discuss some of the pros and cons of this approach, and while we won’t dismiss it wholeheartedly, we’ll provide some guidance as to when it’s likely time to seek regular physical therapy appointments with a trained healthcare professional.
Let’s define what we mean by “DIY” physical therapy
I stated above that we often meet with patients who have gleaned some information from sources they’ve found online, and even engaged in some at-home exercises to see if they help.
When I say “DIY”, or “do it yourself” physical therapy, I’m referring to patients who have either a.) gotten a diagnosis at some point in the past or b.) have not gotten a diagnosis and have attempted to self-diagnose based on YouTube videos or articles they’ve read.
Perhaps this describes your journey; if it does, I don’t blame you! If you’ve injured yourself somehow, or if you’ve got some chronic pain showing up unexpectedly, the tendency is to try and take care of it ourselves. Most of us start this process by taking to the internet. This is totally understandable.
The problem with DIY physical therapy
I’ll state up front: I’m not against a DIY approach to physical therapy. It shows a great deal of initiative on your part, and for many people it can work out just fine. HOWEVER:
DIY physical therapy is not without its complexities and potential hazards. One significant risk is the potential for further injury or long-term disability due to incorrect performance of exercises. It’s tempting when one reads that to assume that we are referring to the correct exercise “technique,” which essentially only scratches the surface:
- Incorrect technique or a misunderstanding of the exercise’s purpose can render an exercise ineffective at best, or cause more harm, at worst.
- Overdoing an exercise by using too much weight or too many sets, too soon, can backfire dramatically by causing an injury to become worse (remember that we’re often directly working the area from which the pain is radiating).
- Underdoing an exercise, while certainly a less grievous infraction, can cause a patient to believe an exercise is useless or doesn’t work.
Another challenge is the risk of misdiagnosis. Self-diagnosing musculoskeletal pain using online resources can lead to incorrect conclusions and inappropriate treatment plans. Note that even as professionals, we get our musculoskeletal injuries looked at by other professionals we trust. Objective evaluation by a medical professional is a core component of how physical therapy works.
Why do we do this? Because everybody struggles to be objective about their own pain and conditions.
Without professional observation, an individual may overlook the actual cause of pain.
An example of this would be a patient complaining of shoulder pain. A patient could interpret their pain as an “impingement” of the shoulder (a common conclusion), when in fact they’ve actually got an AC joint dysfunction.
If this is the case, the patient will likely engage in exercises for shoulder impingements. They may be the correct exercises, except they don’t realize that they don’t actually have a shoulder impingement. This patient will be doing exercises that will likely aggravate their AC joint issue, and will certainly not help their pain.
When does DIY physical therapy actually make sense?
While the above may paint a somewhat bleak picture of DIY physical therapy, I’d like to state that I’m not actually against doing physical therapy in the comfort of your own home, or at your own pace. There are times when doing physical therapy at home make a lot of sense.
The lure of at-home physical therapy lies in its convenience and potential lower cost of physical therapy. It provides the flexibility of performing treatments at your own pace, in your preferred environment, eliminating the need for frequent visits to a physical therapy clinic.
Doing physical therapy at home, DIY, can improve adherence in some patients if time is their limiting factor, or if available funds are holding them back.
If you’re planning to engage in DIY physical therapy, I strongly advise you start with a proper assessment, preferably in person, with a physical therapist. Even folks who struggle to afford a full length of treatment can usually swing the funds for an initial evaluation.
Let’s discuss some guidelines for making this approach work:
How to make DIY physical therapy work
First, I’d like to change the terminology we’re using a bit. I prefer the term “at-home” physical therapy to DIY physical therapy. “DIY” implies that the patient is taking matters into their own hands, including diagnosis and assessments of progress.
If, instead, we engage in a proper assessment and evaluation with a physical therapist, then we can let that physical therapist know our plans at the beginning of the treatment process.
As we’ve stated all across our website, physical therapists are generally very willing to provide you with tailored home exercise programs, and sometimes we’re even willing to provide some equipment for you to take home if needed.
This convenience can be further augmented by the potential for Remote Therapeutic Monitoring (RTM), or “telehealth.”
Therefore, I would advise you to follow the following guidelines if you’re planning to engage in at home physical therapy:
Guidelines for DIY physical therapy
- Get assessed by a physical therapist. Do this in person, if possible.
- Tell the physical therapist that you either can’t afford the regular appointments or can’t afford the time commitment of driving to the office 2-3 days per week.
- The physical therapist will tell you if they think that at home, or “DIY” physical therapy can work for you based on your individual symptoms, conditions, and health history.
