As physical therapists, it’s extremely common to get questions about the various signs of progress we’ll see through the process. This is understandable, as physical therapy can be a bit of a longer process than some of the quicker fixes we’d get through interventions like medication or surgeries.
In this article, we’ll attempt to make some generalizations about how to know if physical therapy is working. However, note that every situation is different, and comparison is the enemy of progress. If you’ve got questions about your individual progress, we suggest you discuss these issues with your therapist at your next appointment.
First 2-3 weeks of physical therapy
The first few weeks of physical therapy can be challenging for some, as you’re working out how to make the appointments work around your schedule and experiencing some early success. Here are some of the things you may experience in your first few weeks of physical therapy:
Decreased pain or discomfort
Though we often say it can get worse before it gets better, we’d like to see the “worse” part of that equation take roughly a week at most.
Generally, after the first week you’ll notice some improvement in yourlevel of pain and discomfort. This should be especially true as you’re leaving the physical therapist’s office.
You may begin to notice a reduction in pain or discomfort in the targeted area as your body responds to initial treatment interventions such as manual therapy, modalities, and gentle exercises.
Improved range of motion and flexibility
Though it can take a long time to improve flexibility, we generally see initial improvements fairly quickly.
Through specific stretching exercises and manual techniques, you may experience increased mobility and flexibility in the affected joints and muscles, allowing for smoother and more comfortable movement.
Enhanced balance and coordination (initial improvements)
Initial balance and coordination exercises may help you feel more stable and coordinated as you start to engage the muscles responsible for balance and proprioception.
Balance is a skill, and it improves if we practice. During your physical therapy journey, you’ll have plenty of opportunities to practice the skill of balance, coordination, and stability in your physical therapy sessions, home exercise programs, and daily life.
First 2-3 months
After the first couple of months, we should start to see real improvement that will stick. This is also typically the time period where most simple physical therapy courses of treatment are wrapping up and we’re beginning to plan to set you up with a discharge plan:
Progression in achieving treatment goals
Throughout the first couple of months, you’ll work closely with your therapist to set and achieve specific treatment goals tailored to your needs. Healing and repairing tissue damage can take some time, and progress may be measured through functional assessments, objective measures, and your subjective feedback.
Better posture and alignment
Through targeted exercises and postural awareness training, you’ll work on correcting muscle imbalances and alignment issues, leading to improved posture and reduced strain on joints and muscles.
As you get stronger and more practiced, you’ll be able to hold proper posture for longer periods of time and eventually build a habit of maintaining proper posture.
Reduced reliance on pain medications
As your pain decreases and your functional abilities improve, you may find that you need less medication for pain management. This reduction in reliance on pain medications can contribute to a better overall quality of life and decreased risk of medication-related side effects.
Enhanced balance and coordination (continued progress)
As you continue to challenge your balance and coordination through advanced exercises and activities, you’ll further refine these skills, leading to greater confidence and stability in various situations.
Long-term (several months and years)
We’ve always argued that physical therapy is a lifelong journey, like any physical skillset. When you’re done with your typical course of treatment, we’ll set you up with a discharge home exercise plan that you can continue for as long as you feel that it’s beneficial.
Patients who continue their physical therapy after they’ve been discharged can expect:
Increased strength and muscle tone
With progressive resistance exercises and functional training, you’ll gradually build strength and muscle tone in the targeted areas, contributing to improved stability and performance of daily activities.
Muscle-building is a slow process, but strength-building can take place more quickly because it’s a skill as much as it’s a physiological adaptation. What this means is that you can expect to see confidence boosts from physical strength improvements in addition to slight visual changes in your muscle tone within the first few months.
Increased overall sense of well-being
Over the long term, consistent participation in physical therapy can lead to improvements in overall well-being, including increased energy levels, improved mood, and greater confidence in your ability to move and engage in daily activities.
These physical therapy benefits may continue to develop and become more pronounced over time as you progress through your physical therapy program and incorporate the principles and exercises learned into your daily life.
The power of having a basic habit of taking care of ourselves physically is that we can be healthy anywhere. This is an extremely empowering thing for our patients, and we encourage check-ins over the long term if patients want to continue to be assessed and monitored.
Remember, what’s important in your journey isn’t just that your pain is improved for a few months, it’s that your pain is reduced and your independence is restored over the long haul.
How do you know when physical therapy is not working
Of course, there are always cases where we want to keep an eye on certain tell-tale signs that the plan isn’t going the way we want. We’ve written in the past about what to do if physical therapy isn’t working.
In short, watch for the following signs:
Persistent or worsening pain
Note that there is a difference between basic delayed onset muscle soreness (DOMS) and joint pain.
If your pain persists or worsens despite participating in physical therapy, it may indicate that the current treatment approach is not effectively addressing the underlying issue.
Lack of progress in functional abilities
If you’re not seeing improvements in your ability to perform daily tasks or activities, despite consistent participation in therapy, it suggests that the treatment plan may need to be reassessed or modified.
Limited range of motion or flexibility
If you’re not experiencing any gains in range of motion or flexibility in the targeted area, it may indicate that the exercises and techniques being used are not effectively addressing the underlying mobility issues.
If any of these signs are present for you, make sure to communicate with your therapist immediately.
A good physical therapist will see these signs and suggest that it may be necessary to reevaluate your treatment plan with your therapist to explore alternative approaches or interventions that better suit your needs and goals.
Final thoughts
Of course, our ultimate goal is that you would be pain-free for years to come. Though physical therapy isn’t a quick fix, it’s an excellent way to heal and regain your independence, confidence, and emotional wellbeing over the long haul.
