Yes, You Have Homework
Physical therapy is a lot more than what we do together in the clinic. Yes, the manual (hands on) therapy, therapeutic exercise, and retraining of your brain/muscles/nerves that we work on during a session is very important. But what you do in between our sessions can have an even bigger impact on your outcome.
I’m a big proponent of giving my patients homework. We spend a great deal of time during our in clinic sessions exploring different body systems - this work is what helps me determine what kind of exercises will best benefit them.
When I say “exercises”, I may mean something along the lines of more traditional PT exercises that are assigned to help with strengthening specific muscles or muscle groups. But sometimes exercises take on a very different form than what most people are used to. I might assign a pelvic floor “dropping” exercise, which focuses on how to relax the pelvic floor muscles rather than tightening them (no, kegels aren’t the answer to all that ails your pelvic floor). I might also prescribe something like diaphragmatic breathing exercises. Given the name of my clinic, you probably have some idea how important I think proper breathing technique is for our health.
Your exercises might also be something as “simple” as becoming aware of how often your pelvic floor muscles are clenched due to stressors in your daily life. I use the term simple loosely, because for lots of us it’s anything but. Or it might be as complex as putting together lots of little things we’ve worked on in the clinic to change how you’re performing different tasks in your daily life. That’s not so easy when we try to reprogram muscle memory patterns you’ve been using for years.
No matter what I assign as homework, my attitude toward whether or not you do them is one of balance, I like to think. Yes, I think that what you do between sessions with the information you’ve learned has a much bigger chance of affecting change than the hour we spend together learning it. BUT, if you don’t do your homework, you’ll get zero guilt from me. No tut-tutting. No stern words. And no looking over my glasses at you like a disappointed teacher.
What you do or don’t do between our sessions is up to you. I totally get that life gets in the way sometimes. Not being able to fit your home program into a busy daily schedule isn’t a personal failing. It’s just life. Yes, I think you’ll see improvements much faster if you can stick to your program. But you’ll get zero guilt trips from me if you don’t. A very wise healthcare practitioner once said something simple that made all the difference for me when I told her I hadn’t been following through with our plan to improve my health.
“There’s no shame in this room.”
She’s such a smart person, I’ve adopted it as my treatment philosophy.
Just like there’s no crying in baseball, there’s no shame in pelvic floor PT. I promise.
