Adherence to home exercises

We’ve all been there. We diligently attend our appointment, listen carefully to the advice, head home full of good intentions only to fail before we’ve even started! Or we do the exercises for a bit but then stop because the pain is better. We need to start looking at it in a different way as some research suggests non adherence can be as high as 70%. I think we can can tackle this in two ways: the reasoning behind the exercises and how to build them into our life and form a new habit.

Let’s tackle habit first. Habits are behaviours that our brain has learned to produce without thinking about it and making a resolution stick involves creating a new habit. Habits are learned through repetition and we need to force ourselves to do this repetition to make it stick. Seems easy, right? The average time to form a habit is 66 days!

Maybe if you understand the reasoning behind the exercises, that might start to help. Let’s reframe it as movement rather than exercise. Exercise as a term can seem daunting, if we reframe it in this way, it loses some of the dread factor! In essence we are trying to get you to move with less pain and get you back to doing what you enjoy. With most painful issues, we can find the cause(s) which are often multi factorial. Lack of sleep & increased stress are some of the variables that can affect our perception of pain. We can identify that you have an area of irritation that needs calming down and then concentrate on improving the capacity of that area by adding in some gradual loading movements.

These movements are progressive and to be effective they really need to be done for at least 12 weeks for the best outcome. This is a guide, we are all different and we might need a little more or a little less time. Rehabilitation exercises are rarely a constant line of improvement & more often are a fluctuating line as life throws in those extra stresses, less sleep etc. Sometimes we stop because its too painful, I can totally empathise with this. In this instance you need to contact your therapist and chat through why this might be and how it can be improved. Sometimes a little tweak to what you’re doing can be all that’s needed along with some reassurance.

So how can we improve our adherence to doing our recommended movements? I have a few strategies. The email pings through from Rehab My Patient...print it out! If its left on your phone or computer, it’s all too easy to ignore. Then diarise your movements/exercises. Generally speaking I give mobility work daily and any loading work 3 x weekly with a day off in between. Pick 3 days in your week that you know you could set aside 10-15 minutes. That’s literally all you need. Now that it’s in your diary or on your calendar, set reminders. Set it on your phone, set an alarm, stick up a post it note where you know you’ll see it. Find a way that works for you.

Sarah Jones