- Get proper instruction from the professionals you’re working with during your initial evaluation.
- Follow through on the exercise program they provide.
- Check in with your physical therapist at regular intervals to make adjustments, get new exercises, and receive ongoing assessments as to your progress.
- If possible, engage in telehealth visits with your physical therapist.
Common Mistakes to Avoid in DIY Physical Therapy
Performing physical therapy exercises at home can be beneficial, but it’s not without potential pitfalls. Common mistakes such as ignoring pain signals, skipping warm-up and cool-down, and overdoing exercises can hinder progress and potentially lead to injury.
Being aware of these common mistakes is the first step toward a safer and more effective DIY physical therapy experience. Let’s delve deeper into these common mistakes, starting with ignoring pain signals.
Ignoring Pain Signals
Ignoring pain signals can lead to exacerbated injuries and longer recovery periods. Swelling, limping, or a decrease in performance are serious indicators of a possible sports injury and should be heeded during physical therapy sessions.
Pain encountered during normal daily activities can signal that something within the body is amiss and should not be overlooked during physical therapy.
Inconsistency
As we outlined in our article on the most common reasons patients complain that physical therapy doesn’t work, inconsistency is the number one killer of progress in physical recovery.
This is no different if you’re attempting to do physical therapy on your own at home. If you’ve got a home exercise plan, stick to it! If you’re consistend and the plan doesn’t work, then you’ve got something to discuss with your physical therapist. However, if you’re inconsistent, the physical therapist has no way of knowing whether the plan would have worked or not, and will likely just tell you to start doing your plan.
Overdoing Exercises
Overdoing exercises can lead to setbacks in rehabilitation and overuse injuries. This is more of an issue with at home exercise programs than it is with patients who come into the gym to complete their programs, because we aren’t able to watch you as you go.
Building connective tissue takes time, improving mobility and flexibility takes time, and building strength takes time. Note when your body needs rest, don’t push the weight or resistance more than you’re being instructed to, and everything should be fine. It’s when we say to ourselves, “this exercise is great! I’m going to do twice as many sets tomorrow!” that we begin to run into trouble.
Ignoring the body’s need for rest days during physical therapy can lead to overuse injuries and exacerbate existing conditions, negating the positive aspects of physical therapy.
When to Seek Professional Help: Recognizing the Limits of DIY Physical Therapy
If you’re embarking on this type of a plan, you must go into it recognizing that it has limits. While it offers convenience and potential cost savings, it does not allow for techniques that require the presence of a professional, like soft tissue massage and manual joint mobilization.
Visible physical changes such as swelling around an injured joint, persistent pain lasting more than a few days, or recurring pain that is unmanaged by medication, are signs that professional intervention may be necessary. Let’s delve deeper into these limitations, starting with worsening symptoms or pain.
Worsening Symptoms or Pain
Worsening symptoms or pain may indicate the need for professional intervention in physical therapy.
Ignoring pain can lead to preventable injuries, potential major surgery, and the necessity to refrain from activities.
Persistent or worsening pain, especially if lasting several days, during daily activities, or after rest indicates the need to consult a physical therapist or a doctor.
Plateau in Progress
A plateau in progress during physical therapy is identified when a patient is no longer making significant improvements in the area being addressed by the treatment. Plateaus can occur when standardized outcome measurements do not show a clinically significant change, despite continued therapy efforts.
The way this would present itself in the real world is that you would feel as though you’ve hit a wall. Maybe you’ve gotten 50% better (subjectively speaking), but you’re struggling to feel better all the way. This is a good sign that perhaps a more traditional physical therapy plan may finish the job more effectively.
Complex or Chronic Conditions
Complex or chronic conditions often necessitate the specialized care of a professional physical therapist. Some examples of conditions that may require the expertise of a physical therapist include:
- Chronic pain
- Arthritis
- Fibromyalgia
- Multiple sclerosis
- Parkinson’s disease
- Stroke
- Spinal cord injury
Managing these conditions often necessitates the knowledge and skills of a professional physical therapist.
Should you try DIY physical therapy?
While there isn’t a “correct” answer for everyone, there are certainly cases where DIY physical therapy may make more sense than others. I recommend starting by explaining your situation to a professional, getting assessed, and going from there.
DIY, or “at home” physical therapy can be very effective for patients and fit their lifestyles well if their presenting condition doesn’t necessitate that they come in to the office.
Discuss this option with your physical therapist, and see what they say. You may be pleasantly surprised by the results!
