8 Things Your Physical Therapist Wishes You’d Stop Doing for Better Results

There's ample research and personal anecdotes proving that physical therapy (PT) can have a profound effect on physical function, mobility and quality of life.

For example, a December 2020 study in the journal ‌BioResearch Open Access‌ notes that physical therapy is widely regarded as a safe and effective alternative to opioids for chronic pain management.

To create programs tailored for each patient, physical therapists typically attend school for about eight years, which includes graduate studies. That timeframe is longer if they earn a doctorate. Basically, they know their stuff.

But even though physical therapists have such a high level of education and experience and are eager to see you progress, you may not be getting the results you envisioned. That's because there are a few common mistakes you might be making that can prevent you from getting the best possible care.

Here, physical therapists explain what these mistakes are and what they wish you'd do instead.

Although in-person physical therapy sessions are important, they are only one component of your program, and that's why you'll be given exercises to do at home, according to Mallory Behenna, DPT, an orthopedic physical therapist at Brooks Rehabilitation in Jacksonville, Florida.

"It's very difficult to get better by only working on your areas of concern for one to three hours a week in PT sessions, which is why we give you things to do at home," she tells LIVESTRONG.com. "We want to help you make faster and better progress, and part of that is working as hard as you can for yourself both during and between our visits."

One of the most common reasons people tend to skip appointments is because they're in pain and they believe physical therapy will make that worse, according to Rick Olderman, PT, a physical therapist in Denver, Colorado.

"Especially if the pain is what they are trying to solve in physical therapy, that's exactly when they should be coming in," he tells LIVESTRONG.com. "This gives the therapist a chance to see what is happening at the very moment they're in pain, which is helpful for diagnosing the problem and understanding what makes the pain worse or better."

When you do come in with pain, you might minimize how much it affects you as a way to seem tough in the face of a challenge, but that's likely to backfire, says physical therapist and conditioning coach Carol Mack, DPT, CSCS, owner of CLE Sports PT & Performance in Cleveland, Ohio.

"Our job is to progress a person through their rehab program based on how that person feels on a given day, week, or with the program itself," she tells LIVESTRONG.com. "If someone is having pain with an activity and we don't know about it, that will cause us to give improper recommendations, which will delay or harm the healing process itself."

Let's say you have a knee injury, and you go to PT. Because it's a musculoskeletal issue, you may not think it matters that you have type 2 diabetes or a cardiovascular condition.

Yet factors like that will play a huge role in how your program is designed. The same is true for any previous injuries you've had to the same knee or anywhere else on your body.

"We treat the whole person, and past injuries may have an effect on a person's current issue," Mack says. "Health history is similar. For example, injuries take longer to heal in a person with diabetes. Disclosing this information is important for a realistic picture of someone's prognosis and coming up with a comprehensive treatment plan."

While there are some types of fitness that allow you to go through the motions and still get the benefits — for instance, aerobic activities like swimming or cycling will work your muscles even if you're distracted — physical therapy depends on your ability to isolate certain muscles with a high degree of awareness, Olderman says.

"Many patients do an exercise to fulfill their PT's goal of a certain number of sets and reps," he says. "However, we need you to dial into the exercise to make sure you're targeting the right things. For instance, if you feel an exercise fatiguing your hamstrings but you're supposed to be targeting your glutes, you need to communicate that to your PT so the exercise can be modified."

Being present with what you're doing and communicating along the way will help speed up the process of getting better, he says.

Speaking of communication, it can be tough to be honest that a program or set of exercises isn't working for you — but if you don't speak up, nothing will change, Behenna says.

Even admitting you find the exercises boring is helpful, because that's a clue you're less motivated to do them at home. In general, the more you discuss, the faster your progress tends to be because it allows your PT to modify your program based on that feedback.

"The relationship between patient and PT is one based on trust," she says. "If you do not trust your provider, it will be difficult to get better as you may not believe they can actually help you. We want and need to know how the interventions we choose are affecting you so that we can adjust your treatment plan each visit and work towards your goals."

One of the most challenging directives you can give a PT is to "fix you," as if you're not an active participant in the process, according to Claire Morrow, DPT, a physical therapist at Hinge Health in San Francisco, California.

"Physical therapy should be viewed as a team effort," she tells LIVESTRONG.com. "You and your PT are working together to help you accomplish your movement and functional goals."

Your PT will use their expertise to give you recommendations around behaviors and exercises to help facilitate those goals, and while there are many interventions PTs use that are more passive, like joint mobilization, those are not intended to fix you, she adds. They are meant to help you feel less pain and more comfort with movement so you're able to participate more in your exercise program.

Sure, your PT told you that it would take three months before you could comfortably go back to running or another favorite activity, but you've been following the program and doing your exercises at home and your pain is controlled. Even though it's only been a month, shouldn't that mean you can speed up the timeframe? If only.

"Injuries take time to heal, and it's important to be realistic about expectations and listen to your PT's guidance on how many weeks you may need to fully recover," Mack says. "Feeling frustrated or impatient is normal with an injury, but dwelling on that frustration becomes counterproductive to the healing process, and even worse is that you'll risk re-injuring yourself and making the physical therapy take even longer."